Federal Permit Application for an Annual Dealer Permit

Instructions for the Federal Permit Application for Annual Dealer
Permit
Rev 04/04/2017
In addition to the instructions provided herein, applicants with specific questions are encouraged to contact the
Permits Office at (727) 824-5326 or toll free at (877) 376-4877 between 8:00 a.m. and 4:30 p.m. ET, or visit
the SERO Permits website at sero.nmfs.noaa.gov/permits.

Please consult the U.S. Code of Federal Regulations whose guidance for application requirements, permit
eligibilities, and related information will always prevail. NMFS will return incomplete or illegible applications.

General Instructions:
What Sections do I complete?
Complete all applicable sections of this application form. All application fields should be typed or printed in ink.
Specifically,
All applicants must fill out Section 1, 2, and 3.
If the dealership, as listed in Section 1 and on the applicable state wholesale licenses, is a business
that is owned by another business, fill out Section 4.
If the dealership, as listed in Section 1, is a business, fill out Section 5 for all individual owners of the
dealership listed in Section 1.
Also, complete Section 5 for all individual owners of businesses that own dealership, as listed in Section
4. Copy Sections 4 and 5 as necessary to provide information for all owners of the dealership, and
owners of businesses that own the dealership.
All applicants must fill out Sections 6 and 7.
See pages 2-4 for information about specific sections of this application.
What is the fee?
The application fee is $50 for one fishery and $12.50 for each additional fishery, as described in the table
below. This application fee is collected to cover the administrative cost of processing the application, and is nonrefundable.
The fee to replace one or more permits issued to a dealer is $18. NMFS will not refund money for denied
permits. A check or money order payable to the U.S. TREASURY must accompany each application.
Permits 1 = $50

2 = $62.50

3 = $75

Where do I send the application?
Mail the complete application, payment, and all required supporting documentation to:
NMFS Permits Office (F/SER14)
263 13th Avenue South,
St. Petersburg, FL 33701
To receive permits via overnight carrier, enclose a completed, pre-paid air bill and envelope. Please note using
the prepaid overnight delivery option does not expedite permit processing; it only expedites delivery of your
completed permit package.

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What about reporting compliance?
NMFS will not renew a dealer permit until all reporting requirements for the permit being renewed have been met
(e.g., SAFIS, Trip Ticket, HMS electronic dealer reporting, e-1 Ticket, PC-1 Ticket programs). To avoid delays,
applicants are encouraged to comply with all reporting requirements before submitting a permit application.
• Communications concerning Atlantic shark and/or swordfish dealer reporting requirements must be directed
to the Atlantic Highly Migratory Species (HMS) Management Division at (301) 427-8590
• Communications concerning Gulf and South Atlantic Dealer (GSAD) reporting requirements must be directed

to the SEFSC Quota Monitoring Office at (305) 361-4581. Current reporting status can be viewed
at http://sefsc.noaa.gov/drsr/DealerReportingStatus.jsp
What supporting documentation do I need?
State Wholesale License: Provide a copy of the valid state whole sale license for each state in which the
dealership has a facility
Payment: Include a check or money order made out to the US Treasury. See “What is the Fee” on page 1
of these instructions for more information.
HMS Workshop Certificate: Shark dealers must provide a copy of one of the following HMS Workshop
Certificates:
(A) Valid Dealer Certificate,
(B) Valid Proxy Certificate from an employee of the dealership, or
(C) If the dealer’s has an expired shark dealer permit, or if the dealer has never been issued a shark dealer
permit, a General Participant Certificate from an officer or owner of the dealership will also be accepted.
APPLICATION SECTION 1 –DEALER INFORMATION.
Complete all applicable portions of Section 1.
In Section 1A
• Enter the dealership name as it appears on the state wholesale license(s). If the dealership uses a fictitious
name, or does business as another name, provide the DBA name in the space provided. All dealerships must
provide a valid email address, and telephone number.
• If the dealership is a business, provide the dealership’s Federal Employer Identification Number (FEIN) and date
the dealership was formed.
• For a brief definition of applicable business types, see our frequently asked questions at
http://sero.nmfs.noaa.gov/operations_management_information_services/constituency_services_branch/permits/
permit_faq/index.html
• If the dealership is an individual, provide the dealer’s Social Security Number (SSN) and date of birth.
In Section 1B
• Provide a mailing and physical address for the dealership in Section 1b.

APPLICATION SECTION 2 – Permits Requested.
Indicate the fishery and transaction type of the permits requested.

