Initial/renewal IFQ application

OMB Control No. 0648-0551 Expiration Date: 

U.S. DEPT OF COMMERCE, NOAA
NMFS IFQ Program, F/SER29
263 13th Avenue South
St. Petersburg, FL 33701-5511
Toll Free (866/425-7627) (8 am - 4:30 pm ET)
http://ifq.sero.nmfs.noaa.gov
727/824-5305 (8 am - 4:30 pm ET)

NOAA FISHERIES SERVICE
FEDERAL APPLICATION
FOR GULF OF MEXICO
INDIVIDUAL FISHING QUOTA (IFQ)
ONLINE ACCOUNT

http://sero.nmfs.noaa.gov

FOR OFFICE USE ONLY
Reviewer's Initials
and Date
Sanction Case Number if
Sanctioned and date held
Date Sanction Released
and Initials
Application ID

APPLICATION INSTRUCTIONS
1. Current IFQ participants need to complete this application to certify they are or are NOT a United States citizen or a permanent resident alien.
2. As of January 1, 2012, all United States citizens and permanent resident aliens are eligible for participation in the Gulf red snapper IFQ program. This
application is to establish an IFQ account for new participants and update account information for existing participants. However, a valid commercial permit
for Gulf reef fish, a Gulf red snapper IFQ vessel account, and Gulf red snapper IFQ allocation are required to possess (at and after the time of the advance
notice of landing), land or sell Gulf red snapper subject to this IFQ program.
3. Follow the instructions at the top of each section. Make sure all the information is correct then sign and date the application below. The IFQ applicant
signing the application must be an account holder listed in section 1 and a United States citizen or permanent resident alien.
4. Mail your completed application to: U.S. Department of Commerce, NOAA, National Marine Fisheries Service F/SER29, 263 13th Avenue South,
St. Petersburg, FL 33701-5511.
Public reporting burden for this collection of information is estimated to average 10 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 suggestions for reducing this burden to PRA Officer, National Marine Fisheries Service, F/SER2, 263 13th Avenue
South, St. Petersburg, FL 33701-5511.
The National Marine Fisheries Service requires this information for the conservation and management of marine fishery resources. The data reported will be
used to develop, implement, and monitor fishery management activities for a variety of uses. Responses to this collection are required to obtain or retain an
IFQ online account under the Magnuson-Stevens Act. Non-confidential information will be released via a NOAA Fisheries Service website. Non-confidential
information means: name, address, city, state, zip code, etc. All other data submitted will be handled as confidential material in accordance with NOAA
Administrative Order 216-100, Protection of Confidential Fishery Statistics. Notwithstanding any other provisions of the law, no person is required to respond
to, nor shall any person be subjected 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.

SIGNATURE FOR APPLICATION
The undersigned certifies under penalty of perjury that the foregoing information is true and correct (28 USC 1746; 18 USC 1621; 18 USC 1001,
16 USC 1857). Knowingly supplying false information for the purpose of obtaining an IFQ Online Account is a violation of Federal law punishable by a fine
and/or imprisonment. Please note: The individual signing below MUST be either the IFQ account holder OR must be one of the officers or shareholders
that is a U.S. citizen or permanent resident alien listed in section 2 of this application.

Applicant Signature

Position in Company
(if applicable)

Print Name

Date

Last Form Revision 8/10/2011

1. IFQ ONLINE ACCOUNT HOLDER INFORMATION
1) Check the appropriate box below if the applicant is a new or existing IFQ online account holder. Provide the USER ID for an existing
account holder.
2) Complete this page for all IFQ online account holders. If the account holder is a business, enter the Federal ID number and date the
business filed with the state. If the account holder is an individual, enter their Social Security Number.
3) If you have more than two account holders, copy the blank form or provide the required information on a separate sheet of paper.
4) Check the appropriate box below to certify that the applicant is or is NOT a United States citizen or permanent resident alien.
5) Place an "x" in the Mailing Recipient block to indicate who will receive the renewal application and related information. Please only
mark one box.
Check here if the applicant is a NEW IFQ online account holder.
Check here if the applicant is an EXISTING IFQ online account holder. Provide the IFQ online account holder's USER ID: ___________________

