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 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