Application for replacement of certificates or permits

Revised: 6-29-2011

OMB Control No. 0648-0272 Expiration Date: 10-31-2011

APPLICATION FOR
REPLACEMENT OF CERTIFICATES
OR PERMITS

United States Department of Commerce
National Oceanic and Atmospheric Administration
National Marine Fisheries Service, Alaska Region
Restricted Access Management Program (RAM)
P.O. Box 21668
Juneau, AK 99802-1668
Telephone (800) 304-4846 toll free or
(907) 586-7202 in Juneau
Fax: (907) 586-7354

BLOCK A - IDENTIFICATION OF APPLICANT
1. Name:

2. NMFS Person ID:

3. Business Mailing Address: [ ] Permanent or [ ] Temporary

4. Date of Birth or Date of Incorporation:

5. Business Telephone Number:

6. Business Fax Number:

7. E-mail Address (if available):

BLOCK B – REPLACEMENT REQUEST (Check Only the Items That Apply)
Part I – BSAI Crab Permits and Scallop Permits
[ ]

Crab Annual IFQ Fishing Permit: Permit Number _____________________________

[ ]

Crab Annual IPQ Fishing Permit: Permit Number _____________________________

[ ]

Registered Crab Receiver: Permit Number _____________________________

[ ]

Crab Federal Vessel Permit: Permit Number ________________ Vessel ADF&G Number: _________________

[ ]

Crab IFQ Hired Master Permit: (Application to be completed and signed by permit holder)
Skipper Name: __________________________

Skipper NMFS ID Number: ______________________

[ ]

Crab QS or PQS Transfer Eligibility Certificate (TEC)

[ ]

Crab License Limitation License (LLP): License Number _____________________________

[ ]

Scallop License Limitation License (SLLP): License Number _____________________________

Application for Replacement of Certificates, Permits, or Licenses
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BLOCK B – REPLACEMENT REQUEST (Check Only the Items That Apply)
PART II – Pacific Halibut and Sablefish IFQ Program Permits
[ ] Halibut/Sablefish IFQ Fishing Permit: Permit Number ________________________
[ ] Halibut/Sablefish IFQ/CDQ Hired Master Permit for individual permit holder:
Permit Number ______________________ Species _________________________
[ ] Halibut/Sablefish Transfer Eligibility Certificate (TEC): NMFS Person ID Number _________________
[ ] Registered Buyer Permit: Permit Number _________________________
PART III – Federal Groundfish Permits
[ ]

Federal Fisheries Permit (FFP): Permit Number _________________________

[ ]

Federal Processor Permit (FPP): Permit Number ________________________
Vessel ADF&G Number (if stationary floating processor) ___________________________

[ ]

Groundfish License Limitation License (LLP): License Number ____________________

[ ]

American Fisheries Act (AFA) Inshore Cooperative: Permit Number _____________________

[ ]

American Fisheries Act (AFA) Inshore Processor: Permit Number _____________________

[ ]

American Fisheries Act (AFA) Catcher Vessel Permit: Permit Number ____________________

[ ]

American Fisheries Act (AFA) Catcher/Processor Permit: Permit Number ____________________

[ ]

American Fisheries Act (AFA) Mothership Permit: Permit Number ________________________________

PART IV – Halibut Subsistence
[ ] Subsistence Halibut Registration Certificate (SHARC):
Tribal SHARC Number ____________________

Or

Rural Resident SHARC Number ___________________

[ ] Subsistence Halibut Ceremonial Permit: Permit Number ________________________
PART V – Charter Halibut
[ ] Replace Charter Halibut Permit: Permit Number ________________________________
BLOCK C - REASON FOR REPLACEMENT REQUEST
[ ] Lost [ ] Destroyed [ ] Stolen [ ] Other (explain) _______________________________________________________
BLOCK D – CERTIFICATION OF APPLICANT
Under penalties of perjury, I declare that I have examined this application, and to the best of my knowledge and belief, the
information is true, correct, and complete.
1. Signature of Applicant or Authorized Representative:
2. Date:
3. Printed Name of Applicant or Authorized Representative (Note: If authorized representative, attach authorization):

