Pacific Islands Region NMFS Permit Application

FEDERAL FISHERIES PERMIT APPLICATION FORM
U.S. DEPARTMENT OF COMMERCE
NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION
NATIONAL MARINE FISHERIES SERVICE
PACIFIC ISLANDS REGION

OMB Control No.: 0648-0490
Expiration Date: 12/31/2006

For Office Use:
GC ___________
Issued__________
Transmit_________

Mail or deliver this application to:

2006

1.

2.
3.
4.

NMFS Pacific Islands Regional Office
1601 Kapiolani Blvd., Suite 1110
Honolulu, Hawaii 96814-4700
Tel:(808)944-2200
Fax:(808)973-2941

(Check U appropriate circle or circles for type of permit application)
± Application Processing Fee: $48.00
(Make checks or money orders payable to: Dept. Of Commerce, NOAA)
General Longline Permit (Western Pacific) ±
Receiving Vessel Permit ±
Hawaii Closed Area Exemption ± (see reverse side of this page)
Pacific Remote Island Areas Troll & Handline ±
LOBSTER - Northwestern Hawaiian Islands Limited Entry ± (see reverse side of this page)
American Samoa ±
Guam ±
Northern Mariana Islands ±
Main Hawaiian Islands ±
Pacific Remote Island Areas (PRIA) ±
BOTTOMFISH - Hoomalu Zone: ± Mau Zone: ± Mau Zone Application Processing Fee $65.00
(Submit supplementary info sheet)
Guam Large Vessel ±
Northern Mariana Islands (NMI) ± Pacific Remote Island Areas ±
PRECIOUS CORAL ±
Permit Area:______________________________

LONGLINE - Hawaii Limited Entry Permit

VESSEL NAME:

___________________________

VESSEL OFFICIAL NUMBER: ___________________

VESSEL OWNER: _____________________________________________________

_________________

First & Last Name

Social Security Number

Privacy Act Statement: Federal Regulations (at 50 CFR Part 660) authorize collection of this information. This information is used to
verify the identity of the applicant(s) and to accurately retrieve confidential records related to federal commercial fishery permits.
Where the requested information is a Social Security Number, disclosure is mandatory in accordance with the Debt Collection Act (31
U.S.C. 7701).

NAME OF CORPORATION OR PARTNERSHIP THAT OWNS VESSEL: _______________________________________
BUSINESS ADDRESS: ______________________________

__________________

___________

__________

City

State

Zip Code

Street

EMAIL: _____________________________________
HOME ADDRESS: ______________________________

__________________

Street

BUSINESS PHONE: (____)____________

___________

City

Zip Code

HOME PHONE: (____)____________ FAX:(____)___________

VESSEL CAPTAIN: _________________________________________________
First & Last Name

CAPTAIN'S MAILING ADDRESS:

____________

State

_________________
Social Security Number

If same as owner's business address, check

_____________________________

________________________

Street

City

here: ±

____________
State

______________
Zip Code

APPLICANT: ____________________________________________________________ DATE: ______________
Print Name & Signature of Vessel Owner

PERMIT TRANSFEROR: ___________________________________________________ DATE: _____________
Print Name & Signature of Permit Owner Transferring Permit

Permit Number of Transferred Permit: ___________________
You must submit a copy of the vessel's current U.S. Coast Guard Certificate of Documentation
(documented vessel) or registration certificate from state/territorial agency (for undocumented vessel)
with this application form.

OMB Control No.: 0648-0490
Expiration Date: 12/31/2005

(page 2)
Federal Fisheries Application Form - Pacific Islands Region

SUPPLEMENTAL INFORMATION FOR:
**

MAIN HAWAIIAN ISLANDS LONGLINE FISHING PROHIBITED AREA EXEMPTION**

VESSEL: _______________________
VESSEL OFFICIAL NUMBER: ___________________
Basis for Exemption Eligibility (all boxes must be checked to be eligible):
~
~

Applicant currently holds a Hawaii longline limited entry permit
Applicant was the owner or operator of a vessel that made landings of pelagic management
unit species taken on longline gear prior to 1970 from waters now closed to longline fishing.
~ Applicant was the owner or operator of a vessel that made landings of pelagic management
unit species taken on longline gear in at least five (5) years since (and including) 1970 from
waters now closed to longline fishing.
~ Applicant was the owner or operator of a vessel that made at least 80 percent of its
landings of longline-caught pelagic management unit species in any calendar year in waters now
closed to longline fishing.
-----Attach document(s) demonstrating exemption eligibility (check as many boxes as may apply):
~ State of Hawaii Catch Reports
~ Vessel fishing logs
~ Auction receipts
~ Signed affidavits
~ Other (specify): ____________________________________________
SIGNATURE OF APPLICANT:______________________________________

******

NORTHWESTERN HAWAIIAN ISLANDS LOBSTER LIMITED ENTRY PERMIT ******

If the application is being submitted on behalf of a partnership or corporation, indicate the names of all
the owners and their respective percentage of ownership in the partnership or corporation:
VESSEL: _____________________________

VESSEL OFFICIAL NUMBER: ___________________

Name of Shareholder:

Percent (%)
of Ownership

Business Address:

