VMS Certification Form

Atlantic Mackerel, Squid, and Butterfish Amendment 14 Data Collection

VMS Certification Form

VMS installation, activation form and call-in

OMB: 0648-0679

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NMFS NORTHEAST VESSEL MONITORING PROGRAM
FISHING VESSEL NAME: _____________________________________________________
NMFS FISHERIES PERMIT NUMBER: ___________________________________________
COAST GUARD DOCUMENTATION/STATE REGISTRATION NUMBER: ________________
MONITORING FOR (CIRCLE ALL THAT APPLY):
SCALLOP

MULTISPECIES

MONKFISH

HERRING

SURFCLAM/OCEAN QUAHOG

=============================================================

As required by 50 CFR 648.10(e)(1)(ii) and (iii), the vessel owner must confirm the
VMS unit operation and communications service to NMFS by calling the Office of Law
Enforcement (OLE) at (978) 281-9213. This is necessary to ensure that position
reports (and an activity declaration) are automatically sent to and received by NMFS
OLE. Your vessel is not regarded as meeting the VMS requirements until connectivity
with NMFS OLE is verified.

=============================================================

*** PLEASE COMPLETE THIS FORM BY PROVIDING ALL REQUESTED INFORMATION ***
I CERTIFY THAT SUBJECT FISHING VESSEL HAS AN OPERATIONAL VMS UNIT INSTALLED BY:
PURCHASED FROM:

BOATRACS ____

SKYMATE ____

GMPCS ____

INSTALLING DEALER:

NAME, ADDRESS AND TELEPHONE NUMBER:

CLS AMERICA ____

________________________________________________________________
________________________________________________________________
________________________________________________________________

DATE OF INSTALLATION:

________________________________________________________________

SERIAL NUMBER OF VMS UNIT: ______________________________________________________________
E-MAIL ADDRESS OF VESSEL: _______________________________________________________________
VMS UNIT ACTIVATED ON VESSEL AND READY TO SEND FISHING ACTIVITY CODES?

 YES

 NO

VMS UNIT OPERATING INSTRUCTIONS SENT TO VESSEL OWNER BY VMS VENDOR?

 YES

 NO

VESSEL OWNER TRAINED ON USE OF VMS UNIT BY VMS VENDOR?

 YES

 NO

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I UNDERSTAND THAT THE VMS UNIT MUST REMAIN CONNECTED TO THE VMS VENDOR LISTED ABOVE
AT ALL TIMES. I ALSO UNDERSTAND THAT I AM SUBJECT TO THE PROVISIONS AND REQUIREMENTS
OF 50 CFR §648.9 AND §648.10 REGARDING USE OF THE VMS. I HAVE RECEIVED INSTRUCTIONS
FROM THE VMS VENDOR LISTED ABOVE AND UNDERSTAND HOW TO OPERATE THE VMS UNIT.

=============================================================
PERMIT HOLDER’S NAME (printed): ___________________________________
PERMIT HOLDER’S SIGNATURE:

DATE:

_______________

=============================================================
SEND THIS ORIGINAL COMPLETED FORM TO:
NOAA FISHERIES
NE OFFICE OF LAW ENFORCEMENT
55 GREAT REPUBLIC DRIVE
GLOUCESTER, MA 01930
ATTN: NE VMS PROGRAM
or, fax to 1-978-281-9317

OMB Control No. 0648-0202
Expiration Date: 07/31/2016

Public reporting burden for this collection of information is estimated to average 5 minutes per
response, including time for reviewing instructions, searching existing data sources, gathering and
maintaining data needed, and completing and reviewing the collection of information. Send
comments regarding this burden estimate or suggestions for reducing this burden to: John K.
Bullard, Regional Administrator, Northeast Region, NMFS, 55 Great Republic Drive, Gloucester, MA
01930-2276; and to Office of Information and Regulatory Affairs, Office of Management and Budget,
Washington, DC 20503.
The information will be used in the management of the Atlantic sea scallop, Northeast multispecies,
monkfish, herring and surfclam/ocean quahog fisheries by ensuring compliance with VMS
regulations listed under 50 CFR §648.9 and §648.10 (b). 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. Any
information submitted by any person to obtain a permit is not confidential, and may be disclosed
upon request.


File Typeapplication/pdf
File TitleMicrosoft Word - VMS_CERTIFICATION_FORM_REV_JUNE_2013
AuthorPaul.H.Jones
File Modified2013-07-24
File Created2013-06-11

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