State Waters Exemption Form

SCALLOP STATE WATERS EXEMPTION PROGRAM FORM
Enrollment Date1: ________________________
End date2: ______________________________
1

Vessel must remain enrolled for at least 7 full days

2

Vessel must cancel enrollment by submitting this form following the minimum 7-day enrollment period.

OMB Control No.: 0648-0491
Expiration Date: 08/31/2010