Gillnet Tag Replcement Form

Print Form

Missing and Additional Tag Order Form
Instructions: All vessels issued either a Northeast multispecies or monkfish limited access permit, and
required to use gillnet tags, will be required to account for the total number of tags issued. Should tags be
lost, missing, or destroyed, vessel operators must report the missing tag numbers to National Marine
Fisheries Service (NMFS), as soon as possible. You may declare lost tags and/or order replacement tags,
by mailing this order form with a check or money order for the total cost of the tags (@ $ 1.20 per tag) to:
NMFS Sustainable Fisheries Division, Gillnet Tag Program, 55 Great Republic, Gloucester, MA 01930.
Please make checks payable to National Band and Tag Company. Note, there is an additional
shipping and handling fee of $ 5.00 for orders of less than 20 gillnet tags.
For your convenience, you may FAX your lost tag declaration or your replacement tag request to (978)
281-9135. Please be advised that your replacement tags will not be issued until payment for the tags is
received by NMFS.
Owner Name

Vessel Permit # ______________________

Vessel Name _________________________________________
Owner Address _____________________________________________________________
Phone Number __________________________________
Identify specific tags lost (provide specific tag numbers or a tag range -- use 2nd page if needed)
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________
$______________
$______________

Number of Tags Needed
Amount for tags (# of tags x $ 1.20)
$ 5.00 Shipping and Handling Fee (For orders of less than 20 tags)

$______________

TOTAL AMOUNT ENCLOSED

Reason for tag loss (Optional)
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________

_____________________________
Signature of Applicant

_______________________
DATE

OMB # 0648-0202 EXP 11-30-2009

Page 1 of 1