Fisheries Certificate of Origin

CAPTAIN’S STATEMENT

Fishing Vessel Name:

Fishing Vessel Trip Dates

Trip Start Date:

Trip End Date:

Fishing Vessel Flag:

Fishing Vessel Ocean Area of Harvest:

I, , as captain of the above named (print name)

fishing vessel, hereby certify that no purse seine net or other fishing gear was intentionally deployed on or used to encircle dolphins during the fishing trip and that no dolphins were killed or seriously injured in the sets in which the tuna were caught. I also certify that I have completed the National Marine Fisheries Service dolphin-safe training course.

Captain’s signature Date signed