Application for community and military permit

Revised: 02/20/2009

CHARTER
HALIBUT
PROGRAM

OMB Control No. 0648--XXXX Expires: XX/XX/XXXX

Application For
COMMUNITY CHARTER HALIBUT
PERMIT or
MILITARY CHARTER HALIBUT
PERMIT

U.S. Department of Commerce
NOAA National Marine Fisheries Service
Restricted Access Management
P.O. Box 21668
Juneau, AK 99802-1668
Fax: 907-586-7354
Telephone: 800-304-4646 toll
Free or 907-586-7202 in Juneau

BLOCK A--TYPE OF PERMIT
Indicate type of permit for which you are applying.
[

]

Community Charter Halibut Permit
An authorized Community Quota Entity (CQE) must apply for this permit on behalf of the eligible community.
Complete Blocks A and B. Sign and date Block D. See instructions for list of eligible communities.
Enter the name of the community you represent below:

[

]

Military Charter Halibut Permit
Complete Blocks A and C and sign and date Block D.
Enter the Branch of the United States Armed Services you represent below:

Attach official documentation from the Branch of Service you represent to verify the authority
to apply for the MWR permits.
BLOCK B –APPLICANT INFORMATION
1. Applicant’s Name
2. Business Mailing Address (Street or P.O. Box, City, State, Zip Code):

3. Business Telephone Number:
4. Business Fax Number:
5. Business E-mail Address:

BLOCK C – COMMUNITY CHARTER HALIBUT PERMIT(S) REQUEST
1. Enter the name(s) of the community that the CQE represents (duplicate this page if needed).
2. For each community charter permit you are requesting, specify the name(s) of the person(s) and number of permits to be
issued to that person.
Full Legal Name of Person
Number of Permits to be
Using the Community Charter Halibut Permit
Issued to That Person

Community Charter Halibut Permit or Military Charter Halibut Permit Application
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3. List the locations, including the latitude and longitude, where all trips will begin or end within the boundaries of the
Community for which you are applying. (attach additional pages if necessary).
Location Name
Latitude
Longitude

BLOCK D – MILITARY CHARTER HALIBUT PERMIT(S) REQUEST
List the number of Military Charter Halibut Permits you are requesting for each area:

_______ for 2C and _______ for 3A

BLOCK E – CQE APPLICANT SIGNATURE
Under penalty of perjury, I certify by my signature below that I have examined the information and the claims provided on
this application and, to the best of my knowledge and belief, the information presented here is true, correct, and complete.
Individual signing this application may be required to provide documentation of his/her authority to apply on behalf of the
Applicant.
Signature of Applicant:

Date:

Printed Name of individual completing this application
on behalf of CQE

Title of individual completing this application
on behalf of CQE

BLOCK F – MILITARY APPLICANT SIGNATURE
Under penalty of perjury, I certify by my signature below that I have examined the information and the claims provided on
this application and, to the best of my knowledge and belief, the information presented here is true, correct, and complete.
Individual signing this application is required to provide documentation of his/her authority to apply on behalf of the
Applicant.
Signature of Applicant:

Date:

Printed Name of individual completing this application
on behalf of Branch of Military Service

Rank in Service of individual completing this application
on behalf of Branch of Military Service

Community Charter Halibut Permit or Military Charter Halibut Permit Application
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Application Instructions
COMMUNITY CHARTER HALIBUT PERMIT
OR
MILITARY CHARTER HALIBUT PERMIT
GENERAL INFORMATION
Application forms are available National Marine Fisheries Service (NMFS) offices and on the NMFS, Alaska
Region, web site at http://www.alaskafisheries.noaa.gov.
When completed, the application should be mailed to:
NMFS Alaska Region
Restricted Access Management (RAM)
P.O. Box 21668
Juneau, Alaska 99802-1668
faxed to:

907-586-7354

or delivered to:
709 West 9th Street Suite 713
Juneau, Alaska 99801
Please allow at least ten 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
corporate account number for express delivery.
It is important that all blocks are completed and attachments provided. Failure to answer any of the questions or
provide any of the required documents could result in delays in the processing of your request for a transfer.
Direct any questions you may have to NMFS, RAM at 1-800-304-4846 (option 2) or (907) 586-7202 (option 2).

