Application to opt out of Rockfish fishery

Revised: 07-07-2011

OMB Control No. 0648-0545

Application to Opt Out of
Rockfish Cooperatives

Expiration Date: 01/31/2013

U.S. Dept. of Commerce
NOAA National Marine Fisheries Service (NMFS)
Restricted Access Management (RAM)
P.O. Box 21668
Juneau, AK 99802-1668
800- 304-4846 toll free / 907-586-7202 in Juneau
907-586-7354 fax

This application must be submitted annually and received by NMFS no later than 1700 hours A.l.t. on March 1 of the
year for which the applicant wishes to opt-out of participating in a rockfish cooperative, or if sent by U.S. mail, the
application must be postmarked by that time.
BLOCK A -- APPLICANT INFORMATION
1. Applicant Name:

2. NMFS Person ID:

3. Permanent Business Mailing Address:

4. Business Telephone Number:

5. Business Fax Number:

6. E-mail Address (if available):

7. Is the applicant a U.S. citizen?

[

] YES

[ ] NO

[

] YES

[ ] NO

9. Is the applicant an Eligible Rockfish Harvester?

[

] YES

[ ] NO

10. Is the applicant opting-out of participating in a rockfish cooperative?

[

] YES

[ ] NO

11. Does the applicant hold an LLP license with Rockfish quota share (QS)
assigned to the catcher/processor sector?

[

] YES

[ ] NO

If YES, enter date of birth ___________________
8. Is the applicant a U.S. corporation, partnership, association, or other
non-individual business entity?
IF YES, enter date of incorporation: _______________________

BLOCK B -- VESSEL INFORMATION
1. Name of Vessel:

2. ADF&G Number:
3. USCG Number:
4. LLP license Number(s):

Application to Opt Out of Rockfish Cooperatives
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BLOCK C -- LLP HOLDERSHIP DOCUMENTATION
If the LLP License Holder (Applicant) is not an individual (i.e. is a corporation, partnership, association, or some other
non-individual entity), the name(s) of all owners of the Applicant must be provided, together with the percent of
ownership. In the space below, enter all of the names of all of the owners of the Applicant, and indicate the percent of
ownership. If a listed owner is not an individual, provide the same information for each such owner until all owners,
and their percent of ownership, is revealed to the individual level.
% Ownership in
Name
LLP License

BLOCK D -- APPLICANT CERTIFICATION
Under penalties of perjury, I declare that I have examined this application, and to the best of my knowledge and belief,
the information is true, correct, and complete.
1. Signature of Applicant (or Authorized Representative):
2. Date:

3. Printed Name of Applicant (or Authorized Representative); if representative, attach authorization:

__________________________________________________________________________________
PUBLIC REPORTING BURDEN STATEMENT
Public reporting burden for this collection of information is estimated to average 2 hours per response, including the time for reviewing
the instructions, searching the existing data sources, gathering and maintaining the data needed, and completing and reviewing the
collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including
suggestions for reducing the burden, to Assistant Regional Administrator, Sustainable Fisheries Division, NOAA National Marine
Fisheries Service, Alaska Region, P.O. Box 21668, Juneau, AK 99802-1668.
ADDITIONAL INFORMATION
Before completing this form, please note the following: 1) Notwithstanding any other provision of 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; 2) This information is
mandatory and is required to manage commercial fishing efforts under 50 CFR part 679 and under section 402(a) of the MagnusonStevens Act (16 U.S.C. 1801, et seq.); 3) Responses to this information request are confidential under section 402(b) of the MagnusonStevens Act as amended in 2006. They are also confidential under NOAA Administrative Order 216-100, which sets forth procedures to
protect confidentiality of fishery statistics.

__________________________________________________________________________________

Application to Opt Out of Rockfish Cooperatives
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INSTRUCTIONS
Application to Opt Out of Rockfish Cooperatives
GENERAL INFORMATION
Each year, a person holding an License Limitation Program (LLP) license with catcher/processor operation type and rockfish
quota share (QS) assigned to that LLP may opt-out of participating in a rockfish cooperative for a calendar year by
completing a timely Application to Opt-out of Rockfish Cooperative. A person may not assign an LLP license assigned
rockfish QS in the catcher/processor sector to both a rockfish cooperative and opt-out of participating in a rockfish
cooperative. An LLP license holder who opts-out may not fish for that fishing year with any vessel named on that LLP
license in any directed fishery for any rockfish primary species in the Central Gulf of Alaska (GOA) and waters adjacent to
the Central GOA as specified under § 679.20.
Type or print legibly in ink; retain a copy of completed application for your records. The Application to Opt-out of

Rockfish Cooperatives may be submitted by mail, fax, or hand delivery or carrier.
Application forms are available on the NMFS Alaska Region website at http://alaskafisheries.noaa.gov, or by contacting
NMFS at 800–304–4846, Option 2.
A completed application must be received by NMFS no later than 1700 hours, A.l.t., on March 1 of each year, or if sent by
U.S. mail, the application must be postmarked by that time. For applications delivered by hand delivery or carrier only, the
receiving date of signature by NMFS staff is the date the application was received. If the application is submitted by fax, the
receiving date of the application is the date stamped received by NMFS.
Objective written evidence of timely application will be considered as proof of a timely application.
When complete, submit application
by mail to:

NMFS Alaska Region
Restricted Access Management (RAM)
P.O. Box 21668
Juneau, AK 99802-1668

by fax to:

(907) 586-7354

or deliver to:

Room 713, Federal Building
709 West 9th Street
Juneau, AK 99801

If you need additional information, contact RAM at (800) 304-4846 (Option 2) or (907) 586-7202 (Option 2).
Please allow at least 10 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.

COMPLETING THE APPLICATION
BLOCK A. APPLICANT INFORMATION
1. Name
2. NMFS person ID
3. Permanent business mailing address
Application to Opt Out of Rockfish Cooperatives
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4. Business telephone number, business fax number, and business e-mail address (if available)
5. Indicate whether applicant is a U.S. citizen; if YES, provide date of birth
6. Indicate whether applicant is a U.S. corporation; if YES, provide date of incorporation
7. Indicate whether the applicant is an Eligible Rockfish Harvester
8. Indicate whether the applicant is opting-out of the rockfish cooperatives
9. Indicate whether the applicant holds an LLP license with Rockfish quota share (QS)
assigned to the catcher/processor sector
BLOCK B. VESSEL INFORMATION
1. Name of vessel and Alaska Department of Fish and Game (ADF&G) vessel registration number
2. United States Coast Guard (USCG) documentation number
3. LLP license number(s) held by the applicant and used on that vessel
BLOCK C. LLP HOLDERSHIP DOCUMENTATION
Names of all persons, to the individual level, holding an ownership interest in the LLP license and the percent of
ownership each person and individual holds in the LLP license.
BLOCK D. APPLICANT CERTIFICATION
The applicant must sign and date the application certifying that all information is true, correct, and complete to the best of his
or her knowledge and belief. If the application is completed by a designated representative, then explicit authorization signed
by the applicant must accompany the application.

Application to Opt Out of Rockfish Cooperatives
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