IFQ Online Account Holder
Check one

INDIVIDUAL or SOLE PROPRIETORSHIP

JOINT OWNERSHIP

PARTNERSHIP

CORPORATION

OTHER ____________

Check here certifying the applicant is a United States citizen or permanent resident alien.
Check here certifying the applicant is NOT a United States citizen or permanent resident alien.

Mailing Recipient - Mark this box if you want this entity to receive all mailings; mark only one person.
Mr/Mrs/Ms

Last Name or Name of Business

First Name

Suffix - JR,
SR, etc.

Middle Name

Mailing Address

Apt/Suite #

City

State

County/parish

Zip Code

Country

Physical Address

Apt/Suite #

City

State

County/parish

Zip Code

Country

Check box if same as Mailing Address

Tax ID # (FED ID or SSN)

Date of Birth or Date Business Filed (MM/DD/YYYY)

Area Code

Phone Number

IFQ Online Account Holder
Check one

INDIVIDUAL or SOLE PROPRIETORSHIP

JOINT OWNERSHIP

PARTNERSHIP

CORPORATION

OTHER ____________

Check here certifying the applicant is a United States citizen or permanent resident alien.
Check here certifying the applicant is NOT a United States citizen or permanent resident alien.

Mailing Recipient - Mark this box if you want this entity to receive all mailings; mark only one person.
Mr/Mrs/Ms

Last Name or Name of Business

First Name

Middle Name

Suffix - JR,
SR, etc.

Mailing Address

Apt/Suite #

City

State

County/parish

Zip Code

Country

Physical Address

Apt/Suite #

City

State

County/parish

Zip Code

Country

Check box if same as Mailing Address

Tax ID # (FED ID or SSN)

Date of Birth or Date Business Filed (MM/DD/YYYY)

Page 2

Area Code

Phone Number

2. OFFICER/SHAREHOLDER INFORMATION FOR
CORPORATION/BUSINESS/LLC THAT HOLD THE IFQ ONLINE ACCOUNT
1) If this IFQ online account is held by a business, then complete this section for each officer or partner associated with the business. Provide the
information for all officers or partners that are shown on your most recent annual report. If your business is structured as a corporation, identify all
shareholders in the corporation that own at least 1% or more of the shares, as well as the percentage of all shares in the corporation held by each
shareholder. Individuals holding less than 1% of the shares (minor shareholders) should not be individually listed. Total shareholders must equal 100%.
2) Check the appropriate box below to certify that the applicant is or is NOT a United States citizen or permanent resident alien.

Business name:

Federal Tax ID #:

ALL individuals associated with the above-named account holder must be included in this application. Provide name, Social Security Number, address,
telephone number with area code, date of birth, and position held in business.
Position held - check ALL that apply
President/CEO

Vice President

Secretary

Treasurer

Director/Manager

Shareholder

Other

Percent (%) of Corporation Held (1% or more)
Check here certifying the applicant is a United States citizen or permanent resident alien.
Check here certifying the applicant is NOT a United States citizen or permanent resident alien.
Mr/Mrs/Ms

Last Name

First Name

Suffix - Jr,Sr,etc

Middle Name

Mailing Address

Apt/Suite #

City

State

County/parish

Zip Code

Country

Physical Address

Apt/Suite #

City

State

County/parish

Zip Code

Country

Check box if same as Mailing Address

SSN

Date of Birth (MM/DD/YYYY)

Area Code

Phone Number

Position held - check ALL that apply
President/CEO

Vice President

Secretary

Treasurer

Director/Manager

Shareholder

Other

Percent (%) of Corporation Held (1% or more)
Check here certifying the applicant is a United States citizen or permanent resident alien.
Check here certifying the applicant is NOT a United States citizen or permanent resident alien.
Mr/Mrs/Ms

