Permit form for vessels fishing in the exclusive economi

OMB No. 0648-0205 Form Approval Expires: 10/31/2006

U.S. DEPT OF COMMERCE, NOAA
NMFS PERMITS BRANCH, F/SER1

FEDERAL PERMIT APPLICATION FOR
VESSELS FISHING IN THE EXCLUSIVE
ECONOMIC ZONE (EEZ)

263 13th Avenue South
St. Petersburg, FL 33701
727/824-5326 (8:00 am - 4:30 pm ET)
http://sero.nmfs.noaa.gov

FOR OFFICE USE ONLY
Reviewer's Initials and Date
Check or Money Order Number
Violation Date
Violation Clear Date
Application ID
Non Compliance Hold Date
Non Compliance Cleared Date

FOR OFFICE USE ONLY

Expiration Date(s)

A COPY of your current (not expired) USCG Certificate of Documentation or, if the vessel is not documented, your state
vessel registration must be on file or accompany this application. Do not send your original.

1. VESSEL INFORMATION
OFFICIAL NUMBER FROM USCG CERTIFICATE OF
DOCUMENTATION (if applicable)

YEAR BUILT

LENGTH (FEET)

TOTAL HORSEPOWER

STATE REGISTRATION NUMBER (if applicable)

USCG DOCUMENTED VESSELS ONLY
GROSS TONS

HOLD CAPACITY
(Pounds of Harvest)

NET TONS

VESSEL NAME

HULL IDENTIFICATION or IMO NUMBER

PRODUCT STORAGE
(check all that apply)

HULL MATERIAL

FUEL TYPE

FIBERGLASS

DIESEL

STEEL

GASOLINE

WOOD

OTHER
________________

ICE
HAILING PORT CITY

CEMENT
HAILING PORT COUNTY

HAILING PORT STATE
OTHER
________________

TOTAL FUEL
CAPACITY (GALLONS)

FREEZER
LIVE WELL
OTHER
________________

PASSENGER CAPACITY DATA FOR CHARTER/ HEADBOAT VESSELS
UNINSPECTED VESSEL "6-PACK"

This vessel is best described as:
Commercial Fishing

Charter

Headboat

USCG INSPECTED VESSEL (Specify passenger
Capacity as listed on the USCG Certificate of
Inspection)

Page 1

Last Form Revision 04/14/2006

2. PERMITS
INSTRUCTIONS: Indicate which permit(s) and transaction(s) you are applying for. Find the fishery in the left column and mark the check box beside
that fishery to indicate what transaction you want.

OPEN ACCESS COMMERCIAL PERMITS
FISHERY

NEW

RENEWAL

DUPLICATE

COMMERCIAL ATLANTIC DOLPHIN/ WAHOO (ADW)
SPINY LOBSTER TAILING (LT)
SPINY LOBSTER (LC) (Not required for the EEZ off Florida)

SOUTH ATLANTIC ROCK SHRIMP (RS)
SPANISH MACKEREL (SM)
SOUTH ATLANTIC PENAEID SHRIMP (SPA)
ROYAL RED SHRIMP ENDORSEMENT TO GULF OF MEXICO SHRIMP (SPR)
GULF OF MEXICO SHRIMP (SPG)

OPEN ACCESS CHARTER/HEADBOAT PERMITS
NEW

FISHERY

RENEWAL

DUPLICATE

SOUTH ATLANTIC CHARTER/ HEADBOAT FOR SNAPPER-GROUPER (SC)

SOUTH ATLANTIC CHARTER/ HEADBOAT FOR COASTAL MIGRATORY PELAGICS (CHS)
ATLANTIC CHARTER/ HEADBOAT FOR DOLPHIN/ WAHOO (CDW)

