High Seas Fishing Permit Application

U.S. DEPARTMENT OF COMMERCE
NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION
NATIONAL MARINE FISHERIES SERVICE

OMB Control No. 0648-0304
Expiration Date: 06/30/2008

HIGH SEAS FISHING PERMIT APPLICATION
SECTION 1. VESSEL INFORMATION (please print legibly or type)
USCG DOC. OR STATE REG. NO

VESSEL NAME

CREW SIZE (INCLUDING OFFICERS)

SHAFT HORSEPOWER

RADIO CALL SIGN

REFRIGERATION TYPE: (Check only one or write in)
[ ] ICE

[ ] BRINE

[ ] BLAST [ ] PLATE [ ] TUNNEL [ ] RSW

OTHER (write in):____________________________

FISHING VESSEL TYPE (Check the box for the vessel type that best describes your vessel. Check only one)
LONGLINERS
OTHER LINERS
PURSE SEINERS
[ ] 0623 – Freezer Longliner
[ ] 0705 – Jigging Line Vessels (for
[ ] 0228 – Tuna Purse Seiner
squid only)
[ ] 0624 – Factory Longliner
[ ] 0229 – Purse Seiner Other
[ ] 0710 – Handliner
[ ] 0626 – Tuna Longliner
GILL NETTERS
[ ] 0720 – Pole and Line Vessel
[ ] 0410 – Drift Netters
[ ] 0627 – Longliner Other
[ ] 0730 – Troller
[ ] 0490 – Gill Netter Other

SECTION 2. AUTHORIZED HIGH SEAS FISHING ACTIVITIES (Check all that apply)
Using as a reference the attached list of Authorized High Seas Fishing Activities, check those under which you intend to
fish on the high seas. You must select at least one; however, check only those under which you will actually fish. You are
responsible for meeting the reporting requirements for all you select.

[ ] 50 CFR 635 – Atlantic Highly Migratory Species
[ ] 50 CFR 660, Subpart K – Pacific Highly Migratory Species Fisheries
[ ] 50 CFR 665, Subpart C – Western Pacific Pelagic Fisheries
[ ] South Pacific Albacore Troll Fishing
[ ] 50 CFR 300, Subpart C – Pacific Tuna Fisheries
50 CFR 300, Subpart D – South Pacific Tuna Fisheries
50 CFR 300, Subpart G – Antarctic Marine Living Resources

SECTION 3. VESSEL OWNERSHIP INFORMATION
Managing Owner as shown on USCG Form 1270 or
State Registration
Company Name (If vessel is incorporated)
Owner Name
Last

First

Middle

Date Incorporation Filed
Month
Day
Year

Suffix
Month

Mailing Address

City

Phone #

Tax Identification
Number

Date of Birth
Day
Year
State

Zip code

Fax #

SECTION 4. VESSEL OPERATOR INFORMATION
Operators Name
Last

First

Mailing Address

Phone #

Middle

Suffix

Month

City

Date of Birth
Day
Year
State

Zip code

Fax #

SECTION 5. VESSEL STATUS
Has the vessel identified above flown the flag of another nation within the last three years? YES________.
NO__________.
If yes, provide the following information for each period during which the vessel operated under other than the U.S flag:
Period: Beginning mm-dd-yyyy; End mm-dd-yyyy, Vessel Name, Flag, International Radio Call Sign, Homeport,
Owner Name, Address, Phone, Fax; Operator Name, Address, Phone, Fax (If necessary provide additional information
on a separate
sheet of paper)
Has the vessel identified above, under its current name/flag, or any previous names/flags, had any permit or license
suspended or
revoked within the past three years?
YES_________________ NO_______________ If yes, list and attach on a separate sheet of paper the circumstances
surrounding each such instance and include an explanation of the current status of the suspension or revocation.

SECTION 6. SIGNATURE (All applications must be signed and dated)
By signing this application, the undersigned owner or operator of the vessel identified above, declares under penalty of
law that all information in this application is true, accurate and complete. A non-refundable application fee of $67.00 in the
form of a check or money order made payable to “U.S. Department of Commerce – NOAA” must accompany
each application.

Signature

Name (Print legibly or type)

Date:

Submission of application information is mandatory in order to be considered for a permit and is used in determining if a
permit should be issued. The
public reporting burden for this collection of information is estimated to average 30
minutes per response, including time for reviewing instructions, searching existing data sources, gathering and
maintaining data needed, and completing and reviewing the information. Send comments regarding this burden estimate
or suggestions for reducing this burden to : NMFS, Office of International Affairs, 1315 East West Highway, Silver Spring,
MD 20910. 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.
Your Social Security Number (SSN) is confidential and is protected under the Privacy Act. Disclosure of your SSN is
mandatory. The primary purpose for requiring the SSN and TIN is to verify the identity of individuals/entities doing
business with the government as required by the Debt Collection Improvement Act of 1996 (Public Law 104-134).

INSTRUCTIONS FOR HIGH SEAS FISHING PERMIT APPLICATION
SECTION 1. VESSEL INFORMATION
Enter the U.S. Coast Guard Official Documentation Number assigned to the vessel. Also, attach to the application
form a photocopy of the vessel’s current documentation (Form CG-1270). Include copy of current decal
endorsement, if necessary, as proof of existence of current documentation. If the vessel is not USCG documented,
enter the vessel’s current state or tribal registration number and attach a copy of the vessel’s current state or tribal
registration. Insure that all photocopies are completely legible.
Enter the current name of the vessel.
Enter the radio call sign currently assigned to the vessel.
Enter the number of crew members and officers the vessel normally carries. Enter
shaft horsepower.
Indicate refrigeration type.
Indicate fishing vessel type that best describes your vessel. Check only one box.
SECTION 2. AUTHORIZED HIGH SEAS FISHING ACTIVITIES
Using as a reference the attached list of Authorized High Seas Fishing Activities, indicate those under which you
will fish on the high seas. Indicate only those under which you will actually fish. You are responsible for
meeting the reporting requirements for all you select.
SECTION 3. VESSEL OWNERSHIP INFORMATION
If the vessel is owned by a corporation, enter the company name, date of incorporation, tax identification number,
business address and voice and fax phone numbers. Attach a copy of the certificate of incorporation.
If the vessel is owned by an individual or partnership, enter the names of all owners, date of birth for each owner,
and address and telephone information for each owner (if more than one owner, attach required information for
each additional owner on separate paper). If a partnership, attach a copy of the partnership agreement.
SECTION 4. VESSEL OPERATOR INFORMATION
Enter the name, date of birth and address and telephone information for the vessel operator.
SECTION 5. VESSEL STATUS
Indicate whether the vessel has flown the flag of a nation other than the United States within the last three years. If
yes, provide the additional information requested.
Indicate whether the vessel, under its current or any previous names/flags, had any permit or license suspended or
revoked within the past three years. If yes, provide the additional information requested.
SECTION 6. SIGNATURE
Sign and print your name and enter the date the application was signed. Be sure to include your application fee of
$67.00 in the form of a check or money order made payable to the “U.S. Department of Commerce – NOAA.”