West Coast Groundfish Observer Contact Information

Northwest Trawl Catch Shares

Submit by Email

Observer and Catch Monitor Contact Information Form
Observer Provider

Submission Date:

Full Name (F, MI, L)
NW ID #

Full Name (F, MI, L)
Home Port

NW ID #

Home Port

Street Address

Street Address

City

City

State:

Zip Code

State:

Zip Code

Cell Phone Number:

Cell Phone Number:

Home Phone Number:

Home Phone Number:

Full Name (F, MI, L)

Full Name (F, MI, L)

NW ID #

Home Port

NW ID #

Home Port

Street Address

Street Address

City

City

State:

Zip Code

State:

Zip Code

Cell Phone Number:

Cell Phone Number:

Home Phone Number:

Home Phone Number:

Full Name (F, MI, L)

Full Name (F, MI, L)

NW ID #

Home Port

NW ID #

Home Port

Street Address

Street Address

City

City

State:

Zip Code

State:

Zip Code

Cell Phone Number:

Cell Phone Number:

Home Phone Number:

Home Phone Number:

If you have questions, contact Rebecca Hoch (206) 437-2415, [email protected]
Public reporting burden for this collection of information is estimated to average 5 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 Janell majewski, NWFSC, 2725 Montlake Blvd, East, Seattle, Washington 98112. 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.
Trawl Catch Shares v.3 11/10/2010

OMB Control #: 0648-0500 Expiration Date: MM/DD/YYYY