RSA 15C-15.004 - Form: Certificate of Inspection for Homemade Vessels

STATE OF FLORIDA CERTIFICATE OF INSPECTION FOR HOMEMADE VESSELS

Control # ___

I, _________ (Print or Type) hereby certify that I have personally inspected the vessel described below and that it meets the legal definition of a homemade vessel as defined in Section RSA 327.01(21), FS.

Name of Applicant: _________ Date of Inspection: _____

Length: ____________ Fuel: [ ] Gas: [ ] Diesel: [ ] Other: _______________

VESSEL TYPE			HULL MATERIAL						PROPULSION
[ ] Runabout		[ ] High Perf.	[ ] Wood			[ ] Fiberglass			[ ] Outboard		[ ] Inboard/Outboard
[ ] CabinCruiser		[ ] Sailboat	[ ] Alum.			[ ] Wood/F.G.			[ ] Inboard		[ ] Air Prop.
[ ] Bass Boat		[ ] Fishing	[ ] Steel			[ ] Other _____			[ ] Sail		[ ] Other _____
[ ] Airboat		[ ] Center Console
[ ] Houseboat		[ ] Dinghy
[ ] Trawler		[ ] Other ___
Specific Comments: _____
Organization: [ ] FMP [ ] GFWFC			Region # _________ Badge # ________
					______________________ Signature of Inspecting Officer
DEP 20-126-FMP

Notes

RSA 15C-15.004

Specific Authority RSA 327.04 FS. Law Implemented RSA 328.01(6) FS.

New 10-16-84, Formerly 16N-34.04, 16N-34.004, 62N-34.004.