LIMITED ACCESS/MORATORIUM CHARTER/ HEADBOAT and COMMERCIAL PERMITS

TRANSFER

FISHERY
GULF OF MEXICO CHARTER/HEADBOAT FOR COASTAL MIGRATORY PELAGIC FISH (CHG)
GULF OF MEXICO CHARTER/HEADBOAT FOR REEF FISH (RCG)
HISTORICAL CAPTAIN GULF OF MEXICO CHARTER/HEADBOAT FOR COASTAL MIGRATORY PELAGIC FISH (HCHG)
HISTORICAL CAPTAIN GULF OF MEXICO CHARTER/HEADBOAT FOR REEF FISH (HRCG)
KING MACKEREL (KM)
GILLNET FOR KING MACKEREL (GN)
GULF OF MEXICO REEF FISH (RR, RRE)
RED SNAPPER CLASS 1 LICENSE - 2000 POUND (L1)
RED SNAPPER CLASS 2 LICENSE - 200 POUND (L2)
SOUTH ATLANTIC ROCK SHRIMP LIMITED ENTRY AREA ENDORSEMENT (RSE)
SOUTH ATLANTIC UNLIMITED SNAPPER-GROUPER (EXCLUDING WRECKFISH) (SG1, ST1)
SOUTH ATLANTIC 225 LB TRIP LIMIT SNAPPER-GROUPER (EXCLUDING WRECKFISH) (SG2, ST2)
SWORDFISH DIRECTED (SFD)
SWORDFISH HANDGEAR (SFH)
SWORDFISH INCIDENTAL (SFI)
SHARK DIRECTED (SKD)
SHARK INCIDENTAL (SKI)

Page 2

RENEWAL

DUPLICATE

3. VESSEL OWNER AND LESSEE INFORMATION
Please copy this page as needed to provide information on all persons or businesses that own or lease the vessel listed in Section 1.
1) Please complete this section for each owner of the vessel as shown on the Coast Guard Documentation or, if not documented, on the state
registration certificate. If the owner is a business or partnership, enter the Federal ID number and date the business was formed or partnership was
filed. If the owner is an individual, enter the Social Security Number.
2) Complete the Additional Owner or Lessee section for a second joint owner if the vessel is owned by more than one owner, or if the vessel is leased,
for the entity that is leasing the vessel from the vessel owner. If you need more spaces, copy the blank form or provide the required information on a
seperate sheet of paper.
3) Place an "X" in the Mailing Recipient block to indicate who will receive the permit and all related information. Please only mark one box.
4) If the vessel is operated under a lease or other written management agreement that bestows control over the destination, function or operation of the
vessel to a person other than the vessel owner (as stated on the Coast Guard Documentation or state registration), you must submit information on each
lessee. If you need more spaces for additional lessees, copy the blank form or provide the required information on a seperate sheet of paper.

Vessel Owner as shown on the USCG Certificate of Documentation,
or for undocumented vessels, the State Registration; and/or Vessel Lessee Information
This entity is a vessel OWNER
Check one

or vessel LESSEE

(For lessees only) LEASE START DATE:

INDIVIDUAL or SOLE PROPRIETORSHIP

JOINT OWNERSHIP

LEASE EXPIRATION DATE:

PARTNERSHIP

CORPORATION

OTHER ____________

Mailing Recipient - Mark this box only if you want this entity to receive all mail concerning this permit.
Mr/Mrs/Ms

Last Name or Name of Business

First Name

Middle Name

Suffix Name

Mailing Address

Apt/Suite #

City

State

County

Zip Code

Country

Physical Address

Apt/Suite #

City

State

County

Zip Code

Country

Check box if same as Mailing Address

Federal ID # or SSN #

Date of Birth/business filed

Area Code

Phone Number

Income Qualifier: If this entity is the income qualifier for any permits applied for in this application, indicate below to which fishery the income applies.
Commercial King Mackerel

Commercial Spiny Lobster

Spanish Mackerel

Reef Fish

Second Vessel Owner as shown on the USCG Certificate of Documentation or State Registration, or
Vessel Lessee
This entity is a vessel OWNER
Check one

or vessel LESSEE

(For lessees only) LEASE START DATE:

INDIVIDUAL or SOLE PROPRIETORSHIP

JOINT OWNERSHIP

PARTNERSHIP

LEASE EXPIRATION DATE:
CORPORATION

OTHER ____________

Mailing Recipient - Mark this box only if you want this entity to receive all mail concerning this permit.
Mr/Mrs/Ms

