International Dolphin Conservation Program vessel permit

OMB Control No.
0648-0387
Expires:
January 31, 2012

VESSEL PERMIT APPLICATION - 2011
$200.00 Fee
Species Sought:

Yellowfin and Other Tuna and Tuna-like Species

The collection of information is mandated by the Marine Mammal Protection Act (16 U.S.C. 1371) and by implementing
regulations contained at 50 CFR §216.24(b)(1). The information supplied on this form will be used by the National
Marine Fisheries Service to authorize the incidental take and to alert vessel owners of applicable rules and
regulations regarding the permit for the taking of marine mammals incidental to commercial purse seine fishing for
yellowfin tuna in the eastern tropical Pacific Ocean. The name of the vessel and owner, official number, tonnage,
carrying capacity and business address supplied on this form may be released under the Freedom of Information Act.
other information supplied on this form are considered proprietary and therefore subject to data confidentiality
restriction of National Oceanic and Atmospheric Administration Administrative Order 216-100.

All

1. VESSEL INFORMATION
a. NAME OF VESSEL:

b. OFFICIAL NUMBER:

c. TONNAGE:

d. CARRYING CAPACITY:

e. MAXIMUM VESSEL SPEED:

(short or metric tons)

(knots)

f. FEDERAL, STATE, AND COMMERCIAL FISHING LICENSES:
(include type, identification numbers, and expiration dates)

g. TYPES OF PROCESSING EQUIPMENT:

2. OWNER INFORMATION
I hereby certify that the above-named vessel, bearing the official number indicated, is owned
as follows. (State the nature of ownership, e.g., corporation, partnership, joint venture, etc., after
the owner's name.):

OWNER'S NAME:
BUSINESS ADDRESS:
TELEPHONE:
FAX:

3. VESSEL PERMIT HOLDER INFORMATION
THE VESSEL PERMIT WILL BE ISSUED TO THE OWNER IDENTIFIED IN BLOCK 2. PROVIDE THE FOLLOWING
INFORMATION IF THE PERMIT IS TO BE ISSUED TO THE MANAGING OWNER INSTEAD OF THE OWNER:
MANAGING OWNER'S NAME
BUSINESS ADDRESS:
TELEPHONE:
FAX:

4. OPERATOR INFORMATION
NAME OF PERMITTED OPERATOR:

5. MARINE MAMMAL SAFETY INFORMATION
Does the above-named vessel intend to make intentional purse seine sets on marine
mammals to capture tuna?

YES

NO

Dolphin Safety Panel

YES

NO

Dolphin Safety Panel Markers

YES

NO

IF YES, IS THE VESSEL EQUIPPED WITH THE FOLLOWING DOLPHIN SAFETY GEAR?

Dolphin Safety Panel Hand Holds are securely fastened

YES

NO

Dolphin Safety Panel Corkline Hangings are securely fastened

YES

NO

An operational Dolphin Safety Light capable of producing 140,000 lumens

YES

NO

Minimum of 3 speedboats equipped with towing bridles or towing posts

YES

NO

At least two Operational Facemasks, Snorkels, or Viewboxes

YES

NO

Operational Raft

YES

NO

6. VESSEL CONTACT PERSON
THE FOLLOWING PERSON HAS THE AUTHORITY TO DEAL WITH NMFS ON BEHALF OF THE VESSEL:
a. NAME:
BUSINESS ADDRESS:

b. RELATIONSHIP TO VESSEL OWNER
OR MANAGING OWNER (specify):

TELEPHONE:
FAX:

7. PERSON COMPLETING THIS APPLICATION
a. NAME:

b. RELATIONSHIP TO VESSEL OWNER OR
MANAGING OWNER:

I agree to release to the National Marine Fisheries Service (NMFS) all records made by Inter-American
Tropical Tuna Commission observers during fishing trips aboard the vessel under this permit and furnish
the international observer program with all release forms required to authorize the observer data to be
provided to NMFS. Under penalty of perjury, I declare that the information in this application is true
and complete.

SIGNATURE OF THE PERSON COMPLETING THIS APPLICATION

DATE

Upon completion, submit with $200.00 fee in check payable to: National Marine Fisheries
Service; Protected Resources; 501 West Ocean, Blvd., Suite 4200; Long Beach, CA 90802-4213
Public reporting burden for this collection of information 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 Regional Administrator,
Southwest Region, National Marine Fisheries Service, 501 West Ocean Boulevard, Suite 4200, Long Beach, California,
90802-4213, (562) 980-4001.
The National Marine Fisheries Service may not conduct or sponsor, and a person is not required to respond to, a
collection of information unless it displays a current and valid OMB Control number.