Last Name

First Name

Suffix - Jr,Sr,etc

Middle Name

Mailing Address

Apt/Suite #

City

State

County/parish

Zip Code

Country

Physical Address

Apt/Suite #

City

State

County/parish

Zip Code

Country

Check box if same as Mailing Address

SSN

Date of Birth (MM/DD/YYYY)

Area Code

Phone Number

MINOR SHAREHOLDERS - Check here if one or more of your shareholders each individually holds shares that total less than 1% of the total
shares of the corporation/business/LLC. For example, there might be three shareholders whose total shares added together is 2% of the total
shares but each shareholder individually only holds 0.66% of the shares.
TOTAL PERCENTAGE (%) of corporation/business/LLC held by minor shareholder(s) that individually holds less than 1% of the total
shares of the corporation/business/LLC.

Page 3

2. ADDITIONAL OFFICER/SHAREHOLDER INFORMATION FOR
CORPORATION/BUSINESS/LLC THAT HOLD THE IFQ ONLINE ACCOUNT
1) If this IFQ online account is held by a business, then complete this section for each officer or partner associated with the business. Provide the
information for all officers or partners that are shown on your most recent annual report. If your business is structured as a corporation, identify all
shareholders in the corporation that own at least 1% or more of the shares, as well as the percentage of all shares in the corporation held by each
shareholder. Individuals holding less than 1% of the shares (minor shareholders) should not be individually listed. Total shareholders must equal 100%.
2) Check the appropriate box below to certify that the applicant is or is NOT a United States citizen or permanent resident alien.

Business name:

Federal Tax ID #:

ALL individuals associated with the above-named account holder must be included in this application. Photocopy this page or attach additional sheets as
necessary to list all officers, directors, shareholders, and registered agents of the business. Provide name, Social Security Number, address, telephone
number with area code, date of birth, and position held in business.
Position held - check ALL that apply
President/CEO

Vice President

Secretary

Treasurer

Director/Manager

Shareholder

Other

Percent (%) of Corporation Held (1% or more)
Check here certifying the applicant is a United States citizen or permanent resident alien.
Check here certifying the applicant is NOT a United States citizen or permanent resident alien.
Mr/Mrs/Ms

Last Name

First Name

Suffix - Jr,Sr,etc

Middle Name

Mailing Address

Apt/Suite #

City

State

County/parish

Zip Code

Country

Physical Address

Apt/Suite #

City

State

County/parish

Zip Code

Country

Check box if same as Mailing Address

SSN

Date of Birth (MM/DD/YYYY)

Area Code

Phone Number

Position held - check ALL that apply
President/CEO

Vice President

Secretary

Treasurer

Director/Manager

Shareholder

Other

Percent (%) of Corporation Held (1% or more)
Check here certifying the applicant is a United States citizen or permanent resident alien.
Check here certifying the applicant is NOT a United States citizen or permanent resident alien.
Mr/Mrs/Ms

Last Name

First Name

Suffix - Jr,Sr,etc

Middle Name

Mailing Address

Apt/Suite #

City

State

County/parish

Zip Code

Country

Physical Address

Apt/Suite #

City

State

County/parish

Zip Code

Country

Check box if same as Mailing Address

SSN

Date of Birth (MM/DD/YYYY)

Area Code

Phone Number

MINOR SHAREHOLDERS - Check here if one or more of your shareholders each individually holds shares that total less than 1% of the total shares
of the corporation/LLC/business. For example, there might be three shareholders whose total shares added together is 2% of the total shares but
each shareholder individually only holds 0.66% of the shares.
TOTAL PERCENTAGE (%) of corporation/business/LLC held by minor shareholder(s) that individually holds less than 1% of the total shares
of the corporation/business/LLC.

Page 4