THE OF FISHERIES ACT – MOLLUSC FISHERY A9/_______________ LICENCE HOLDER NAME _____________________________________ LICENCE No: (operator’s name): MONTH: ___________________________ YEAR: __________ NIL RETURN (tick, if appropriate): VESSEL REGO No’s: _________________ : _______________________ TOTAL DAYS FISHED:__________ GRID NUMBER AREA (specify) FISHING METHOD FINISH DATE DATE CATCH WEIGHT WEIGHT WEIGHT WEIGHT NUMBER NUMBER NUMBER NUMBER (list species) (kg) (kg) (kg) (kg) * (whole, meat only, half shell, etc) DESTINATION STORAGE WEIGHT PRODUCT SOLD FORM* N.T. INTERSTATE (fresh, SOLD (list species) (public or traders no.) (state and traders name) frozen, etc ) (kg) official use only COMMENTS:_____________________________________________________________________________ I _________________________________________________ declare that the information on this return is true and accurate. (print operator’s name) _______________________________________ ______/______/______ SIGNATURE OF LICENCE HOLDER DATE: (operator’s signature):
THE OF – FISHERIES ACT MOLLUSC FISHERY LICENCE No: A9/_______________ LICENCE HOLDER NAME (operator’s name): _____________________________________ MONTH: ___________________________ YEAR: __________ NIL RETURN (tick, if appropriate): VESSEL REGO No’s: _________________ : _______________________ TOTAL DAYS FISHED:__________ GRID NUMBER AREA (specify) FISHING METHOD DATE FINISH DATE CATCH (list species) WEIGHT (kg) NUMBER WEIGHT (kg) NUMBER WEIGHT (kg) NUMBER WEIGHT (kg) NUMBER * (whole, meat only, half shell, etc) PRODUCT SOLD (list species) FORM* STORAGE (fresh, frozen, etc ) WEIGHT SOLD (kg) DESTINATION N.T. (public or traders no.) INTERSTATE (state and traders name) official use only COMMENTS:_____________________________________________________________________________ I _________________________________________________ declare that the information on this return is true and accurate. (print operator’s name) SIGNATURE OF LICENCE HOLDER (operator’s signature): _______________________________________ DATE: ______/______/______
mollusc-fishery-return-form.docx