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pdfOMB Control No. 0648-0393
Expiration Date: 06/30/2009
Revised: 02/03/2009
Application for
American Fisheries Act (AFA)
INSHORE CATCHER VESSEL
COOPERATIVE PERMIT
United States Department of Commerce
NOAA/National Marine Fisheries
Service (NMFS)
Restricted Access Management (RAM)
P.O. Box 21668
Juneau, Alaska 99802-1668
Due December 1 of the year prior to the year for which the co-op permit will be in effect.
Late applications will not be accepted.
1. Name of Cooperative:
BLOCK A - COOPERATIVE CONTACT INFORMATION
2. Name of Cooperative Representative:
5. Co-op Business Mailing Address (P.O. box or street, city, state, zip code): [ ] Permanent [ ] Temporary
6. Business Telephone No.:
7. Business Fax No.:
8. E-mail Address (if available):
BLOCK B - DESIGNATED COOPERATIVE PROCESSOR INFORMATION
Provide the following information for the AFA Inshore Processor who is designated in the cooperative contract as the
processor to whom the cooperative has agreed to deliver at least 90 percent of its Bering Sea and Aleutian Islands
Management Area (BSAI) pollock catch
1. Name:
2. Physical location of AFA Inshore Processor:
3. Federal Processor Permit Number:
Application for AFA Inshore Catcher Vessel Cooperative Permit
Page 1 of 6
OMB Control No. 0648-0393
Expiration Date: 06/30/2009
BLOCK C - COOPERATIVE CONTRACT INFORMATION
This application is not valid and cannot be processed without the submission of a copy of the co-op contract and certification.
Have you attached:
(1) A copy of the cooperative contract or a renewal letter providing notice that a previously
filed cooperative contract will remain in effect for the subsequent fishing year. Renewal
letters must include the details of any material modifications to the cooperative contract
since it was last filed with NMFS.
Yes [
] No [
]
(2) A written certification that:
♦
The contract was signed by the owners of at least 80 percent of the qualified catcher
vessels;
Yes [
] No [
]
♦
The cooperative contract requires that the cooperative deliver at least 90 percent of
its BSAI pollock catch to its designated AFA processor; and
Yes [
] No [
]
♦
Each catcher vessel in the cooperative is a qualified catcher vessel as defined in
50 CFR 679.4(l)(6)(ii)(D)(1) if it meets the following permit requirements:
Yes [
] No [
]
Yes [
] No [
]
•
AFA permit. The vessel must have a valid AFA catcher vessel permit with an
inshore endorsement;
•
LLP permit. The vessel must be named on a valid License Limitation Permit
(LLP) permit authorizing the vessel to engage in trawling for pollock in the
Bering Sea subarea. If the vessel is more than 60 feet (18.3 m) length overall
(LOA), the vessel must be named on a valid LLP permit endorsed for the
Aleutian Islands (AI) to engage in trawling for pollock in the AI; and
•
Permit sanctions. The vessel has no permit sanctions that otherwise make it
ineligible to engage in fishing for pollock in the BSAI.
(3) A copy of a letter requesting a business review letter on the fishery cooperative from the
Department of Justice and any response to such request?
BLOCK D - VESSEL INFORMATION
List all co-op member catcher vessels. List complete information for each co-op catcher vessel member
(attach additional pages if necessary).
1. Vessel Name:
2. ADF&G No.:
3. USCG No.:
4. AFA Permit No.:
1. Vessel Name:
2. ADF&G No.:
3. USCG No.:
4. AFA Permit No.:
1. Vessel Name:
2. ADF&G No.:
3. USCG No.
4. AFA Permit No.:
Application for AFA Inshore Catcher Vessel Cooperative Permit
Page 2 of 6
OMB Control No. 0648-0393
Expiration Date: 06/30/2009
1. Vessel Name:
2. ADF&G No.:
3. USCG No.:
4. AFA Permit No.:
1. Vessel Name:
2. ADF&G No.:
3. USCG No.:
4. AFA Permit No.:
1. Vessel Name:
2. ADF&G No.:
3. USCG No.:
4. AFA Permit No.:
1. Vessel Name:
2. ADF&G No.:
3. USCG No.:
4. AFA Permit No.:
1. Vessel Name:
2. ADF&G No.:
3. USCG No.:
4. AFA Permit No.:
1. Vessel Name:
2. ADF&G No.:
3. USCG No.:
4. AFA Permit No.:
1. Vessel Name:
2. ADF&G No.:
3. USCG No.:
4. AFA Permit No.:
1. Vessel Name:
2. ADF&G No.:
3. USCG No.:
4. AFA Permit No.:
1. Vessel Name:
2. ADF&G No.:
3. USCG No.:
4. AFA Permit No.:
Application for AFA Inshore Catcher Vessel Cooperative Permit
Page 3 of 6
OMB Control No. 0648-0393
Expiration Date: 06/30/2009
BLOCK E - CERTIFICATION OF NOTARY AND APPLICANT
Under penalty of perjury, I declare that I have examined this application, and to the best of my knowledge and belief, the
information presented hereon is true, correct, and complete.
1. Signature of Co-op Representative:
2. Date:
3. Printed Name of Co-op Representative:
4. Notary Public (Signature)
ATTEST
6. Affix Notary Stamp or Seal Here
5. Commission Expires
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 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 Sue Salveson, Assistant Regional Administrator, Sustainable Fisheries Division, Alaska Region, NMFS, P.O. Box 21668, Juneau, AK 998021668.
