1. Please tick appropriate: BoatShoreSpecies 2. Species: 3. Meazure unit: lbozkg Weight: 4. Length: Measure as indicated below taking X to X from tip of nose to fork of tail and XX to XX from tip of nose to tip of tail. For round fish take girth measurement Y to Y around the widest part of the body. For skates, rays or flatfish take widest measurement Z to Z across widest part 5. Girth or Width (see measurements diagrams): 6. Date of Catch: 7. Place of Catch: 8. Method of Catch: 9. Angler: MrMrsMsMiss Your Name: Your Surename: 10. Permanent Address: Your Email: 11. Membership or Angling Clubs: 12. Tackle Used (every item in this section must be completed. A sample of the actual line must accompany the claim): ROD Make: Tip Length (centre of reel to end of tip): Butt Length (centre of reel to butt cap): REEL Make & Model: Size: LINE Make: Manufacturer's breaking strain: Length of double line: Length of trace: Type of gaff: Length: Number & type of hooks: Type of lure or bait: 13. Boat (if used) Name: Length: Skippers name: Skippers Address: Skippers Signature 14. Line Class Entered (see acceptable classes) **European only / *LTC only: 2lb*/1kg4/28/412/616/820/1030/1550/2480/37130/60AT**/AT**SH**/SH** 15. Scales Location: Type: Manufacturer: Serial: Date Last Certified: Person or agency certifying scales: Weighmaster: Address: Signature: (A copy of the scale certificate valid within one year of the date of weighing must accompany the claim) 16. Witness (to weighing other than angler) Name: Address: Witness to catch other than skipper (two names & address if possible) Name: Address: Name: Address: 17. Payment information I am an EFSA member, enclosed is Euro 20 application feeI am not EFSA member, enclosed is Euro 30 for an annual membership and application fees Please send extra copies of my record certificate at Euro 5 each: Please send extra European record patch(es) at Euro 10 each Enclosed is a Euro check or money order for the European record application processing fee Enclosed is a copy of record application fee wire transfer made to: Barclays Bank, Tamar Group, Liskeard, Cornwall, England Code 20-50-40 Account EFSA No. 43575688 Swift code BUKBGB22 IBAN GB64BUKB20504043575688 Declaration of angler (note signature of angler required for all claimants. Oath and notary seal only required in the event of no witnesses to the catch) I, the undersigned, hereby take oath and attest that the fish described in the application was hooked, fought and bought to the gaff by me without assistance from anyone, except as specifically provided in the regulations; and that it was caught in accordance with EUROPEAN LINE CLASS RULES; and that the line submitted with this application is the actual line used to catch the fish. I further declare that all information is true and correct to the best of my knowledge. Signature of Angler: Date: Sworn by me this: date: Notary Signature and seal
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PLEASE DO NOT WRITE BELOW THIS LINE (for official use only) ----------------------------------------------------------------
Line strength test:
Fish identified by:
Registered under line class:
Signature:
Data Ratified:
Data identified:
Signature of fish recorder:
Record category:
A copy of this form may be taken in order to complete a record claim. The copyright remains the property of the The European Federation of Sea Anglers (EFSA) and the Light Tackle Club (LTC)