Pacific Whiting Vessel License Application

OMB 0648-0583 Expires: 1/31/2012

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UNITED STATES DEPARTMENT OF COMMERCE
National Oceanic and Atmospheric Administration
National Marine Fisheries Service, Northwest Region
Fisheries Permits Office
7600 Sand Point Way NE, Bldg. 1
Seattle, WA 98115-0070
Phone: (206) 526-4353

Fax: (206) 526-4461

www.nwr.noaa.gov

INSTRUCTIONS
Please complete one application for each vessel you wish to qualify for a Pacific Whiting Vessel License.
SECTION A – Sector Qualification: Designate which sector(s) endorsement the vessel qualifies for in the Pacific
Whiting fishery.
SECTION B - Vessel Information/Vessel Owner Information/Certification: Provide the current vessel name and
vessel official number (USCG documentation number). If the vessel is registered to Pacific Coast Groundfish Limited
Entry Permit, please include the permit number. Please provide the vessel owner name (as registered with USCG), the
vessel owner business address (street or P.O. Box), city, state, and zip code, and business phone number and fax
number.
An authorized representative of the vessel owner must sign and date the application in the presence of a notary. Please
print the name of the individual signing the application. The application must be notarized by notary public registered in
the United States. If the applicant fails to sign, date and have the document notarized, NMFS will consider the application
to be incomplete and will not review it. By signing this document, the authorized representative certifies that all
information provided in the application true, correct and complete, including any supplemental documentation.
SECTION C – Proof of Participation Date and Amount of Whiting Landed, Delivered, Received, or
Caught/Processed by Vessel: In this section, there are listings for the four different whiting vessel sectors and the
corresponding qualifying years of participation in the whiting fishery for each sector. For each applicable sector, the
applicant must provide one date during a qualifying year where whiting was landed, delivered, received/processed or
caught/processed by the vessel named in Section A and provide the total amount of whiting landed, delivered,
received/processed or caught/processed on that date. For catcher vessels that delivered to a mothership, please provide
the name and documentation number for the mothership that received the whiting specified in this section. For catcher
vessels that landed whiting at a first receiver, please provide the name of the first receiver and the location of the landing
specified in this section. If you are providing a fish ticket as verification of the landing, please provide the fish ticket
number and state that issued the fish ticket. The fish ticket provided must demonstrate that the gear used was mid-water
trawl, the landing occurred during the primary season and that whiting made up more than 50% of the total landing by
weight. For motherships, please provide the name and documentation number of the vessel that made the delivery
specified in this section. Whiting harvested or processed by a vessel that has since been totally lost, scrapped, or rebuilt
(with a new vessel documentation number) will not be considered for this license. Whiting caught or processed illegally or
landed illegally will not be considered for this license. Catch and/or processing history associated with a vessel
purchased by through the Pacific Coast groundfish capacity reduction program (68 FR 62435-62440 – November 4, 2003)
will not be considered in meeting the qualification criteria.
SUPPLEMENTAL DOCUMENTATION: The applicant must provide documentation (i.e.; state fish receiving ticket, final
observer report, a signed copy of a daily receipt of fish and cumulative production logbook, bill of lading) that provides
proof of the amount (in pounds) of whiting either landed, delivered, received or caught/processed for the date given in
Section C. This documentation must provide a date of landing or processing, indicate the vessel that landed or processed
the whiting, and clearly show that whiting was landed or processed species and the amount of whiting in pounds for the
given date. If the supplemental documentation is not provided as specified above, NMFS will consider the application to
be incomplete and will not review it. NMFS may request a current copy of USCG Certificate of Vessel Documentation and
other such relevant and credible documentation as it deems necessary.
DEADLINE: Your application must be received at the address given above no later than March 30, 2009. Any
application received after March 30, 2009 will not be processed by NMFS and returned to the applicant.
PACIFIC WHITING VESSEL LICENSE APPLICATION - PAGE 1

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OMB Control No. 06480583 Expires on 1/31/2012

UNITED STATES
ES DEPARTMENT OF COMMERCE

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VESSEL LICENSE
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National Oceanic and Atmospheric Administration
National Marine Fisheries Service, Northwest Region
Fisheries Permits Office
7600 Sand Point Way NE, Bldg. 1
Seattle, WA 98115-0070

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Phone: (206) 526-4353

Fax: (206) 526-4461

www.nwr.noaa.gov

SECTION A – SECTOR QUALIFICATION
Indicate which sector(s) endorsement the vessel is applying for. Check all that apply.