Application for Replacement of Certificates, Permits, or Licenses
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INSTRUCTIONS
APPLICATION FOR
REPLACEMENT OF CERTIFICATES, PERMITS, OR LICENSES
Use this application to request a replacement for a certificate or permit that was previously issued by NMFS and
that subsequently was lost, destroyed, or stolen.
Please type or print legibly in ink and retain a copy of the completed application for your records.
When completed, submit application:
by mail to:

NMFS Alaska Region
Restricted Access Management (RAM)
P.O. Box 21668
Juneau, Alaska 99802-1668

or deliver to:

709 West 9th Street, Room 713
Juneau, AK 99801

or fax to:

(907) 586-7354

Allow at least 10 business days for your application to be processed.
Items will be sent to you by first class mail, unless you provide alternate instructions and include a prepaid mailer
with appropriate postage or corporate account number for express delivery. Additional information is available
from RAM, as follows:
Website: http://www.alaskafisheries.noaa.gov/ram/default.htm
Telephone (toll free): 800-304-4846 (press “2”)
Telephone (in Juneau): 907-586-7202 (press “2”)
e-Mail: [email protected]

COMPLETING THE APPLICATION
Provide the information requested below regarding the replacement of the item(s) requested.
BLOCK A - IDENTIFICATION OF APPLICANT
1. Name: The full name of the applicant that is the holder of the permit or certificate, and/or license being
replaced.
2. NMFS Person ID: The identification number assigned to the applicant by NMFS, RAM.
3.

Business Mailing Address: Enter the business mailing address, including street or P.O. Box number, state,
and zip code, where the item(s) should be sent.
Check whether the address provided is a permanent or temporary address. If you check “Permanent
Address,” we will update the official RAM database. If you choose “Temporary Address,” we will use it
for this one application only and we will not change the RAM database.

4. Date of Birth or Date of Incorporation. Enter date of birth if applicant is an individual; enter date of
incorporation if applicant is a corporation, partnership, association or other non-individual business entity.
Application for Replacement of Certificates, Permits, or Licenses
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5-7. Business Telephone, Fax Numbers and email address: The business telephone and business fax numbers,
including the area codes, and email address.
Note: It is important to provide a number where NMFS may leave a message to avoid delay in processing the
application if any questions arise.
BLOCK B - REPLACEMENT REQUEST (Parts I through IV)
Check the block for each of the items you are requesting to be replaced. Fill out only the information that pertains
to the items that have been checked.
BLOCK C - REASON FOR REPLACEMENT REQUEST
Indicate the reason(s) for replacement of the items checked in Block B.
BLOCK D – CERTIFICATION OF APPLICANT
Printed name and signature of application and date signed.
If completed by authorized representative, attach authorization.
PUBLIC REPORTING BURDEN STATEMENT
Public reporting burden for this collection of information is estimated to average 30 minutes per response,
including the time for reviewing the 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 the burden, to
Assistant Regional Administrator, Sustainable Fisheries Division, NOAA National Marine Fisheries Service,
Alaska Region, P.O. Box 21668, Juneau, AK 99802-1668.
ADDITIONAL INFORMATION
Before completing this form please note the following: 1) Notwithstanding any other provision of 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; 2) This information is mandatory and is required to manage
commercial fishing efforts under 50 CFR part 679 and under section 402(a) of the Magnuson-Stevens Act
(16 U.S.C. 1801, et seq.). 3) Responses to this information request are confidential under section 402(b) of the
Magnuson-Stevens Act as amended in 2006. They are also confidential under NOAA Administrative Order
216-100, which sets forth procedures to protect confidentiality of fishery statistics.

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