HMS International Trade Permit - addition to PRA stateme

OMB &RQWURO1R0648-0327 Expiration Date: 07/31/2015

NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION

HIGHLY MIGRATORY SPECIES
INTERNATIONAL TRADE PERMIT

(READ INSTRUCTIONS PRIOR TO COMPLETING THE INITIAL APPLICATION)

SECTION 1 - DEALER/BUSINESS INFORMATION
Business Name

Business Type G Sole Proprietorship or Individual
(Check one)

G Joint Owner

G Partnership

G Other ____________

Federal ID No.

Date Business Formed (mm/dd/yy)

Dun & Bradstreet (DUNS) No. (optional)

U.S. Importer No.

G Corporate

Mailing Address

Daytime Phone No.
(

City

State

Zip Code

Email Address

Website

)

Fax Phone No.
(

)

Cell Phone No.
(

)

SECTION 2 - ADDITIONAL FACILITIES (add additional sheets if necessary)
Business Name

Physical Address

Daytime Phone No.

Fax Phone No.

(

(

)

City

State

Business Name

Physical Address

Zip Code

Daytime Phone No.

Fax Phone No.

(

(

)

City

)

State

Business Name

Physical Address

)

Zip Code

Daytime Phone No.

Fax Phone No.

(

(

)

City

)

State

Zip Code

SECTION 3 - APPLICANT INFORMATION
Name

Social Security No.

Position in Business (if applicable)

Street Address (if different from Section 1)

Daytime Phone No.
(

City

State

Zip Code

(
Email Address

)

Fax Phone No.

Birth Date (mm/dd/yy)

)

Cell Phone No.
(

)

SECTION 4 - ADDITIONAL FEDERAL OR STATE DEALER LICENSES
List All Dealer License Number(s) with Corresponding State or Federal Agency
1.

2.

3.

4.

SECTION 5 – PAYMENT and DELIVERY INFORMATION
Mail this application with a check or
money order made out to the United
States Treasury for $25.00 to:

Delivery Options
(check the appropriate box)

G 2-Day Priority Mail (address in Section 1)
NMFS Permits Team
Southeast Regional Office
263 13th Avenue, South
St. Petersburg, FL 33701

G Federal Express
(For FedEx delivery, include completed
air bill – see instructions on reverse side)

FOR OFFICE USE ONLY
SERO Dealer No.
Expiration Date

Reviewer’s Initials

Violation Date

Cleared Date/Initials

SECTION 6 - APPLICANT SIGNATURE
Signature:

Date:

Print or type name:

Position in Business (if applicable)

NOAA National Marine Fisheries Service (NMFS)
Highly Migratory Species International Trade Permit
A NMFS Highly Migratory Species International Trade Permit is required pursuant to 50 CFR 300.182 to
import, export, or re-export swordfish, bluefin tuna, southern bluefin tuna, frozen bigeye tuna, and/or
shark fins, regardless of ocean area of origin.

Application Instructions
Section 1

Print or type the requested information.

Section 2

Print or type the names and addresses of additional facilities where fish are received, if
applicable. If more space is needed, attach an additional sheet.

Section 3

Print or type the requested information.

Section 4

List all other state and Federal licenses, if applicable.

Section 5

Select appropriate delivery options. For FedEx delivery, a completed airbill, including your
account number or major credit card number with expiration date, is required. Include a
check or money order for $25 made payable to the United States Treasury.

Section 6

The application must be complete and signed by the applicant (as named in Section 3) or it
will be returned. The applicant’s signature declares under of penalty of law that all
information on the application is true, accurate and complete.

Paperwork Reduction Act Notification: Public reporting burden for this collection of information is estimated to average
5 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: NMFS, Highly Migratory Species Division, 1315 East West Highway, Silver Spring, MD 20910. The
Paperwork Reduction Act requires potential respondents for a dealer permit to be notified of certain information regarding their
rights and the burden associated with applying for a Federal dealer permit. One of the regulatory steps taken by NMFS to carry out
conservation and management objectives is the requirement of a permit for users of the resources. Section 971(d) of the Atlantic
Tunas Convention Act authorizes the promulgation of regulations as may be necessary and appropriate to implement the
recommendations of the International Commission for the Conservation of Atlantic Tunas (ICCAT). This permit is necessary for the
implementation of required ICCAT trade monitoring programs. Name and address information will be released via a NOAA
website. Pursuant to Section 402(b) of the Magnuson-Stevens Act, and consistent with NOAA Administrative Order 216-100
(Confidentiality of Fisheries Statistics), the Agency does not release confidential information submitted in compliance with
provisions of the Act, other than in aggregate form and under circumstances required or authorized by law. Whenever data are
requested or released to the general public, the Agency ensures that information on the pecuniary business activity of a dealer is
not identified. 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.