COMPLETING THE APPLICATION FORM - SPECIFIC INSTRUCTIONS
BLOCK A—TYPE OF PERMIT
Indicate the type of permit for which you are applying.
♦

Community Charter Halibut Permit
If Applicant is a Community Quota Entity (CQE) requesting Community Charter Halibut Permits, enter
the name of the community represented by the CQE in this application.
NOTE: Each eligible community must form a non-profit entity or CQE to represent it prior to applying
for a Community Charter Halibut Permit. This non-profit must apply to NMFS/RAM for certification
of eligibility as a CQE using the “Application for a Non-Profit to be Designated as a Community Quota
Entity (CQE)”.

Community Charter Halibut Permit or Military Charter Halibut Permit Application
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Only the following communities are eligible to obtain Community Charter Halibut Permits in the area
designated for the community. One Application form must be submitted for each community; multiple
communities may not be listed on a single application.
Eligible Communities for 2C
Community Charter Halibut Permits
Angoon
Coffman Cove
Edna bay
Hollis
Hoonah
Hydaburg
Kake
Kassan
Klawock
Metlakatla
Meyers Chuck
Pelican
Point Baker
Port Alexander
Port Protection
Tenakee
Thorne Bay
Whale Pass
♦

Eligible Communities for 3A
Community Charter Halibut Permits
Akhiok
Chenega
Halibut Cove
Karluk
Larsen Bay
Nanwalek
Old Harbor
Ouzinkie
Port Graham
Port Lions
Seldovia
Tatitlek
Tyonek
Yakutat

Military Charter Halibut Permit
If Applicant is applying for Military Charter Halibut Permits,
o Enter the Branch of the United States Armed Services you represent
o Attach official documentation from the Branch of Service you represent to verify the authority
to apply for the MWR permits.

Complete Blocks A, C and sign Block D
BLOCK B –APPLICANT INFORMATION
1.

Applicant’s name

2.

Business mailing address (Street or P.O. Box, city, state, zip code)

3-5. Business telephone number, business fax number, and business e-mail address
BLOCK C – COMMUNITY CHARTER HALIBUT PERMIT(S) REQUEST
1.

Enter the name(s) of the community that the CQE represents.

2.

For each community charter halibut permit you are requesting, specify the following information.
Name(s) of the persons who will use the community charter halibut permit on behalf of the CQE.
The number of community charter halibut permits to be issued to that person.

Community Charter Halibut Permit or Military Charter Halibut Permit Application
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3.

List location boundaries of community, including latitude and longitude, where all trips will begin or
end.

BLOCK D – MILITARY CHARTER HALIBUT PERMIT(S) REQUEST
List the number of Military Charter Halibut Permits you are requesting for each area, 2C and 3A.
BLOCK E – CQE APPLICANT SIGNATURE
The individual completing this application must print his/her name, provide his/her title, and sign and date this
application. This individual may be required to provide documentation demonstrating his/her authority.
BLOCK F – MILITARY APPLICANT SIGNATURE
The individual completing this application must print his/her name, provide his/her rank in service, and sign and
date this application. This individual must attach official documentation from the Branch of Service they
represent to verify the authority to apply for the MWR permits.
__________________________________________________________________________________________________
PUBLIC REPORTING BURDEN STATEMENT
Public reporting burden for this collection of information is estimated to average one hour 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, Alaska Region, NMFS, P.O. Box 21668, Juneau, AK 99802-1668.
ADDITIONAL INFORMATION
Before completing this form please note the following: 1) 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 Charter Halibut Moratorium Program for IPHC Regulatory Areas 2C or
3A; 3) Federal law and regulations require and authorize NMFS to manage charter halibut programs in Alaska; 4)
Submission of this information is mandatory for any entity participating in charter halibut fishing; 5) This information is
used to monitor the charter moratorium program under the Northern Pacific Halibut Act of 1982; 6) Responses to this
information request are not confidential.
___________________________________________________________________________________________________

Community Charter Halibut Permit or Military Charter Halibut Permit Application
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