IGFA Fish Registry Application

Read all IGFA rules and world record requirements before printing, completing and signing this application. The angler's signature on the completed form must be witnessed by a notary. This application must be accompanied by line or tippet samples and photographs as specified in the World Records Requirements. Hybrids and other species that may pose a problem of identity should be examined by an ichthyologist or qualified fishery biologist

I AM SUBMITTING THIS ENTRY FOR:

___ An all-tackle world record.

___ A world record in the following line class:

_______________ lb / _______________ kg

___ A fly rod world record in the following tippet class:

_______________ lb / _______________ kg

___ A state freshwater record in the following line class:

_______________ lb / _______________ kg

___ 10 Pound Bass Club*

___ 25 Pound Snook Club*

*Call IGFA Executive Administrator, Special Clubs for fees

SPECIES
Common name: ______________________________

Scientific name: _____________________________

WEIGHT: Fish was weighed in: ___lbs ___kgs

lbs:__________ oz:__________ kg:__________

Digital weight (if weighed on electronic scales, give weight

exactly as shown):______________________

DATE OF CATCH (MM/DD/YY): ________________

PLACE OF CATCH:__________________________

___________________________________________

Was the fish released alive? ___Yes ___No

LENGTH (see measurement diagram)

inches: x to x ___________ xx to xx ____________

cm: x to x ____________ xx to xx ____________

GIRTH (see measurement diagram)

inches:______________ cm:______________

METHOD OF CATCH (trolling, casting, fly fishing, etc.):

________________________________________________

FIGHTING TIME:__________________________________

Was this catch recorded on video? ___Yes ___No

ANGLER (Print name as you wish it to appear on your record or contest certificate):

_________________________________________________

Daytime Phone:_____________________________________

Permanent address - required for certificate mailing (include country and address code):

_________________________________________________

_________________________________________________

_________________________________________________

Age if 16 or under: _____

Angler's fishing club (if any):__________________________

EQUIPMENT
Rod
Make:____________________________________________

Tip length (center of reel to end of tip):
_________________________________________________
Butt length (center of reel to lower end of butt):

_________________________________________________
Reel
Make: ________________________ Size: ______________

Line or tippet
Make: ___________________________________________

Size stated on label: _______________________________

_________________________________________________

__ I am an IGFA member, enclosed is $10 application fee.
__ I am not an IGFA member, enclosed is $35 application fee.
__ I wish to be an IGFA member, enclosed is $45 membership and application fees.

Enclosed is $___________ check or money order for the World Record application processing fee. Or please charge to my:

__Visa __MasterCard __American Express __Discover

Account No. __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

Exp. date: ____/____ Signature: _____________________

___Please send ___ extra copies of my record certificate at $5 each.

Note: All items must be filled in. If an item does not apply, write "none used". Do not leave any spaces blank.

Length of double line:_________________________

Make of backing:_______________ Size:________

OTHER EQUIPMENT:

Type of gaff:_______________ Length:___________

Length of trace or leader:____________________________

Number and type of hooks:____________________________

Name of lure, fly or bait:_____________________________

BOAT (if used)

name:___________________________________________

Make:___________________ Length:__________________

Captain's Name:____________________________________

Signature:________________________________________

Address:_________________________________________

________________________________________________

Mate's Name:______________________________________

Address:_________________________________________

________________________________________________

SCALES (note: IGFA can certify portable scales for members for $13, including return shipping charges)

Location of scale:__________________________________

Type:____________________________________________

Manufacturer:_____________________________________

Date last certified:_________________________________

Person and/or agency that certified scales:

_______________________________________________

Weighmaster:_____________________________________

Signature:________________________________________

Address:_________________________________________

________________________________________________

WITNESSES:

Witness to weighing (ther than angler, captain or weighmaster):

________________________________________________

Address:_________________________________________

________________________________________________

Witness to catch (other than captain). List two names and addresses if possible.
1. ______________________________________________

________________________________________________

2. ______________________________________________

________________________________________________

Number of persons witnessing the catch:__________________

VERIFICATION OF SPECIES IDENTITY
(See World Record requirements.)

Signature of examining ichthyologist:
________________________________________________

Title, degree or qualifications:_________________________

Address:_________________________________________

________________________________________________

Anglers are encouraged to write a detailed description of the catch. In some cases this may be required. The description may be used in a future IGFA publication.

AFFIDAVIT
I, the undersigned, hereby take oath and attest that the fish described in this application was hooked, fought, and brought to gaff by me without assistance from anyone, except as specifically provided in the regulations; and that it was caught in accordance with IGFA angling rules; and that the line submitted with this application is true and correct to the best of my knowledge. I understand that IGFA reserves the right to employ verification procedures. I agree to be bound by any ruling of the IGFA relative to this application.

Signature of angler:___________________________________________________________________

Sworn before me this _______________ day of _________________________ the year __________

Notary signature and seal:______________________________________________________________

When completely filled out and signed, mail this application with photos and line sample by quickest means to:
INTERNATIONAL GAME FISH ASSOCIATION, 300 Gulf Stream Way, Dania Beach, FL 33004 USA
PHONE: (954) 927-2628 WEBSITE: www.igfa.org FAX: (954) 924-4299