Application to Downgrade Leasing Baseline

APPLICATION TO DOWNGRADE
NE MULTISPECIES DAYS-AT-SEA (DAS)
LEASING BASELINE
Provide all information requested.
SUBMIT TO
Provide all information requested.
NE MULTISPECIES DAS LEASING PROGRAM
US DEPARTMENT OF COMMERCE, NOAA
NATIONAL MARINE FISHERIES SERVICE
55 GREAT REPUBLIC DRIVE, GLOUCESTER, MA 01930

Owner Name:
Vessel Name:

Permit
#:
ONe
ONE BLACKBURN DRIVE,
GLOUCESTER,
MA 01930
Official
#:

(or state registration #)

Current Vessel Specifications:

Length Overall: ______
Horsepower: ________

Check One:
____ Downgrade DAS Leasing baseline of above vessel to the
specifications on verified documents that have been previously
submitted.
____ Downgrade DAS Leasing baseline of above vessel to the
specifications on verified documents that I am currently submitting
with this application.
Signed: _______________________

Dated: _____________________

(Vessel Owner)
By signing this application you agree to downgrade the vessel specifications Length Overall (LOA) and Horsepower (HP) for DAS
Leasing purposes only. This is a one-time DAS Leasing baseline downgrade for this permit that can not be reversed for this
vessel and can not be applied for again in the future, even if the current vessel baseline specifications change through
modification or replacement. If a vessel replacement occurs after a DAS Leasing baseline downgrade has occurred the DAS
Leasing baseline will revert to the original DAS Leasing baseline specifications for that permit.
This form is required to obtain approval for the downgrade of DAS leasing baseline specifications under 50 CFR 648.82(k)(4)(xi)
for NE multispecies permit holders. Signature of this form certifies that permit holders comply with limited access permit
requirements specified in 50 CFR 648.4 and that information provided on this form is true, complete and correct to the best of their
knowledge, and made in good faith (18 U.S.C. 1001). Making a false statement on this form is punishable by law.
Information obtained from the lease application is held confidential as required by NOAA Administrative Order 216-100,
Confidentiality of Fisheries Statistics, and would be used only in summarized form (without identifying the source of data, i.e.,
vessel name, owner, etc.) for management of the fishery in the future.
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 1 hour per response, including time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the
information. Send comments regarding this burden estimate or suggestions for reducing this burden estimate or any other aspect
of this collection of information to NMFS, 55 Great Republic Drive, Gloucester MA 01930.
OMB Control No. 0648-0475
Expiration Date: 12/31/2013