“ Catcher Vessel - Shoreside
“ Catcher Vessel – Mothership
“ Mothership
“ Catcher Processor
SECTION B – VESSEL INFORMATION/VESSEL OWNER CERTIFICATON
Permit Number (if applicable)

Vessel Name

USCG Doc or State Registration Number

GF
Current Vessel Owner Name(s) (Last, First, Middle Name or Business Name)
Business Name

Last

Business Mailing Address

First

Middle Name

( Street or PO Box)

Business Phone

(

)

Business Fax (optional)

(
City

State

Zip Code

)

Business Email (optional)

The remainder of Section B must be completed by a notary to certify that
the individual(s) signing this form have satisfactorily identified themselves.
Under penalties of perjury, I hereby declare that I, the undersigned, completed this application, and the information contained herein is true, correct,
and complete to the best of my knowledge and belief.
Signature of Applicant or Authorized Representative (See Note 1)

Date

Printed Name of Applicant or Authorized Representative (NOTE: If form completed by a representative, attach authorization.)

Notary Public Signature

“

ATTEST

Date Commission Expires

PACIFIC WHTING VESSEL LICENSE APPLICATION – PAGE 2 OF 4

Affix Notary Stamp or Seal Here

OMB Control No.0648-0583; Expires 1/31/2012

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UNITED STATES
ES DEPARTMENT OF COMMERCE
National Oceanic and Atmospheric Administration
National Marine Fisheries Service, Northwest Region
Fisheries Permits Office
7600 Sand Point Way NE, Bldg. 1
Seattle, WA 98115-0070
Phone: (206) 526-4353

Fax: (206) 526-4461

www.nwr.noaa.gov

Section C –Date of Participation and Amount of Whiting Landed, Delivered,
Received/Processed or Caught/Processed
For all applicable vessel sectors, provide for the vessel named in Section A one date during qualifying years when whiting was landed,
delivered, received/processed or caught/processed and the total amount of whiting landed, delivered , received or caught/ processed on
that date. You must submit record to verify the amount(s) for the date(s)( indicated below.

Catcher Vessels Landing at First Receivers (shoreside facility) Sector
(Qualifying Years January 1, 1994 - January 1, 2007)
Provide one date in a qualifying year when the vessel named in Section A made a landing of whiting during the primary
season with midwater gear and the amount of whiting exceeds 50% of the total landing by weight(mm/dd/yyyy):
_________________
Provide the total amount of whiting delivered by the vessel for the landing
made on the date given above: __________________________________________________
Provide First Receiver Name/Location (city/state): ____________________________________
Fish Ticket Number/State (i.e.; #12345/WA): ________________________________________
Catcher Vessels Delivering to Mothership Sector
(Qualifying Years January 1, 1997 – January 1, 2007)
Provide one date in qualifying year when the vessel named in Section A made
a whiting delivery to a mothership (mm/dd/yyyy): _____________
Provide the total amount of whiting delivered by the vessel on the date given above: _________________
Name/USCG Official Number of Mothership receiving whiting from catcher vessel:__________________________
Mothership Sector
(Qualifying Years January 1, 1997 – January 1, 2007)
Provide one date in a qualifying year when the vessel named in Section A received and processed
a delivery of whiting (mm/dd/yyyy): _____________
Provide the total amount of whiting received and processed for the date given above: ______________
Name/USCG Official Number of catcher vessel that delivered whiting to the mothership:______________________
Catcher Processor Sector
(Qualifying Years January 1, 1997 – January 1, 2007)
Provide one date in a qualifying year when the vessel named in Section A
Caught and processed whiting (mm/dd/yyyy): _____________
Provide the total amount of whiting caught and processed for the date given above: _________________
NOTE: For each applicable sector, the applicant is required to provide documentation (i.e.; state fish receiving ticket,
final observer report, a signed copy of a daily receipt of fish and cumulative production logbook, bill of lading) that
provides proof of the date of participation in the Pacific Whiting fishery by the applicant vessel and the amount (in
pounds) of whiting landed, delivered, received, or caught/processed on that date.

PACIFIC WHTING VESSEL LICENSE APPLICATION- PAGE 3

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OMB Control No.0648-0583; Expires 1/31/2012

