Annual reporting form

Highly Migratory Species EFP, SRP, and Display Permit ANNUAL Report
This form is mandatory for all HMS exempted fishing, scientific research, and display permit holders; voluntary for all letter of
acknowledgment permit holders. Please complete this form within 30 days of the expiration of your permit and mail to the National Marine
Fisheries Service, HMS Management Division, Attn: Craig Cockrell, 1315 East-West Highway, Silver Spring, MD 20910.
Certification: I certify that the information provided by me on this form is true to the
best of my knowledge, and made in good faith. FALSE STATEMENT ON THIS
FORM IS PUNISHABLE BY LAW.

Permit Number: _____________________________________
Vessel Name: _______________________________________
Authorized Sampler (print): ____________________________
Was NMFS funding used to collect these specimens? (Circle
one)
Yes
No
Species (Common Name)

Billfish

Total Number
Caught

Name of Permit Holder/Associate (print): _____________________
Signature of Permit Holder/Associate: ________________________
Date: _________________
Total Number Kept

Total Number
Discarded

Alive

Alive

Dead

Total Number Tagged

Dead

Blue Marlin
White Marlin
Longbill Spearfish
Atlantic Sailfish
Billfish Unspecified
Billfish Larvae

Swordfish

Swordfish

Tuna

Bluefin Tuna

Swordfish Larvae

Yellowfin Tuna
Bigeye Tuna
Albacore Tuna
Blackfin Tuna
Skipjack Tuna
Tuna Unspecified
Tuna Larvae
Large Coastal
Sharks

Sandbar
Silky
Tiger
Blacktip
Spinner
Bull
Scalloped Hammerhead
Lemon
Nurse
Great Hammerhead
Other:

Small Coastal
Sharks

Finetooth
Bonnethead
Blacknose
Atlantic Sharpnose

Pelagic Sharks

Blue
Porbeagle
Oceanic Whitetip
Common Thresher
Shortfin Mako

Prohibited
Sharks

Sand Tiger
Bigeye Thresher
Night
Dusky
Atlantic Angel
Other:

Protected
Resources

Turtles (sp. _________)
Other:

PAPERWORK REDUCTION ACT NOTICE: Collection of information through an exempted fishing permit program provides essential information for the conservation and management of Atlantic
tunas, swordfish, and billfish. Information on distribution and migratory patterns will be used for stock assessment and in developing international catch sharing agreements. Public reporting burden for
this collection of information is estimated to average 40 minutes per response. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for
reducing this burden to: NMFS, Highly Migratory Species Management Division (F/SF1), 1315 East-West Highway, Silver Spring, MD 20910. Reporting of exempted fishing permit activity is required
under the authority of the Atlantic Tunas Convention Act. It is NOAA policy to preserve the confidentiality of information submitted under this reporting requirement, except that NMFS may release such
information in aggregate or summary form, such that individual identifiers are not disclosed (NAO 216-100). 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, OMB Control #0648-0471 Expires 06/30/2011.

Instructions for the Annual Report Form
NOTE: All data provided are confidential and will be used to determine the cumulative effects of exempted
fishing activities on marine resources as well as provide scientific information on species that would otherwise
be prohibited from collection/possession. Consistent and accurate reporting is critical for achieving the benefits
of conservation and management of Atlantic Highly Migratory Species fisheries. This form is mandatory for all
Exempted Fishing, Scientific Research, and Display Permit holders. This form is voluntary for all Letter of
Acknowledgment Permit holders. If you have any questions, please contact the HMS Management Division at
(301) 713-2347. For additional copies of the Interim Report Form, respondents may either make additional
copies or contact the HMS Management Division at the number listed above.
STEP 1
Please use a ballpoint pen and print clearly to record the following on the form:
$
Permit Number: The permit number located at the top of each permit issued.
$
Vessel Name: The name of the vessel authorized and used to collect or tag fish.
$
Authorized Sampler (print): The name of the person authorized to sample, collect, or tag fish.
$
Was NMFS funding used to collect these specimens? Circle yes or no, as appropriate.
$
Name of Permit Holder/Associate: Printed name of permit holder/associate as listed on permit.
$
Signature of Permit Holder/Associate: Signed name of permit holder/associate as listed on permit.
$
Date: Date of signature as listed above.
STEP 2
Please use a ballpoint pen and print clearly to record the following on the form:
$
Species (Common Name): For each species caught during the life of the permit, please record the
following information:
1. Total Number Caught: Sum total = should equal the sum of the next five columns combined.
2. Total Number Kept: Sum total of fish/protected resources kept dead as well as sum total of fish kept
alive.
3. Total Number Discarded: Sum total of fish/protected resources discarded dead as well as sum total
of fish/protected resources discarded alive (excluding fish/protected resources tagged and
released alive).
4. Total Number Tagged: Sum total of fish/protected resources tagged. This sum does not include
fish/protected resources discarded alive.
STEP 3
$
Make copies of all interim report forms for your records.
$
Mail the original interim report form to the National Marine Fisheries Service, HMS Management
Division, Attn: Craig Cockrell, 1315 East-West Highway, Silver Spring, MD 20910.

PAPERWORK REDUCTION ACT NOTICE: Collection of information through an exempted fishing permit program provides essential information for the
conservation and management of Atlantic tunas, swordfish, and billfish. Information on distribution and migratory patterns will be used for stock assessment and in
developing international catch sharing agreements. Public reporting burden for this collection of information is estimated to average 40 minutes per response. Send
comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: NMFS, Highly
Migratory Species Management Division (F/SF1), 1315 East-West Highway, Silver Spring, MD 20910. Reporting of exempted fishing permit activity is required under
the authority of the Atlantic Tunas Convention Act. It is NOAA policy to preserve the confidentiality of information submitted under this reporting requirement, except
that NMFS may release such information in aggregate or summary form, such that individual identifiers are not disclosed (NAO 216-100). 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. OMB Control #0648-0471 Expires
06/30/2011.