AMLR Dealer permit application

OMB No.:01648-0194
(Expires 6/30/2016

THE UNITED STATES OF AMERICA
DEPARTMENT OF COMMERCE
NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION
APPLICATION FOR DEALER PERMIT TO IMPORT and/or RE-EXPORT ANTARCTIC MARINE LIVING RESOURCES

Under the provisions of the Antarctic Marine Living Resources Convention Act 1984, the following persons(s)
submit(s) this application to import/and re-export Antarctic Marine Living Resources.

(1)

COMPANY(Business) NAME:
ADDRESS:
CITY:______________________ ST:________________ZIP CODE:_______________________
PHONE:_______________________ FAX: __________________________________

(If Nonresident then Provide the Following Information about Registered Agent)

(1a)

COMPANY(Business) NAME:
ADDRESS:
CITY:______________________ ST:________________ZIP CODE:_______________________
PHONE:_______________________ FAX: __________________________________

(2)

SPECIES: _________________________________________

(3)

ESTIMATED ANNUAL TOTAL TONNAGE TO BE IMPORTED: ____________________________

(4)

Please check one of the following:
I am applying for a re-export permit in addition to an import permit.
I am applying for a re-export only.

(5)

Signature:________________________Title:

Submitted Date :__________________

Completion of this application is required to obtained a permit to import Antarctic marine living resources under provisions of the Antarctic Marine
Living Resources Convention Act of 1984 (16 USC 2431 et seq). No permit will be issued without completion of this application. Permits to import
AMLR enable NMFS to track all imports and ensure that all AMLR are being imported in compliance with all applicable regulations. Continuing
measures and U.S. regulations implementing them appear in Volume 50, Part 300 Subpart G of the Code of Federal Regulations. Annual measures
are noticed in the Federal Register and are also available at CCAMLR website located at http://www.ccamlr.org.
Public reporting burden for this collection of information is estimated to average 10 minutes per response, including the time review ing instructions, searching existing data
sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Notw ithstanding any other prvision of the law, no person
is required to respond nor shall any person be subject to a penalty for failure to com ply w ith, a collection of informatoin subject to the requirem ents of the Paperw ork
R eduction A ct, inless that collection of information displays a currently valid O M B C ontrol N um ber. Send C om ments regarding this burden estimate or any other aspect
of this collection of information, including suggestions for reducing this burden, to N ational M arine Fisheries Service, O ffice of International A ffairs, 1315 East W est
H ighw ay, A ttention: C C A M LR Permit O ffice, Silver Spring, M aryland, 20910.