DEADLINE: Your application must be received at the address given above no later than March 30, 2009. Any
application received after March 30, 2009 will not be processed by NMFS and returned to the applicant.
WARNING STATEMENT: A false statement on this form is punishable by permit sanctions (revocation, suspension, or modification) under 15 CFR 904,
a civil penalty of up to $100,000 under 16 USC 1858, and as a federal crime under 18 USC 1001.
PRA STATEMENT: Public reporting burden for this collection of information is estimated to average 45 minutes per response, including the time for
reviewing the 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 aspect of this collection of information, including suggestions for reducing the
burden, to NOAA/National Marine Fisheries Service, Northwest Region, Attn: Assistant Regional Administrator, Sustainable Fisheries Division, 7600
Sand Point Way NE, Seattle, WA 98115.
Sustainable Fisheries Privacy Act Statement: This information is collected under the authority of the Magnuson-Stevens Fishery Conservation and
Management Act. The information is used to verify the identity of the applicant(s) and to accurately retrieve confidential records related to federal
permits.
The TIN (EIN or SSN) is collected under the authority of the Debt Collection Improvement Act of 1996 (Public Law 104-134).The primary purpose for
requesting the TIN (EIN or SSN) is for the collection and reporting on any delinquent amounts arising out of such person’s relationship with the
government pursuant to the Debt Collection Improvement Act of 1996 (Public Law 104-134). Reporting of the TIN (EIN or SSN) is mandatory, and permit
applications, renewals and transfer requests will not be processed without this information. Personally identifiable information is confidential and
protected under the Privacy Act (5 U.S.C. 552a). Business information may be disclosed to the public.
The information will be subject to the following routine uses:
In addition to those disclosures generally permitted under 5 U.S.C. 552a (b) of the Privacy Act, these records or information contained therein may
specifically be disclosed outside the Department of Commerce (Department). These records or information contained therein may specifically be
disclosed as a routine use as stated below. The Department will, when so authorized, make the determination as to the relevancy of a record prior to its
decision to disclose a document.
1. In the event that a system of records maintained by the Department to carry out its functions indicates a violation or potential violation of
law or contract, whether civil, criminal or regulatory in nature and whether arising by general statute or particular program statute or contract, or rule,
regulation or order issued pursuant thereto, or the necessity to protect an interest of the Department, the relevant records in the system of records may
be referred to the appropriate agency, whether Federal, State, local or foreign, charged with the responsibility of investigation or prosecuting such
violation or charged with enforcing or implementing the statute or contract, or rule, regulation or order issued pursuant thereto, or protecting the interest
of the Department.
2. A record from this system of records may be disclosed in the course of presenting evidence to a court, magistrate or administrative tribunal,
including disclosures to opposing counsel in the course of settlement negotiations.
3. A record in this system of records may be disclosed to a Member of Congress submitting a request involving an individual when the
individual has requested assistance from the Member with respect to the subject matter of the record.
4. A record in this system of records may be disclosed to the Department of Justice in connection with determining whether the Freedom of
Information Act (5 U.S.C. 552) requires disclosure thereof.
5. A record in this system will be disclosed to the Department of Treasury for the purpose of reporting and recouping delinquent debts owed
the United States pursuant to the Debt Collection Improvement Act of 1996.
6. A record in this system may be disclosed to the Department of Homeland Security for the purposes of determining the admissibility of
certain seafood imports into the United States.
7. A record in this system of records may be disclosed to a contractor of the Department having need for the information in the performance of
the contract, but not operating a system of records within the meaning of 5 U.S.C. 552a(m).
8. A record in this system of records may be disclosed to approved persons at the state or interstate level within the applicable Marine
Fisheries Commission for the purpose of co-managing a fishery or for making determinations about eligibility for permits when state data are all or part of
the basis for the permits.
9. A record in this system of records may be disclosed to the applicable Fishery Management Council (Council) staff and contractors tasked
with development of analyses to support Council decisions about Fishery Management Programs.
10. A record in this system of records may be disclosed to the applicable NMFS Observer Program for purposes of identifying current permit
owners and vessels and making a random assignment of observers to vessels in a given fishing season.
11. A record in this system of records may be disclosed to the applicable Regional or International Fisheries Management Body for the
purposes of identifying current permit owners and vessels pursuant to applicable statutes or regulations and/or conservation and management measures
adopted by a Regional or International Fisheries Management Body: the Food and Agriculture Organization of the United Nations, Commission for the
Conservation of Antarctic Marine Living Resources, Inter-American Tropical Tuna Commission, International Pacific Halibut Commission, International
Commission for the Conservation of Atlantic Tunas.
12. A record in this system of records may be disclosed to appropriate agencies, entities, and persons when (1) it is suspected or confirmed
that the security or confidentiality of information in the system of records has been compromised; (2) the Department has determined that as a result of
the suspected or confirmed compromise there is a risk of harm to economic or property interests, identity theft or fraud, or harm to the security or
integrity of this system or other systems or programs (whether maintained by the Department or another agency or entity) that rely upon the
compromised information; and (3) the disclosure made to such agencies, entities, and persons is reasonably necessary to assist in connection with the
Department’s efforts to respond to the suspected or confirmed compromise and prevent, minimize, or remedy such harm.

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