Modern Day Muskellunge

World Record Application


1) This official world record application form or an exact reproduction must be used for world record claims, and all rules and regulations must have been complied with.

2) This application must be filled out by the angler personally, in a legible and readable manner.

3) The angler is responsible for obtaining the required witness signatures and assuring that all are properly notarized as specified within the rules and regulations.

4) The angler is responsible for assuring that all photograph requirements are met and included.

5) The angler must indicate the line type, make and test used.

6) Leader information, if used must be stated, and a nylon coated leader is mandatory for use with wire line, and must be included.

7) The angler is responsible for obtaining any additional statements or affidavits as required within the rules and regulations.

8) The angler and witnesses must all appear in person for notarization of application and supporting statements.

9) If a notary is unavailable, a committee representative’s signature may be used.

10) Any deliberate falsification of an application or supporting documents shall disqualify applicant from any future world record application, and if applicable, disqualify any prior world record(s).

11) Fish must have been caught in the legal open season, during legal fishing hours if applicable, for the waters fished. Any fish captured in fish hatchery waters, fish sanctuary or private waters not available to the general public, is not eligible.

12) Witness information must include full address, email address if any, and telephone contact number for both application and any supporting documentation.

13) Decision of the Record Review Committee shall be final.




 

Name of Angler: (print)_______________________________________________________________________

Address: _____________________________________________________________________________

City: _______________________________________________ State/Prov.: _________ Zip:________

Phone: ______-______-________ Email: __________________________ Height: _______________

Date of Catch: ________________ Location of Catch: ______________________________________

State/Prov. Of Catch: _____________________________ Nearest Town: _______________________




 

See Rules, Regulations and Equipment Criteria to Complete the Following:


Weight of Fish: _____________lbs/kilos (circle one) _____________oz./grams (circle one)

Total Length of Fish: ______________________________________ inches/centimeters (circle one)

Note: Fish must be of legal length for water where caught, such as 54” (137 centimeters) for Canada’s trophy category waters.

Fork Length of Fish: _______________________________________ inches/centimeters (circle one)

Girth of Fish: _____________________________________________ inches/centimeters (circle one)

Rod Length (ctr. of reel to rod tip): ___________in./cm. (circle one) Type Line Used: _________________

Line Manufacturer: ________________________________________ Line Test: ______________________

Plug or Artificial Lure or Bait used: ___________________________________________________________

Type of Leader Used (if any): _____________________________________ Length: ______________

Check: Method of Catch; Casting: _______ Trolling: ______ Live/Dead Bait (circle one): ________

Check: Method of landing; Gaff: _________ Net: ________ Other (describe) _____________________________

 

AFFIDAVIT: I, the undersigned, do hereby affirm and attest that my catch has complied with all Angling Rules, Regulations and Equipment Criteria as set forth for record consideration by the International Record Committee, as well as all laws where caught, and that all required photographs and supporting documentation, line sample and leader (if any) is provided herewith:

Signature of Angler: ___________________________________________________________________

Signature of Notary: _____________________________________________ Seal:


AFFIDAVIT: I/we the undersigned do hereby attest and affirm that I/we actually witnessed the capture of this fish being applied for record, and further attest and affirm that the applicant adhered fully to the International Rules, Regulations and Equipment Criteria as set forth for record consideration by the International Record Committee, as well as having complied with all laws where the fish was caught:

Printed Name: _________________________________________________________________________

Signature of Catch Witness #1: _________________________________________________

Address: _____________________________________________________________________________

City: _______________________________________________ State/Prov.: _________ Zip:________

Phone: ______-______-________ Email: __________________________________________________

Signature of Notary: _____________________________________________ Seal:

Printed Name: _________________________________________________________________________

Signature of Witness #2: _________________________________________________

Address: _____________________________________________________________________________

City: _______________________________________________ State/Prov.: _________ Zip:________

Phone: ______-______-________ Email: __________________________________________________

Signature of Notary: _____________________________________________ Seal:


AFFIDAVIT: We the undersigned do hereby affirm and attest that we witnessed the actual weighing and measuring of this fish. We also attest that we are not associates of the angler:

