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Federal Northeast Seafood Dealer                   
Initial Dealer Permit Application
	

SECTION 1 ‑ DEALER INFORMATION

Company name:                                                            __                                   

Owner’s Name:	                                                         ____                                           

Mailing Address:________________________________

Email Address:__________________________________                             

City:                                             State  :                Zip Code:                           ___   

Telephone:                                                Fax Number:                                     ___   

**Vessel Name:                                 ___      **Vessel Hull Number:_____________                           
**(if you are applying for an Atlantic Mackerel at Sea Processor permit or an Atlantic Herring at Sea Processor permit, you must enter a vessel name and hull number above and include a copy of the vessel’s current Coast Guard Documentation or State Registration.)

If regulated species are purchased or received for commercial purposes at more than one place of business, each address must be listed.  List those additional addresses on the back of this form in Section 1A. 


SECTION 2 - FISHERIES

Select the fisheries desired by placing an (X) in the boxes provided.  Select all fisheries that apply.  


Atlantic bluefin tuna


Northeast multispecies


Scup









Other Atlantic Tunas 
(Yellowfin, Bigeye, Skipjack, 


American lobster


Black sea bass










Albacore)


Skate



Monkfish









Surfclam/Ocean quahog - Dealer


**Atlantic mackerel at sea processor 



Atlantic bluefish









Surfclam/Ocean quahog - Processor


Squid, Atlantic mackerel, butterfish


Spiny Dogfish










Summer flounder


Atlantic herring - Dealer



Tilefish










Atlantic sea scallop


**Atlantic herring At Sea Processor


Atlantic Deep-sea Red Crab










Atlantic Hagfish


** (see note in Section 1)













SECTION 3 ‑ OWNER'S NAME AND SIGNATURE 
I affirm, subject to the penalties provided in 18 USC 1001, that all information I have given in obtaining this permit is true and correct.  

Print Name: __________________________                                                                                              

Signature:                                                            Date:  _________________                                  

OMB# 0648-0202   



SECTION 1A - ADDITIONAL DEALER INFORMATION. If regulated species are purchased or received for commercial purposes at more than one place of business, each address must be listed below.

Company Address






               Company Address





                    Company Address







Company Address








For further information, call Northeast Permits Operations at (978) 281‑9370

The information requested on this form is not confidential and will be available to the general public upon request.

The Paperwork Reduction Act requires potential respondents for a dealer/processor permit be notified of certain information regarding their rights and the burden associated with applying for a Federal dealer/processor permit.  One of the regulatory steps taken by the National Marine Fisheries Service (NMFS) to carry out conservation and management objectives is the requirement of a permit for users of the resources.  All the fisheries included on this application require a permit to purchase, or otherwise receive for transport for a commercial purpose, other than solely for transport on land, species harvested by the owner or operator of a fishing vessel issued a Federal fisheries permit for these species.  Section 303(b)(1) of the Magnuson-Stevens Fishery Conservation and Management Act (MSFCMA) specifically recognizes the need for permit issuance.

The purpose and use of permits is to:  (1) register fish dealers and processor, (2) list the characteristics of dealer/processor operations, (3) exercise influence over compliance (e.g. withhold issuance pending collection of unpaid penalties and / or required reports), (4) provide a mailing list for the dissemination of important information to the industry, (5) provide a universe for data collection samples, and (6) obtain first purchase information on landings to evaluate the biological, economic and social implications of management measures.

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 15 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:  National Marine Fisheries Service, Permit Office, 55 Great Republic Drive, Gloucester, MA 01930‑2276.
 					
OMB# 0648-0202   Expiration Date   April 30, 2013