Federal Fisheries Vessel Permit Application - Renewal

U.S. Department of Commerce
National Oceanic and Atmospheric Administration
National Marine Fisheries Service – Permits Operations
55 Great Republic Drive
Gloucester, MA 01930
August 25, 2009

Attn:

«NAME_FIRST» «NAME_MIDDLE» «NAME_LAST»
«ADDRESS1»
«CITY», «ST» «ZIP»

Permit Number: «Operator_Key»
Dear Vessel Operator Permit Holder,
Your current commercial vessel operator permit will expire on «Date_Expired». You will need to
apply for a permit renewal. Enclosed you will find a preprinted renewal application. Review the
information carefully and make any corrections on the back of the application. All fields must be filled
in. Please write legibly. You must enclose 1 current color passport-sized photo of yourself.
Please sign and date the form and return it to the address on the application. If you have any questions,
please call Permit Operations at 978-281-9370 x6437.
Sincerely,

Vincie Susanno,
Legal Instruments Examiner

U.S. Department of Commerce
National Oceanic and Atmospheric Administration
National Marine Fisheries Service – Permits Office
55 Great Republic Drive
Gloucester, MA 01930

RENEWAL APPLICATION FOR COMMERCIAL VESSEL OPERATOR PERMIT
August 25, 2009
ALL FIELDS MUST BE FILLED IN
Please make any changes and or corrections to this information on the back of this application
«Operator_Key»

Permit Number:
«Date_Expired»
Full Name:

Current Expiration Date:

«NAME_LAST » «NAME_MIDDLE» «NAME_LAST»

Mailing Address:

Phone Number:
Hair Color: «Eye»

«ADDRESS1»
«CITY», «ST» «ZIP»

(«Area_Code») «Phone_Number» Date of Birth:
Eye Color: «Hair»

Height: «Weight»

«Birth_Date»
Weight: «Height»

Note: You must enclose 1 current color passport-sized photo of yourself to obtain your new permit.
I affirm, subject to the penalties provided in 18 USC 1001, that all information I have given in obtaining
this permit is true and correct.
Signature:______________________________________________ Date:_____________
Please check here if you made any changes/corrections on back of this application _______
Public reporting burden for this collection of information is estimated to average 1 hour per response, including time for reviewing instructions, searching
existing data sources, gathering and maintaining data needed, and completing and reviewing the information. Send comments regarding this burden
estimate or suggestions for reducing this burden to NOAA Fisheries, One Blackburn Drive, Gloucester, MA 01930-2298. The purpose and use of these
permits are to (1) register industry participants and fishing vessels, (2) exercise influence over compliance, (3) provide a mailing list for the dissemination of
important information to the industry, (4) register participants to be considered for limited entry, and (5) provide a universe for data collections samples.
Both the MSFCA and Executive Orders 12866 et al, require the determination of this information. 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. Any information
submitted by any person to obtain a permit is not confidential, and may be disclosed upon request.

OMB# 0648-0202 EXP 11/30/2009
CORRECTIONS
Fill in this section only if making changes/corrections to the front of this application.

Full Name: _________________________________________________________________________

Mailing Address: ___________________________________________________________________

Phone Number: ______________________________________________________________________

Date of Birth: _____________________________________________________________________

Eye Color: _________________________________________________________________________

Hair Color: ________________________________________________________________________

Weight: ____________________________________________________________________________

Height: ____________________________________________________________________________

OMB# 0648-0202 EXP 11/30/2009