Last Name or Name of Business

First Name

Middle Name

Suffix Name

Mailing Address

Apt/Suite #

City

State

County

Zip Code

Country

Physical Address

Apt/Suite #

City

State

County

Zip Code

Country

Check box if same as Mailing Address

Federal ID # or SSN#

Date of Birth/business filed

Area Code

Phone Number

Income Qualifier: If this entity is the income qualifier for any permits applied for in this application, indicate below to which fishery the income applies.
Commercial King Mackerel

Commercial Spiny Lobster

Spanish Mackerel
Page 3

Reef Fish

4. OFFICER/SHAREHOLDER INFORMATION FOR ENTITIES THAT OWN OR LEASE THE VESSEL
Please copy this page as needed to provide information on all persons or businesses that own or lease this vessel.

1) Please complete this section for each officer or partner associated by partnership, corporation, or other business relationship to a vessel owner or
lessee listed in section 3.

Owner or lessee of the vessel:

Owner

Lessee

Business name:
Federal Tax ID #
All individuals associated with the above-named vessel owner or lessee must be included in this application. Photocopy this page or attach additional
sheets as necessary to list all officers, directors, shareholders, and registered agents of the business. Provide names, Social Security Numbers,
addresses, phone number, date of birth, and position held in business.

Position held
President/CEO
Mr/Mrs/Ms

Vice President

Secretary

Treasurer

Last Name or Name of Business

Mailing Address

Apt/Suite #

Physical Address

Director/Manager

Agent

First Name

Other
Middle Name

Suffix Name

City

State

County

Zip Code

Country

Apt/Suite # City

State

County

Zip Code

Country

Check box if same as Mailing Address

SSN #

Date of Birth

Area Code

Phone Number

Income Qualifier: If this entity is the income qualifier for any permits applied for in this application, indicate below to which fishery the income applies.
Commercial King Mackerel

Commercial Spiny Lobster

Spanish Mackerel

Reef Fish

Position held
President/CEO
Mr/Mrs/Ms

Vice President

Secretary

Treasurer

Last Name or Name of Business

Director/Manager

Agent

First Name

Other
Middle Name

Suffix Name

Mailing Address

Apt/Suite #

City

State

County

Zip Code

Country

Physical Address

Apt/Suite #

City

State

County

Zip Code

Country

Check box if same as Mailing Address

SSN #

Date of Birth

Area Code

Phone Number

Income Qualifier: If this entity is the income qualifier for any permits applied for in this application, indicate below to which fishery the income applies.
Commercial King Mackerel

Commercial Spiny Lobster

Spanish Mackerel

Page 4

Reef Fish

5. HISTORICAL CAPTAIN, RED SNAPPER CLASS 1 LICENSE QUALIFIER, AND/OR OTHER INCOME QUALIFIERS
Please copy this page as needed to provide information on persons who are Historical Captains; Red Snapper Class 1 License Qualifiers; and
Income Qualifiers/Operators who are not also a vessel owner or lessee, or related though business association to the vessel owner or
lessee, as listed in Section 3 or Section 4 of this application.
Please complete this section of the application only if you are applying for:
* A Gulf of Mexico Charter/Headboat permit with a Historical Captain provision,
* A Red Snapper Class 1 License that you have leased from a Red Snapper Class 1 License qualifier, or
* A King Mackerel, Spanish Mackerel, Reef Fish, or Commercial Spiny Lobster permit for which you have met the income qualification
requirement by using the fishing income of an operator who is neither a vessel owner or lessee as listed in Section 3 of this application, nor is the
operator an officer or a shareholder of a business that owns or leases the vessel, as listed in Section 4 of this application.
For all other applications, this page should be blank.