_____________________________________

_____________

_______________________________________

_____________________________________

_____________

_______________________________________

_____________________________________

_____________

_______________________________________

_____________________________________

_____________

_______________________________________

SIGNATURE OF APPLICANT:___________________________________________
PAPERWORK REDUCTION ACT INFORMATION
Public reporting burden for this collection is estimated as follows: 30 minutes for Hawaii longline
limited access permit renewal/transfer, longline general permit initial issuance/renewal, and receiving
vessel permit initial issuance/renewal; 120 minutes for main Hawaiian Islands longline fishing prohibited
area exemption; 30 minutes for Northwestern Hawaiian Islands crustaceans limited access permit transfer,
main Hawaiian Islands, American Samoa, Guam, NMI and PRIA crustacean permits; 30 minutes for Guam
bottomfish large vessel and NMI bottomfish permits; 30 minutes for precious coral permit initial/reissuance (established, conditional, refugia, exploratory areas), Pacific remote island areas troll and
handline, bottomfish, and crustacean permits; and 2 hours for all permit denial appeals. Each burden
includes time for reviewing instructions, searching existing data sources, gathering and maintaining the
data needed, and completing and reviewing the collection of information. Send comments regarding this
burden estimate or any other aspects of this collection of information, including suggestions for reducing
this burden, to NMFS Pacific Islands Regional Administrator, 1601 Kapiolani Blvd. Suite 1110, Honolulu,
Hawaii 96814-4700.
This information is being collected to ensure accurate and timely records about the persons licensed to
participate in fisheries under Federal regulations in the Western Pacific Region. This will enable NMFS
and the Western Pacific Fishery Management Council to (a) determine who would be affected by changes in
management; (b) inform license holders of changes in fishery regulations; and (c) determine whether the
objectives of the fishery program are being achieved by monitoring entry and exit patterns and other
aspects of the fisheries. The information is used in analyzing and evaluating the potential impacts of
regulatory changes on persons in the regulated fisheries as well as in related fisheries. Responses to
the collection are required to obtain the benefit of a license for the fishery involved (ref. 50 CFR
660.13). Data provided concerning the vessel and/or business of the respondents are handled as
confidential under the Magnuson-Stevens Fishery Conservation and Management Act (Sec. 402(b)).
Notwithstanding any other provision of the law, no person is required to respond to, nor shall any person
be subject to a penalty for failure to comply with, a collection of information subject to the
requirements of the Paperwork Reduction Act, unless that collection of information displays a currently
valid OMB Control Number.

OMB Control No.: 0648-0490
Expiration Date: 12/31/2005

(page 3)

SUPPLEMENTARY INFORMATION FOR:
Northwestern Hawaiian Islands Bottomfish Fishery:
Ho’omalu Zone Limited Access Permit Application
Mau Zone Limited Access Permit Application
VESSEL OWNER NAME:_________________________________
VESSEL NAME:________________________________

OFFICIAL NO: ___________________

HO’OMALU ZONE PERMIT APPLICATION:
Place a check (U) mark alongside the criterion which provides the basis for your
application.
1. New permit under historic participation or investment criteria
____ Owner of vessel which made at least one landing of NWHI bottomfish on or
before 8/7/85; if permits are being requested for two or more vessels,
documentation must show that each vessel made at least one landing of
NWHI bottomfish each year in 1986 and 1987
____ Previously non-owner skipper of vessel which landed NWHI bottomfish on or
before 8/7/85 and now owner (50% or greater interest) of vessel for
bottomfish fishery
____ Incurred substantial expenditure, or received written commitment for
loan, on or before 8/7/85, to obtain vessel for NWHI bottomfish fishery
____ Made an offer on or before 8/7/85 to purchase a vessel for use in the
NWHI bottomfish fishery
____ Owner of vessel which qualified for Ho’omalu Zone permit which was
voluntarily surrendered by the owner to the Regional Administrator
2. New permit based on eligibility point system
___

Owner of 25% or greater interest in a vessel which may qualify on the
basis of points earned through landings of bottomfish from the NWHI or
main Hawaiian Islands

HO’OMALU ZONE OR MAU ZONE PERMIT APPLICATION
If this permit application is file by a partnership or corporation, indicate the
names of all the owners and their respective percentage of ownership of the
partnership or corporation.
Name of Owner (Shareholder):
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________

Percent (%)
of Ownership:
________
________
________
________
________

Signature of Vessel Owner or Designee:________________________________________

OMB Control No.: 0648-0490
Expiration Date: 12/31/2005

(page 4)

Northwestern Hawaiian Islands Bottomfish Fishery: Ho’omalu Zone Limited Access
Permit and Mau Zone Limited Access Permit
PAPERWORK REDUCTION ACT INFORMATION
Public reporting burden for this collection is estimated as follows: 1 hour for initial issuance,
renewal, and landing waiver requests for the Hoomalu and Mau Zones limited access permits; 2 hours
for all permit denial appeals. Each burden includes time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and reviewing the
collection of information. Send comments regarding the is burden estimate any other aspects of this
collection of information, including suggestions for reducing this burden, to NMFS Pacific Islands
Regional Administrator, 1601 Kapiolani Blvd. Suite 1110, Honolulu, Hawaii 96814-4700.
This information is being collected to ensure accurate and timely records about the persons licensed
to participate in fisheries under Federal regulations in the Western Pacific Region. This will
enable NMFS and the Western Pacific Fishery Management Council to (a) determine who would be
affected by changes in management; (b) inform license holders of changes in fishery regulations; and
(c) determine whether the objectives of the fishery program are being achieved by monitoring entry
and exit patterns and other aspects of the fisheries. The information is used in analyzing and
evaluating the potential impacts of regulatory changes on persons in the regulated fisheries as well
as in related fisheries. Responses to the collection are required to obtain the benefit of a
license for the fishery involved (ref. 50 CFR 660.13). Data provided concerning the vessel and/or
business of the respondents are handled as confidential under the Magnuson-Stevens Fishery
Conservation and Management Act (Sec. 402(b)). Notwithstanding any other provision of the law, no
person is required to respond to, nor shall any person be subject to a penalty for failure to comply
with, a collection of information subject to the requirements of the Paperwork Reduction Act, unless
that collection of information displays a currently valid OMB Control Number.