Application for Limited Access Fishery

OMB Control No.: 0648-xxxx
Expiration Date: mm/dd/yyyy
Revised: 05/21/2007

Application for the Amendment 80
Limited Access Fishery

U.S. Dept. of Commerce/NOAA
National Marine Fisheries Service
Restricted Access Management
P.O. Box 21668
Juneau, AK 99802-1668
Fax: 907-586-7354
Telephone: 800-304-4846 toll free / 586-7202 in Juneau

An Amendment 80 limited access fishery permit is required for an Amendment 80 QS holder to catch,
process, and receive Amendment 80 species assigned to the Amendment 80 limited access fishery, or use
halibut and crab PSC assigned to the Amendment 80 limited access fishery.
An Amendment 80 limited access fishery permit is issued annually to an Amendment 80 QS holder who
has submitted:
● A timely and complete application for the Amendment 80 limited access fishery as described
at § 679.91(b)(4) that is approved by NMFS; and
●

A timely and complete EDR for all Amendment 80 QS permits held by that person as described
under § 679.94 that is subsequently approved by NMFS..

This application must be submitted annually and received by NMFS no later than 1700 hours A.l.t. on
November 1 of the year prior to the year for which the applicant wishes to participate in an Amendment
80 fishery, or if sent by U.S. mail, the application must be postmarked by that time.
1. Applicant name

BLOCK A -- APPLICANT IDENTIFICATION
2. NMFS person ID

3. Permanent business mailing address

4. Business telephone number

5. Business fax number

6. e-mail address (if available)

BLOCK B -- AMENDMENT 80 VESSEL IDENTIFICATION
Name of the Amendment 80 vessel owned by applicant
ADF&G number
USCG number
Name of the Amendment 80 vessel owned by applicant

ADF&G number
USCG number

Amendment 80 Limited Access Fishery Permit Application
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OMB Control No.: 0648-xxxx
Expiration Date: mm/dd/yyyy

BLOCK C – AMENDMENT 80 LLP IDENTIFICATION
List the Amendment 80 LLP license number(s) held by the applicant.

BLOCK D – AMENDMENT 80 QS PERMIT INFORMATION
List the Amendment 80 QS permit number(s) held by the applicant.

BLOCK E -- AMENDMENT 80 QS OWNERSHIP DOCUMENTATION
Provide the names of all persons, to the individual level, holding an ownership interest in the Amendment
80 QS Permit(s) held by the applicant and the percentage ownership each person and individual holds in
the Amendment 80 QS Permit.
Name
Percentage
Ownership

BLOCK F -- EDR SUBMISSION
Indicate whether the applicant has submitted a timely and complete EDR for each Amendment
80 QS permit held by that person as required under § 679.94.
YES [__]

NO [__]

Amendment 80 Limited Access Fishery Permit Application
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OMB Control No.: 0648-xxxx
Expiration Date: mm/dd/yyyy

BLOCK G -- APPLICANT CERTIFICATION
The applicant must sign and date the application certifying that all information is true, correct, and
complete to the best of his/her knowledge and belief. If the application is completed by a designated
representative, then explicit authorization signed by the applicant must accompany the application.
Under penalties of perjury, I declare that I have examined this application, and to the best of my
knowledge and belief, the information presented here is true, correct, and complete.
1. Signature of Applicant (or Authorized Representative)

2. Date Signed

3. Printed Name of Applicant (or Authorized Representative)

_____________________________________________________________________________________________
PUBLIC REPORTING BURDEN STATEMENT
Public reporting burden for this collection of information is estimated to average 2 hours per response, including the time
for reviewing the instructions, searching the existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. Send comments regarding the burden estimate or any other
aspect of this collection of information, including suggestions for reducing the burden, to Assistant Regional
Administrator, Sustainable Fisheries Division, NOAA National Marine Fisheries Service, P.O. Box 21668, Juneau, AK
99802-1668.
ADDITIONAL INFORMATION
Before completing this form, please note the following: 1) Notwithstanding any other provision of 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; 2) This information is mandatory and is required to manage commercial fishing efforts
under 50 CFR part 679 and under section 402(a) of the Magnuson-Stevens Act (16 U.S.C. 1801, et seq.) as amended by
Public Law 109-479; 3) Responses to this information request are confidential under section 402(b) of the MagnusonStevens Act. They are also confidential under NOAA Administrative Order 216-100, which sets forth procedures to
protect confidentiality of fishery statistics.
_____________________________________________________________________________________________

