Coastal Pelagics Fishing Limited Entry Permit Applicatio

Southwest Region Permit Family of Forms

CPS_Ap_ Revised

Coastal Pelagic Species Permit Renewals, Transfers and Appeals

OMB: 0648-0204

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UNITED STATES DEPARTMENT OF COMMERCE
National Oceanic and Atmospheric Administration
NATIONAL MARINE FISHERIES SERVICE
Southwest Region
501 West Ocean Boulevard, Suite 4200
Long Beach, California 90802-4213

OMB CONTROL NO. 0648-0204
Expiration Date: 08/31/2013

COASTAL PELAGICS FISHING LIMITED ENTRY PERMIT
PERMIT RENEWAL/PERMIT TRANSFER/CHANGE OF ADDRESS
OR REPLACEMENT OF LOST PERMIT
ACTION DESIRED (Check appropriate box):
[ ] RENEWAL Complete applicant (1) Current vessel information (2)
[ ] PERMIT TRANSFER Complete applicant (1) Current vessel information (2) New permit owner (3) New vessel information (4)
[ ] PERMIT CHANGE OF ADDRESS Complete applicant (1) Current vessel information (2). Put new address in new owner (3).
[ ] REPLACEMENT OF LOST PERMIT Complete applicant (1) Current vessel information (2).
(1) APPLICANT INFORMATION
Name of current permit owner

Permit Number

Address

Phone No.

Signature

Print Name

Date

(2) VESSEL INFORMATION
Vessel Name

Official Number (Coast Guard)

Gross Tonnage

State Official Number

This form is intended to be used for all transfers of limited entry permits to either a new vessel and/or a new owner. If two or more
permits are being applied to a larger vessel, more than one form will be needed. Please refer to the implementing regulations at 50
CFR 660.514 for details.

COASTAL PELAGICS FISHING PERMIT APPLICATION - Page Two
(3) NEW PERMIT OWNER
Name of intended permit owner

Permit Number

Address

Phone No.

Signature

Print Name

Date

(4) NEW VESSEL INFORMATION
Vessel Name

Official Number (Coast Guard)

Gross Tonnage

State Official Number

Comparable capacity means gross tonnage as determined by the formula in 46 CFR 69.209(a) for a vessel not designed for sailing, plus 10 percent
of the vessel’s calculated gross tonnage.
Gross tonnage (GT) means gross tonnage as determined by the formula in 46 CFR 69.209(a) for a vessel not designed for sailing (.67 x length x
breadth x depth/100). A vessel’s length, breadth, and depth are those specified on the vessel’s certificate of documentation issued by the U.S. Coast
Guard or state.
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Warning: A false statement on this form is punishable by permit sanctions (revocation, suspension, or modification) under 15 CFR part 904, a civil
penalty up to $100,000 under 16 USC 1858, and as a federal crime under 18 USC 1001.
The purpose of this information collection is to limit the number of vessels fishing for coastal pelagic species according to the provisions of the
Fishery Management Plan for Coastal Pelagic Species, which was approved by the Secretary of Commerce and implemented by federal regulations
on December 15, 1999 (64 FR 69888). The information on this form is mandatory for owners of vessels who wish to participate in the limited entry
fishery, and is required by 50 CFR 660.512. 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.
Paperwork Reduction Act - Public reporting burden for this collection is estimated to average 30 minutes per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing
this burden to Southwest Region, NMFS, 501 West Ocean Blvd., Suite 4200, Long Beach, California 90802-4213.


File Typeapplication/pdf
File TitleI:\CPS DB\cps_application_without_ssn.wpd
Authorcsf
File Modified2013-04-11
File Created2013-04-11

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