ADDITIONAL INFORMATION
Before completing this form please note the following: 1) The NMFS may not conduct or sponsor this information request, and you are not required
to respond to this information request, unless the form displays a currently valid OMB control number; 2) This information is being used to
implement the American Fisheries Act; 3) Federal law and regulations require and authorize NMFS to manage commercial fishing effort; 4)
Submission of this information is required of persons seeking to participate in the groundfish fisheries under authority of AFA; 5) This information
is mandatory and is required to manage commercial fishing effort under 50 CFR part 679 and under section 402(a) of the Magnuson-Stevens Act (16
U.S.C. 1801, et seq.); 6) Responses to this information request are confidential under section 402(b) of the Magnuson-Stevens Act (16 U.S.C. 1801,
et seq.). They are also confidential under NOAA Administrative Order 216-100, which sets forth procedures to protect confidentiality of fishery
statistics.
Application for AFA Inshore Catcher Vessel Cooperative Permit
Page 4 of 6
OMB Control No. 0648-0393
Expiration Date: 06/30/2009
Instructions
APPLICATION FOR AMERICAN FISHERIES ACT (AFA)
CATCHER VESSEL INSHORE CO-OP PERMIT
IMPORTANT! This inshore co-op permit application and any amendments that add or delete co-op member
vessels must be received by National Marine Fisheries Service (NMFS), Restricted Access Management
(RAM) by December 1 of the year prior to the year for which the co-op permit will be in effect. Late
applications will NOT be accepted.
Type or print legibly in ink; retain a copy of completed application for your records. Mail completed forms to:
NMFS Alaska Region, RAM,
P.O. Box 21668,
Juneau, AK 99802-1668.
Due to the requirement for a notarized signature, we will not process applications faxed to us.
If you need additional information, call RAM toll free 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 a corporate account
number for express delivery.
Fishery cooperative or cooperative means any entity cooperatively managing directed fishing for BSAI pollock and
formed under section 1 of the Fisherman=s Collective Marketing Act of 1934 (15 U.S.C. 521). In and of itself, a
cooperative is not an AFA entity subject to excessive harvest share limitations, unless a single person, corporation or other
business entity controls the cooperative and the cooperative has the power to control the fishing activity of its member
vessels.
BLOCK A - CO-OP CONTACT INFORMATION
1. Co-op name.
2. Name of Designated Cooperative Representative. Indicate the name of an individual who is designated by the
members of a fishery cooperative to fulfill requirements on behalf of the cooperative including, but not limited to,
the signing of cooperative fishing permit applications; submitting catcher vessel pollock cooperative catch
reports, and submitting annual cooperative fishing reports.
3. Co-op business mailing address, including P.O. Box or street, city, state, and zip code.
4. Business telephone number, including area code.
5. Business FAX number, including area code.
6. Business e-mail address, if any.
BLOCK B - DESIGNATED COOPERATIVE PROCESSOR INFORMATION
1. Name and physical location of AFA Inshore Processor who is designated in the cooperative contract as the
processor to whom the cooperative has agreed to deliver at least 90 percent of its BSAI pollock catch
2. Federal Processor Permit number of the AFA inshore processor.
BLOCK C -- COOPERATIVE CONTRACT INFORMATION
NOTE: This application is not valid and cannot be processed without the submission of a copy
of the co-op contract and certification.
Have you attached the following?
Application for AFA Inshore Catcher Vessel Cooperative Permit
Page 5 of 6
OMB Control No. 0648-0393
Expiration Date: 06/30/2009
1. A copy of the cooperative contract or a renewal letter providing notice that a previously filed cooperative contract
will remain in effect for the subsequent fishing year. Renewal letters must include the details of any material
modifications to the cooperative contract since it was last filed with NMFS.
2. A written certification that:
The contract was signed by the owners of at least 80 percent of the qualified catcher vessels;
The cooperative contract requires that the cooperative deliver at least 90 percent of its BSAI pollock catch to its
designated AFA processor; and
Each catcher vessel in the cooperative is a qualified catcher vessel as defined in 50 CFR 679.4(l)(6)(ii)(D)(1) if it
meets the following permit requirements:
•
AFA permit. The vessel must have a valid AFA catcher vessel permit with an inshore endorsement;
•
LLP permit. The vessel must be named on a valid LLP permit authorizing the vessel to engage in trawling
for pollock in the Bering Sea subarea. If the vessel is more than 60 feet (18.3 m) LOA, the vessel must be
named on a valid LLP permit endorsed for the AI to engage in trawling for pollock in the AI; and
•
Permit sanctions. The vessel has no permit sanctions that otherwise make it ineligible to engage in fishing
for pollock in the BSAI.
3. A copy of a letter requesting a business review letter on the fishery cooperative from the Department of Justice
and any response to such request?
BLOCK D - VESSEL INFORMATION
All co-op member vessels must be listed. List complete information for each co-op member catcher vessel (attach
additional pages if necessary) from USCG official documentation:
1. Complete vessel name.
2. 5-digit ADF&G vessel registration number (example: 51233).
3. U.S. Coast Guard documentation number (example: 566722).
4. Enter the AFA permit number.
BLOCK E - CERTIFICATION OF NOTARY AND APPLICANT
Sign, print your name, and date the application in the presence of Notary Public. Representatives acting on behalf of an
applicant must submit proof of authorization to submit this application on their behalf.
Signature of the co-op representative
Date this application was signed.
Printed name of the co-op representative.
Notary Certification.
A Notary Public must Attest and affix Notary Stamp.
Notary Public verification cannot be completed by the person submitting this application.
Application for AFA Inshore Catcher Vessel Cooperative Permit
Page 6 of 6
File Type | application/pdf |
File Title | C:\PRA\OMB83I pre-ps.WP6.wpd |
Author | rroberts |
File Modified | 2009-04-29 |
File Created | 2009-04-29 |