Interim Reporting Form

Highly Migratory Species EFP, SRP, and Display Permit Interim 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 and mail this form within 5 days of landing/collection/tagging
to the National Marine Fisheries Service, HMS Management Division, Attn: Craig Cockrell, 1315 East-West Highway, Silver Spring, MD 20910.
Permit Number: _______________________________________
Vessel Name: _________________________________________
Authorized Sampler (print): ______________________________
Did you fish? (circle one): YES NO

Fish
#

(Ex)

Date
(Landed,
Caught,
or
Tagged)

Reported
In
Commercial
Logbooks
(Yes or No)

Species
(Common
Name)

1/1/04

No

Sandbar

Gear Used (circle one): PLL
BLL
GIL
PKN
BLK
SCU
PS
TWL HAR
Other: ____________________
Protected Resources Interactions (circle one): YES

Length (inches)
Fork

Total

21.3

Weight
(pounds)
Pectoral
Width

Lower
Jaw

ww

27

Sex

dw

M

HNL
BUY

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.

HND
CSN

Name of Permit Holder/Associate (print):_________________________
Signature of Permit Holder/Associate: ___________________________
Date: _________________

NO

Disposition
Dead,
Alive,
Tagged

Kept,
Discarded,
Released

Alive

Kept

Price
(if
sold,
U.S.
$)

Tag Information
(if applicable)
Type

Number

C

11111

Area
Caught
(Lat/Long)

Area
Released
(Lat/Long)

Port
Landed
(city,
state)

Captivity
Location
(if kept
for public
display)

Water
Depth
(meters)

Surface
Temp.
(E C)

HMS
Aquarium

9

27

1
2
3
4
5
6
7
8
9
10
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 1 hour 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 Interim 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. If you did not fish during any one month, please submit a copy of the Interim Report Form within 5
days of the last day of the "no-fish" month, noting that you did not fish by circling the appropriate response under Fishing
Activity (i.e., Did you fish: YES NO). If you did fish, you must complete and submit a copy of the Interim Report Form
within 5 days of landing, collecting, or tagging fish authorized under an EFP, SRP, or Display Permit. Please use a
separate form for each gear type.
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.
$
Fishing Activity: If you did not fish circle no. If you did fish circle yes.
$
Gear Used: Circle the appropriate code for the gear type used in the authorized fishing activity. The codes are as
follows: PLL = Pelagic Longline; BLL = Bottom Longline; GIL = Gilnet; HNL = Hook and Line (including rod
and reel); HND = Handnet; PKN = Plankton Net; BLK = Blockline; SCU = Scuba; PS = Purse Seine; TWL =
Trawl; HAR = Harpoon; BUY = Buoy; CSN = Castnet; Other = Any other gear type not listed above.
$
Protected Species Interactions: Indicate Yes or No to explain whether any interactions with protected species
occurred during the authorized fishing activity. If you answer yes, please enter the date, protected species
common name, disposition, area caught, area released, and water information as listed in the table format.
$
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 (If the answer to "Did you fish?", in Step 1 above, was no, then proceed to STEP 3 below)
Please use a ballpoint pen and print clearly to record the following on the form:
$
Date: Calendar date (month/day/year) that fish was landed, caught, or tagged.
$
Reported in Commercial Logbooks: Indicate (i.e., Yes or No) whether fish was reported in commercial logbooks.
$
Species: Common name of the Highly Migratory Species (HMS) landed, caught, or tagged. Please also include
the common name of any protected species incidentally caught during the authorized fishing activity.
$
Length: Length of fish in inches (Straight Fork Length)
$
Weight: Weight of the fish in either whole weight (ww) or dressed weight (dw).
$
Sex: Sex (Male = M; Female = F; Unknown = U) of fish.
$
Disposition: Notation of whether the fish is dead, alive, or tagged alive when either kept, discarded or released.
$
Price: Sales price (in U.S. dollars) when fish is sold.
$
Tag Information: Type of tag may be coded for the following: Conventional = C; PIT Tag = P ; or Archival = A.
Tag number is the unique identifier for each tag.
$
Area Caught: Location (i.e., Latitude and Longitude) where fish is caught.
$
Area Released: Location (i.e., Latitude and Longitude) where fish is released.
$
Port Landed: Port location (i.e., city and state) where fish is landed, if kept or sold.
$
Captivity Location: Location (i.e., facility name) where fish is kept or offloaded for public display.
$
Water: Provide measurement of the water depth (in meters) and surface temperature (in degrees Celsius), if
known.
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 1 hour 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.