Northeast Region VMS Installation Certification form (co

NMFS NORTHEAST VESSEL MONITORING PROGRAM
FISHING VESSEL NAME: _____________________________________________________
NMFS FISHERIES PERMIT NUMBER: ___________________________________________
COAST GUARD DOCUMENTATION/STATE REGISTRATION NUMBER: ________________
MONITORING FOR (CIRCLE ALL THAT APPLY):
SCALLOP

MULTISPECIES

MONKFISH

HERRING

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YOU ARE REQUIRED TO CALL THE NOAA FISHERIES SERVICE NORTHEAST
REGION VMS TEAM AT (978) 281-9213 BEFORE COMPLETING AND MAILING
THIS FORM, AND BEFORE TAKING YOUR FIRST FISHING TRIP. THE VMS
TEAM WILL VERIFY THAT YOUR VMS UNIT IS POSITIONING AND THAT
POSITION REPORTS AND A TEST DECLARATION ARE BEING RECEIVED BY
NOAA FISHERIES SERVICE OFFICE OF LAW ENFORCEMENT.
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*** PLEASE COMPLETE THIS FORM BY PROVIDING ALL REQUESTED INFORMATION ***
I CERTIFY THAT SUBJECT FISHING VESSEL HAS AN OPERATIONAL VMS UNIT INSTALLED BY:
PURCHASED FROM:

BOATRACS ____

SKYMATE ____

INSTALLING DEALER:

NAME, ADDRESS AND TELEPHONE NUMBER:

THRANE & THRANE ____

________________________________________________________________
________________________________________________________________
________________________________________________________________

DATE OF INSTALLATION:

________________________________________________________________

SERIAL NUMBER OF VMS UNIT: ______________________________________________________________
E-MAIL ADDRESS OF VESSEL: _______________________________________________________________
VMS UNIT ACTIVATED ON VESSEL AND READY TO SEND FISHING ACTIVITY CODES?

† YES

† NO

VMS UNIT OPERATING INSTRUCTIONS SENT TO VESSEL OWNER BY VMS VENDOR?

† YES

† NO

VESSEL OWNER TRAINED ON USE OF VMS UNIT BY VMS VENDOR?

† YES

† NO

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I UNDERSTAND THAT THE VMS UNIT MUST REMAIN CONNECTED TO THE VMS VENDOR LISTED ABOVE
AT ALL TIMES. I ALSO UNDERSTAND THAT I AM SUBJECT TO THE PROVISIONS AND REQUIREMENTS
OF 50 CFR §648.9 AND §648.10 REGARDING USE OF THE VMS. I HAVE RECEIVED INSTRUCTIONS
FROM THE VMS VENDOR LISTED ABOVE AND UNDERSTAND HOW TO OPERATE THE VMS UNIT.

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PERMIT HOLDER’S NAME (printed): ___________________________________
PERMIT HOLDER’S SIGNATURE:

DATE:

_______________

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SEND THIS ORIGINAL, COMPLETED FORM TO:
NOAA FISHERIES
NE OFFICE OF LAW ENFORCEMENT
1 BLACKBURN DRIVE, ROOM 206
GLOUCESTER, MA 01930
ATTN: VMS PROGRAM
or fax to 1-978-281-9317
OMB# 0648-0202

Expires 11/30/2009

Public reporting burden for this collection of information is estimated to average 7 minutes per
response, including time for reviewing instructions, searching existing data sources, gathering
and maintaining data needed, and completing and reviewing the collection of information. Send
comments regarding this burden estimate or suggestions for reducing this burden to: Patricia A.
Kurkul, Regional Administrator, Northeast Region, NMFS, 1 Blackburn Drive, Gloucester, MA
01930-2298; and to Office of Information and Regulatory Affairs, Office of Management and
Budget, Washington, DC 20503.
The information will be used in the management of the Atlantic sea scallop, Northeast
multispecies, monkfish and herring fisheries by insuring compliance with VMS regulations listed
under 50 CFR §648.9 and §648.10 (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. Any
information submitted by any person to obtain a permit is not confidential, and may be disclosed
upon request.

Revised: December 15, 2006