Official Wyoming State Fish Record Application

Name of Angler ____________________________________________________________________________________

Street Address _______________________________________________________Phone _____________________________

City ______________________________________ State ________________    Zip ________________________________

Specie or Hybrid _________________________   _____________________________

                                             (common name)                               (scientific name)

Weight:  lbs . __________  oz. ____________

Total length  __________  inches __________

Girth  _______________  inches __________

Date of catch __________________________________________________________

Location of catch ________________________   _____________________________

                                         (lake or river)                                  (closest city)

Scale Verification:  Registered scale No. _____________________________

Inspector's name ____________________________________ Location ___________________________________

We the undersigned witnessed the weighing of the fish described above and attest to the weight as listed.

Signature________________________________ Signature ____________________________________

Address _________________________________Address _________________________________

City ______________________________              City ______________________________

The undersigned being a professional fisheries biologist, does hereby verify the identity of the above-described fish.

Signature ________________________________Address ________________________________

Place of Employment __________________________Address __________________________________

AFFIDAVIT OF APPLICANT

I, ______________________________________ state that the fish described in this application was legally caught by me in accordance with the rules established by the Wyoming Game & Fish Department for "state record fish" . I further declare that all the information and statement in this application are true and correct.

________________________________________________Date __________________________

(signature of applicant)             SEND TO:   Wyoming Game & Fish Department,
                                                  Information Section, 5400 Bishop Blvd., Cheyenne WY 82006