THE BRIBIE ISLAND
SPORTFISHING CLUB

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CAPTURE CLAIM CERTIFICATE

Angler   Ph  

All claims to be lodged with Recorder within 30 days of capture date.

NO.

DIV.

SPECIES

LOCATION OF CAPTURE

 NET WEIGH LINE CLASS DATE POINTS

1

              

SCIENTIFIC NAME

 CLAIM FOR
2              

SCIENTIFIC NAME

 CLAIM FOR
3              

SCIENTIFIC NAME

 CLAIM FOR
4              

SCIENTIFIC NAME

 CLAIM FOR
5              

SCIENTIFIC NAME

 CLAIM FOR

I hereby certify that the above-mentioned fish were captured on regulation tackle in accordance with the rules of the Australian National Sportfishing Association.

 
  
Signature of Angler Signature of Weighmaster
 
  
Signature of Witness Signature of Recorder

Please print this form and mail to the Recorder,
Jeff Sorrell, ph 07 3284 2632
410 Anzac Avenue, Kippa Ring Qld 4021.