Federal Northeast Seafood Dealer -Initial Dealer Permit

United States Department of Commerce
National Oceanic and Atmospheric Administration
National Marine Fisheries Service
Northeast Region
55 Great Republic Drive
Gloucester, MA 01930

98

Federal Northeast Seafood Dealer
Initial Dealer Permit Application
SECTION 1 - DEALER INFORMATION
Company/Owner name:

__

Mailing Address:_______________________________________
City:

State:

Telephone:

__

Zip Code:

Fax Number:

Cell Phone:______________________

___
___

Additional Phone:___________________

Email Address:______________________

Additional Email Address:___________________

**Vessel Name:

**Vessel Hull Number:_____________

___

**If you are applying for Atlantic Mackerel at Sea Processor or Atlantic Herring at Sea Processor, you must enter
the vessel name and hull number above and include a copy of the vessel’s current Coast Guard Documentation or
State Registration.)
If regulated species are purchased or received for commercial purposes at more than one place of business, each address
must be listed. List those additional addresses on the back of this form in Section 1A.

SECTION 2 - FISHERIES
Select the fisheries desired by placing an (X) in the boxes provided. Select all fisheries that apply.
Atlantic bluefin tuna

Northeast multispecies

Scup

Other Atlantic Tunas
(Yellowfin, Bigeye, Skipjack,

American lobster

Black sea bass

Albacore)

Skate

Monkfish

Surfclam/Ocean quahog - Dealer

**Atlantic mackerel at sea
processor

Atlantic bluefish

Surfclam/Ocean quahog - Processor

Squid, Atlantic mackerel, butterfish

Spiny Dogfish

Summer flounder

Atlantic herring - Dealer

Tilefish

Atlantic sea scallop

**Atlantic herring At Sea Processor

Atlantic Deepsea Red Crab

Atlantic Hagfish

** (see note in Section 1)

SECTION 3 - OWNER'S NAME AND SIGNATURE
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.
Print Name: __________________________
Signature:

Date: _________________
OMB# 0648-0202

Expiration Date: April 30, 2013

SECTION 1A - ADDITIONAL DEALER INFORMATION. If regulated species are purchased or received for
commercial purposes at more than one place of business, each address must be listed below.
Company Address
Street:
City:

State:

Zip:

State:

Zip:

State:

Zip:

State:

Zip:

Telephone:
Company Address
Street:
City:
Telephone:
Company Address
Street:
City:
Telephone:
Company Address
Street:
City:
Telephone:

For further information, call Northeast Permits Operations at (978) 281-9370
The Paperwork Reduction Act requires potential respondents for a dealer/processor permit be notified of certain
information regarding their rights and the burden associated with applying for a Federal dealer/processor permit.
One of the regulatory steps taken by the National Marine Fisheries Service (NMFS) to carry out conservation and
management objectives is the requirement of a permit for users of the resources. All the fisheries included on this
application require a permit to purchase, or otherwise receive for transport for a commercial purpose, other than
solely for transport on land, species harvested by the owner or operator of a fishing vessel issued a Federal fisheries
permit for these species. Section 303(b)(1) of the Magnuson-Stevens Fishery Conservation and Management Act
(MSFCMA) specifically recognizes the need for permit issuance.
Any information collected on this form may be released to the public unless it is considered confidential as provided
in Section402(b) of the Magnuson-Stevens Act and in NOAA Administrative Order 216-100, Protection of
Confidential Fishery Statistics.
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. Public reporting
burden for this collection of information is estimated to average 15 minutes 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: National Marine Fisheries Service, Permit Office, 55 Great Republic Drive, Gloucester, MA 01930-2276.
OMB# 0648-0202

Expiration Date: April 30, 2013