Federal Northeast Region Seafood Dealer: Initial Dealer

United States Department of Commerce

National Oceanic and Atmospheric Administration
National Marine Fisheries Service
Northeast Region
One Blackburn Drive
Gloucester, MA 01930

Federal Northeast Seafood Dealer
Initial Dealer Permit Application
SECTION 1 - DEALER INFORMATION
Southeast Dealer # (if available) _________
__

Company name:
__

Owner’s Name:

___
___
___

Street Address:
State:

City:

Zip Code:
Fax Number:

Telephone:

___
___

**Vessel Name:
___
**Vessel Hull Number:
**(if you are applying for an Atlantic Mackerel at Sea Processor permit, you must enter a vessel
name and hull number above and include a copy of the vessel’s current Coast Guard
Documentation or State Registration.)

If regulated species are purchased or received for commercial purposes at more than one place of business, each
address must be listed. List those additional addresses on the back of this form in Section 1A.
SECTION 2 - FISHERIES
Select the fisheries desired by placing an (X) in the boxes provided. Select all fisheries that apply.
Atlantic bluefin tuna

Northeast multispecies

Scup

Other Atlantic Tunas
(Yellowfin, Bigeye, Skipjack,

American lobster

Black sea bass

Albacore)

Skate

Monkfish

Surfclam/Ocean quahog - Dealer

**Atlantic mackerel at sea
processor

Atlantic bluefish

Surfclam/Ocean quahog - Processor

Squid, Atlantic mackerel, butterfish

Spiny Dogfish

Summer flounder

Atlantic herring - Dealer

Tilefish

Atlantic sea scallop

Atlantic herring - Processor

Atlantic Deepsea Red Crab

Atlantic hagfish

** (see note in Section 1)

SECTION 3 - OWNER'S NAME AND SIGNATURE
I affirm, subject to the penalties provided in 18 USC 1001, that all information I have given in obtaining this
permit is true and correct.
Print Name: __________________________
Signature:

Date: _________________
Revised: 05/15/2007 OMB Control No.: 0648-0202 Expiration Date: 11/30/2009

SECTION 1A - ADDITIONAL DEALER INFORMATION. If regulated species are purchased or received for
commercial purposes at more than one place of business, each address must be listed below.
Company Address
Street:
City:

State:

Zip:

State:

Zip:

State:

Zip:

State:

Zip:

Telephone:
Company Address
Street:
City:
Telephone:
Company Address
Street:
City:
Telephone:
Company Address
Street:
City:
Telephone:

For further information, call Northeast Permits Operations at (978) 281-9370
The information requested on this form is not confidential and will be available to the general public upon request.
The Paperwork Reduction Act requires potential respondents for a dealer/processor permit be notified of certain
information regarding their rights and the burden associated with applying for a Federal dealer/processor permit.
One of the regulatory steps taken by the National Marine Fisheries Service (NMFS) to carry out conservation and
management objectives is the requirement of a permit for users of the resources. All the fisheries included on this
application require a permit to purchase, or otherwise receive for transport, species harvested by the owner or
operator of a fishing vessel issued a Federal fisheries permit for these species. Section 303(b)(1) of the MagnusonStevens Fishery Conservation and Management Act (MSFCMA) specifically recognizes the need for permit issuance.
The purpose and use of permits is to: (1) register fish dealers and processor, (2) list the characteristics of
dealer/processor operations, (3) exercise influence over compliance (e.g. withhold issuance pending collection of
unpaid penalties), (4) provide a mailing list for the dissemination of important information to the industry, (5)
provide a universe for data collection samples, and (6) obtain first purchase information on landings to evaluate the
biological, economic and social implications of management measures.
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. Public reporting
burden for this collection of information is estimated to average 15 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: National Marine Fisheries Service, Permit Office, One Blackburn Drive, Gloucester, MA 01930-2298.
Revised: 05/15/2007 OMB Control No.: 0648-0202 Expiration Date: 11/30/2009