1. Boat Shore(please tick appropriate)

2. Species (common name)


Species (Scientific)


3. Weight
 
lb   oz kg

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
   
inches X to X    XX to XX

cm X to X XX to XX

5. Girth or Width (see measurements diagrams)

inches Y to Y    Z to Z

cm Y to Y Z to Z
  
6. Date of Catch
/ /

7. Place of Catch

Port Place Country

8. Method of Catch



9. Angler

Mr  Mrs  Ms Miss

Surname

Forename

10. Permanent Address



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)

2lb*/1kg 4/2 8/4 12/6 16/8 20/10 30/15
50/24 80/37 130/60 AT**/AT** SH**/SH**
**European only / *LTC only

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

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 day of 19
Notary Signature and seal

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)