Amendment 80 Limited Access Fishery Permit Application
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OMB Control No.: 0648-xxxx
Expiration Date: mm/dd/yyyy

Instructions for completion of the
Amendment 80 limited access fishery application
This completed application must be received by NMFS no later than 1700 hours A.l.t. on November 1 of the
year prior to the year for which the applicant wishes to participate in a Amendment 80 fishery, or if sent by
U.S. mail, the application must be postmarked by that time.
An Amendment 80 limited access fishery permit is required for an Amendment 80 QS holder to catch, process,
and receive Amendment 80 species assigned to the Amendment 80 limited access fishery, or use halibut and
crab PSC assigned to the Amendment 80 limited access fishery.
An Amendment 80 limited access fishery permit is issued annually to an Amendment 80 QS holder who has
submitted:
● A timely and complete application for the Amendment 80 limited access fishery as described
at § 679.91(b)(4) that is approved by NMFS; and
●

A timely and complete EDR for all Amendment 80 QS permits held by that person as described
under § 679.94 that is subsequently approved by NMFS.

An Amendment 80 limited access fishery permit is valid until whichever of the following occurs first:
●

Until the end of the year for which the Amendment 80 limited access fishery permit is issued; or

●

Until the permit is revoked, suspended, or modified pursuant to § 679.43 or under
15 CFR part 904.

A legible copy of the Amendment 80 limited access fishery permit must be carried onboard an Amendment 80
vessel assigned to the Amendment 80 limited access fishery when fishing in the BSAI or adjacent waters open
by the State of Alaska for which it adopts a Federal fishing season.
Type or print legibly in ink; retain a copy of completed application for your records.
Completed forms should be mailed or faxed to:
NMFS Alaska Region
Restricted Access Management
P.O. Box 21668
Juneau, AK 99802-1668
FAX: (907) 586-7354
If you need additional information, contact Restricted Access Management at (800) 304-4846 (#2)
or (907) 586-7202 (#2).
Please allow at least 10 working days for your application to be processed. Items will be sent by first class
mail, unless you provide alternate instructions and include a prepaid mailer with appropriate postage or
corporate account number for express delivery.
BLOCK A -- APPLICANT IDENTIFICATION
Applicant name and NMFS person ID
Permanent business mailing address

Business telephone number, business fax number, and e-mail address (if available)
Amendment 80 Limited Access Fishery Permit Application
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OMB Control No.: 0648-xxxx
Expiration Date: mm/dd/yyyy

BLOCK B -- AMENDMENT 80 VESSEL IDENTIFICATION
Name, ADF&G vessel registration number, and USCG number of the Amendment 80 vessel(s)
owned by applicant
BLOCK C – AMENDMENT 80 LLP IDENTIFICATION
List the Amendment 80 LLP license number(s) held by the applicant.
BLOCK D – AMENDMENT 80 QS PERMIT INFORMATION
List the Amendment 80 QS permit number(s) held by the applicant.
BLOCK E – AMENDMENT 80 OWNERSHIP DOCUMENTATION
Amendment 80 QS Permit Holder and Ownership Documentation
Full name and NMFS Person ID of all members of the Amendment 80 cooperative
Amendment 80 QS Permit Number(s)
Enter the names of all persons, to the individual level, holding an ownership interest in the
Amendment 80 QS Permit Number(s) assigned to the Amendment 80 cooperative and
the percentage ownership each person and individual holds in the Amendment 80 QS Permit(s).
If the Amendment 80 QS Permit Holder is a non-individual (i.e., a corporation, partnership or other entity),
provide the names of, and the percentage of ownership held by, all of its owners. Information should be
provided to the individual level. See example below:
Name of Owner

% Interest

Joe Potpuller

25%

Alice Potpuller

25%

LLP Family Holdings, Inc.

50%

C. A80QSholder

25% (of 50%)

R. A80QSholder

25% (of 50%)

A. A80QSholder

25% (of 50%)

B. A80QSholder

25% (of 50%)

BLOCK F – EDR SUBMISSION
Indicate (YES or NO) whether the applicant has submitted a timely and complete EDR for
each Amendment 80 QS permit held by that person as required under § 679.94.
BLOCK G -- APPLICANT CERTIFICATION
The applicant must sign and date the application certifying that all information is true, correct, and
complete to the best of his/her knowledge and belief. If the application is completed by a designated
representative, then explicit authorization signed by the applicant must accompany the application.

Amendment 80 Limited Access Fishery Permit Application
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