This entity is a (check all that apply):
Historical Captain for Gulf of Mexico Charter/Headboat for Reef Fish
Historical Captain for Gulf of Mexico Charter/headboat for Coastal Migratory Pelagic Fish
Red Snapper Class 1 License Qualifier
Income Qualifier for: (check all that apply)
Mr/Mrs/Ms

Commercial King Mackerel

Last Name or Name of Business

Commercial Spiny Lobster

First Name

Spanish Mackerel

Middle Name

Reef Fish
Suffix Name

Mailing Address

Apt/Suite #

City

State

County

Zip Code

Country

Physical Address

Apt/Suite #

City

State

County

Zip Code

Country

Check box if same as Mailing Address

SSN #

Date of Birth

Area Code

Phone Number

This entity is a (check all that apply):
Historical Captain for Gulf of Mexico Charter/Headboat for Reef Fish
Historical Captain for Gulf of Mexico Charter/Headboat for Coastal Migratory Pelagic Fish
Red Snapper Class 1 License Qualifier
Income Qualifier for: (check all that apply)
Mr/Mrs/Ms

Commercial King Mackerel

Last Name or Name of Business

Commercial Spiny Lobster

First Name

Spanish Mackerel

Middle Name

Reef Fish
Suffix Name

Mailing Address

Apt/Suite #

City

State

County

Zip Code

Country

Physical Address

Apt/Suite #

City

State

County

Zip Code

Country

Check box if same as Mailing Address

SSN #

Date of Birth

Area Code

Page 5

Phone Number

6. REEF FISH TRAPS AND SNAPPER-GROUPER POTS
COMPLETE THIS SECTION ONLY IF YOU FISH WITH TRAPS OR POTS IN EITHER THE COMMERCIAL GULF OF
MEXICO REEF FISH OR COMMERCIAL SOUTH ATLANTIC SNAPPER-GROUPER FISHERIES
Tag cost is $1.30 per tag made payable by check or money order payable to Floy Tag, Inc.
If you have an existing buoy color code for ANY trap or pot fishery, list it here

Color Code

If you do not have an existing buoy color code for ANY trap or pot fishery,
request your choice here (white is not an available color option).

Color Code

Trap/Pot Information
Gulf of Mexico (GOM)

South Atlantic (SA)

Number of Traps

Size: L x W x H (in inches)

Size: L x W x H (in inches)

Mesh size (in inches)

Mesh size (in inches)

Number of Traps

Payment Reminder:
All applications must include payment of a non-refundable application fee in the form of a check or money order made
payable to the US Treasury. The fee required is $50.00 for the first fishery and $25.00 for each additional fishery
requested with this application.

7. SIGNATURE
The undersigned certifies under penalty of perjury that the foregoing infomation is true and correct (28 U.S.C. section 1746; 18 U.S.C. section 1621; 18
U.S.C. section 1001). Further, the undersigned acknowledges that (1) if a shark permit is received, then shark fishing, catch and gear are subject to the
shark regulations cited in 50 CFR 635.5, without regard to where such shark fishing occurs or where such shark and/or gear are possessed, taken or
landed; and (2) if a spiny lobster tailing permit is requested, the applicant routinely fishes commercially in Federal waters on trips of up to 48 hours or
more and that such fishing activity requires the seperation of the tail and carapace to maintain quality product.
Please note: If the vessel listed in Section 1 is leased, the applicant who signs below must be an individual named as a lessee in Section 3, or an
officer or shareholder of the lessee as listed in Section 4. If the vessel listed in Section 1 is not leased, the applicant must be an individual named as an
owner in Section 3, or an officer or shareholder of the owner as listed in Section 4.

Applicant Signature

Position in Company

Print Name

Operator Signature

Date

if required

Public reporting burden for this collection of information is estimated to average 20 minutes per response, including the 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 suggestions for reducing this burden to Jason Rueter, National Marine Fisheries Service,
F/SER22, 263 13th Avenue South, St. Petersburg, FL 33701.
The National Marine Fisheries Service requires this information for the conservation and management of marine fishery resources. The data reported
will be used to develop, implement, and monitor fishery management activities for a variety of other uses. Responses to this collection are required to
obtain or retain a fisheries permit under the Magnuson - Stevens Act. Name and address information will be released via a NOAA website. All other
data submitted will be handled as confidential material in accordance with NOAA Administrative Order 216-100, Protection of Confidential Fishery
Statistics. Notwithstanding any other provisions of the law, no person is required to respond to, nor shall any person be subjected 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.

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