Printed Name: _________________________________________________________________________

Signature of Weight Witness #1: _________________________________________________________

Address: _____________________________________________________________________________

City: _______________________________________________ State/Prov.: _________ Zip:________

Phone: ______-______-________ Email: __________________________________________________

Signature of Notary: _____________________________________________ Seal:

Printed Name: _________________________________________________________________________

Signature of Weight Witness #2: _________________________________________________________

Address: _____________________________________________________________________________

City: _______________________________________________ State/Prov.: _________ Zip:________

Phone: ______-______-________ Email: __________________________________________________

Signature of Notary: ____________________________________________ Seal:


WEIGHT SCALER’S AFFIDAVIT: I, the undersigned, do hereby attest and affirm that I was the person that did the actual weighing of the fish above noted and that I have no association with the angler:

Printed Name: _________________________________________________________________________

Signature of Weight Scaler: _________________________________________________________

Address: _____________________________________________________________________________

City: _______________________________________________ State/Prov.: _________ Zip:________

Phone: ______-______-________ Email: __________________________________________________

Signature of Notary: ____________________________________________ Seal:

SCALE CERTIFICATION: Registered Scale #: ____________ Make of Scale: _________________

Date Last Certified: ____________________Scale Location (store, etc., town/state/prov.): _________

______________________________________________________________________________________

Please attach signed Certification of Species, Weight and Stomach ContentsStatement of findings,” including contact information of the biologist or committee representative present as per Possession of Fish after Weighing: rule #1 or 2 and include “cleithral bone and scale sample.”

Record Application Check List

_____ “Official” application or exact copy was used

_____ Angler information is complete and “affidavit” notarized

_____ Catch witness(es), if any, information is complete and “affidavit(s) notarized

_____ Weight witnesses information is complete and affidavits notarized

_____ Weigh master information complete and notarized

_____ Original scale certification information is complete

Equipment Criteria:

_____ Photograph of rod used _____ Length remaining stated if broken

_____ Photograph of reel used

_____ Photograph of gaff or net (if used)

_____ Line sample submitted

_____ Leader submitted if required

_____ Photograph of plug/artifical lure submitted _____ Bait-rig submitted if used

Time Limit:

_____ Application meets “time limit” rule _____ “Just Cause” claim submitted if no

Scale Requirements:

_____ Photograph of scale submitted

_____ Scale “re-certification” done /submitted

_____ Photograph of fish on scale incl. _____ Photograph of scale reading incl.

_____ Rule 4; Photograph of scale “contrivance” if used, included

_____ Rule 4; signed and notarized statement included

_____ Weight scaler affidavit signed

_____ Scale Certification information included

Fish Measurement:

_____ Photograph of fish measurement included _____ Fish length legal for water?

_____ Signed and notarized statement of girth measurement included if necessary

Photograph Requirements:

_____ Photograph of Angler “beside” the fish is included and meets requirements

_____ Fish identification statement included if necessary due to photo or “hybrid”

_____ Additional photographs of “hybrid” muskellunge are included

_____ Negative type film was used (see photograph requirement rule #1)

Possession of Fish:

_____ Rule 1 has been complied with, or _____ Rule 2 has been complied with

_____ Species certification, re-weighing and stomach contents statement incl.

_____ Scale sample and cleithral bone has been collected and submitted

Follow-up Questions:

_____ Was equipment rule #6 (gaff or net) complied with?

_____ Were catch rules 1, 2, 3, and 4 adhered to?

_____ Were any of disqualification points 2, 3, 4, 5, 6, 7, 8, 9, 10, and 11 violated?

 

Send completed Application to:


International Muskellunge Record Review Committee
17805 57th Avenue, Chippewa Falls, WI 54729


For immediate contact:


Steve Worrall, Public Relations Director, This e-mail address is being protected from spambots. You need JavaScript enabled to view it or

Larry Ramsell, Chairman, 715-634-9882, This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Jim Bunch, 715-723-8343, This e-mail address is being protected from spambots. You need JavaScript enabled to view it