Quota share holder: identification of ownership interest

Revised: 01/28/2008

OMB Control No.: 0648-0272
Expiration Date: 04/30/2008

QUOTA SHARE (QS)
HOLDER: IDENTIFICATION
OF OWNERSHIP INTEREST

U.S. Dept. of Commerce/NOAA
National Marine Fisheries Service (NMFS)
Restricted Access Management (RAM)
P.O. Box 21668
Juneau, AK 99802-1668

Name of QS holder:

BLOCK A -- IDENTIFICATION OF QUOTA SHARE HOLDER
1. Is this business a publicly held corporation?

[ ] Yes [ ] No

If yes, proceed to Block C.
2. Is this a corporation, association, or partnership?
If yes, is this entity still active?

[ ] Yes [ ] No
[ ] Yes [ ] No

3. Is this an estate that has been probated?

[ ] Yes [ ] No

If yes, on what date was probate finalized:

__________________

BLOCK B - - IDENTIFICATION OF MEMBERS
SHAREHOLDERS, PARTNERS, JOINT VENTURERS, SUCCESSOR-IN-INTERESTS
NOTE: if ownership consists of separate/additional corporations or partnerships the individual owners of those entities and the percentage
of interest those individuals hold in their respective corporations or partnerships must also be listed.

Name

% Interest Held

Do these ownership percentages represent the addition of any new owners since QS was initially issued?
[ ] YES

[

] NO

TOTAL OWNERSHIP:

Quota Share Holder Form: Identification of Ownership Interest
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100 %

BLOCK C – CERTIFICATION
Under penalty of perjury, I declare that I have examined this form, and to the best of my knowledge and
belief, the information I have presented here is true, correct, and complete.
1. Signature

2. Date

3. Printed Name

4. Title

5. Signature of Notary Public

6. Affix Notary Stamp or Seal Below

7. 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
Assistant Regional Administrator, Sustainable Fisheries Division, NOAA National Marine Fisheries Service, P.O. Box 21668, Juneau, AK 99802.

ADDITIONAL INFORMATION
Before completing this form please note the following: 1) 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; 2) This information is mandatory and is required to manage
commercial fishing efforts under 50 CFR part 679 and under section 402(a) of the Magnuson-Stevens Act (16 U.S.C. 1801, et seq.); 3) Responses to
this information request are confidential under section 402(b) of the Magnuson-Stevens Act as amended in 2006. They are also confidential under
NOAA Administrative Order 216-100, which sets forth procedures to protect confidentiality of fishery statistics.

_______________________________________________________________________________________

Quota Share Holder Form: Identification of Ownership Interest
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Instructions
QS HOLDER: IDENTIFICATION OF OWNERSHIP INTEREST
This form must be submitted by corporations, partnerships, associations, and other non-individual entities that
hold quota share (QS) under the Pacific halibut and sablefish Individual Fishing Quota (IFQ) Program (50 CFR
part 679).
Please type or print legibly in ink; you may photocopy and attach additional sheets as necessary. Please sign in
ink, have your signature notarized, retain a copy for your records.
When complete, mail the original form to:
NMFS Alaska Region,
Restricted Access Management (RAM),
P.O. Box 21668,
Juneau, AK 99802-1668.
or deliver to:
Room 713, Federal Building
709 West 9th Street
For information, contact RAM at 800-304-4846 or 907-586-7202.
GENERAL INFORMATION
The information requested herein is needed by RAM to determine compliance with two IFQ program
requirements, including:
1) Limitations On Use of QS and IFQ. This information is needed to determine if persons who hold
QS have exceeded their allowable use limits under the “individually and collectively” language set out
in the IFQ regulations at 50 CFR 679.42(e) and (f); and,
2) Changes in corporations or partnerships. This information is also needed to determine if a
Corporation or Partnership has changed. Under Sec. 679.42(j)(1) - (4), upon a “change” (i.e., the
addition of a new member) to a corporation or partnership that holds catcher vessel QS, the entity may
no longer hire a master to fish the IFQ resulting from the QS it holds; further, such an entity must notify
NMFS of the change within 15 days of its effective date and must then transfer its QS to a qualified
individual.
BLOCK A - IDENTIFICATION OF QS HOLDER
1. Indicate whether the QS Holder is a publicly held corporation.
If YES, sign the certification in Block C and return the form to RAM.
2. Indicate whether the QS Holder is a corporation, association, partnership, or other non-individual entity.
If YES, indicate whether the entity is still active.
If YES, go to Block “B”.
If NO, sign the certification in Block C and return the form to RAM.
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3.

Indicate whether the QS Holder is an estate that has been probated. You must answer YES if the nonindividual QS Holder is an estate and all estate matters with regard to the disposition of the assets,
including QS, have been finalized. Provide the date the estate was settled.

BLOCK B - IDENTIFICATION OF MEMBERS
1.

If ownership consists of separate or additional shareholders, partners, joint venturers, successors-ininterest, associations, corporations, partnerships, or other non-individual entities, list the individual
owners of those entities and the percentage of interest those individuals hold in their respective entities.

2.

Enter the percentage of ownership interest that each constituent member holds; for example, if there are
three equal owners, enter "33-1/3" for each. The total interest of all members should equal 100 percent.

3.

Indicate whether the ownership percentages represent the addition of any new owners since QS initially
was issued. If any of the owners listed have been added since QS were issued, you must answer “yes”

BLOCK C - CERTIFICATION
1-3. Sign and date the application in the presence of Notary Public, and print your name.
4.

Authorized representatives must submit proof of authorization from QS owner and state title.

5-7. Signature, commission expiration date, and stamp of notary public. Not to be completed by the
person submitting this application.

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