APPLICATION SECTION 3 – Receiving Facilities.
Provide information for each physical address where fish are received. The “physical facility” must
be the dealer’s brick and mortar facility. If the facility listed is a marina, boat ramp, dock, or other
location where the boat unloads, than the dealer must own or leases the marina, boat ramp, dock,
or other place. Public docks and boat ramps may not be considered a dealer facility.
Include a copy of the state wholesale license from each state in which the dealer has a facility.
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Company B

APPLICATION SECTION 4 –Businesses that Own Businesses
Complete this section for any business that owns more than 1% of any business within the
ownership hierarchy of the dealership.

Company A

For every business, the sum of ownership, by either individuals or other businesses, must total 100%.
Photocopy this section as necessary to provide information about all businesses within the
ownership hierarchy of the dealer.

• For each business, provide the business’s full name, tax ID number (FEIN), date the business was
formed, phone number, physical and mailing address, and business type.
• Indicate if the business was established by the laws of the United States or any state of the United
States. Note, this information will not affect eligibility to obtain a permit.
• Provide an email address or SMS mobile phone number to receive digital updates about your permit and
application status (when available).
• For a brief definition of applicable business types, see our frequently asked questions at
http://sero.nmfs.noaa.gov/operations_management_information_services/constituency_services_branch/permits/
permit_faq/index.html
•
Example: If the dealer, as identified by the state wholesale license(s), is owned by Company A, provide
information about Company A in Section 4. If Company B owns Company A, also provide information about
Company B in section 4.

APPLICATION SECTION 5 – Businesses Officers and Individual Owners
Complete this section for any individual that owns more than 1% of any business within the ownership
hierarchy of the dealership, as listed in section 1 and 4. For every business, the sum of ownership, by
either individuals or other businesses, must total 100%. Photocopy this section as necessary to
provide information about all businesses within the ownership hierarchy of the vessel
• For each individual owner or officer, include the entity’s full name, tax ID number (SSN), date of birth, phone
number, physical address, mailing address, sex, and race/ethnicity information.
• Indicate if the individual is a United States citizen or permanent resident alien. Note, this information will not
affect eligibility to obtain a permit.
• Provide an email address or SMS mobile phone number to receive digital updates about your permit and
application status (when available).
• Minor shareholders: Complete Section 5b if a business listed in Section 1, or 4 has owners that individually own
less than 1% of the business. Provide the total percentage of ownership which is individually held by owners who
own less than 1%. This section is left blank for most applicants.
Example: If the dealership is owned by Company A, provide information about all owners and officers of
Company A. If Company A is also owned in whole or part by Company B, complete section 5 to provide
information about all individual owners and officers of Company A and Company B.
Photocopy this section as necessary to provide information about all businesses and their respective owners and
officers that comprise the ownership hierarchy of the vessel.

APPLICATION SECTION 6 – Small Business or Organization Certification
This section is required for ALL applicants. Review the business/organization descriptions in the boxes directly under
the word “START”, and identify the one that describes the applicant’s primary activity. Then answer the questions in
the box to the right of the business activity you selected.
If you have questions about these standards or the definition of affiliation, please call Southeast Regional
Economist Mike Travis at 727-209-5982.

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APPLICATION SECTION 7 – SIGNATURE FOR APPLICATION
The applicant must sign the application in section 7. If the dealership is a business, the signee must be an
officer or owner of the dealership business.

KNOWINGLY SUPPLYING FALSE INFORMATION OR WILLFULLY OVERVALUING ANY FISHING INCOME TO OBTAIN A
PERMIT IS A VIOLATION OF FEDERAL LAW PUNISHABLE BY A FINE AND/OR IMPRISONMENT.
Public reporting burden for this collection of information is estimated to average 30 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: PRA Officer, National Marine Fisheries
Service, F/SER26, 263 13th Avenue South, St. Petersburg, FL 33701.
The National Marine Fisheries Service requires this information for the conservation and management of marine fishery resources. The data
reported will be used to develop, implement, and monitor fishery management activities for a variety of other uses. Responses to this collection are
required to obtain or retain a fisheries permit under the Magnuson - Stevens Act. Non-confidential information may be released via a NOAA
Fisheries website. Non-confidential information means: Name, Street Address, City, State, Zip Code, Effective Date of Permit, Permit Types, Vessel
Name, Vessel Identification Number, Vessel length, Vessel tonnage (gross and net), Vessel horse power, in the case of a “for hire” vessel the
Passenger Capacity, or individual, corporate and lease holders of permits. All other data submitted will be handled as confidential material in
accordance with NOAA Administrative Order 216-100, Protection of Confidential Fishery Statistics. 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.

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OMB Control No. 0648-0205; Expiration date: 04/30/2017

U.S. Department of Commerce, NOAA
NMFS PERMITS OFFICE, F/SER14
263 13th Avenue South
St. Petersburg, FL 33701
Toll Free 877-376-4877 (8:00 a.m. - 4:30 p.m. ET)
727-824-5326 (8:00 a.m. - 4:30 p.m. ET)
sero.nmfs.noaa.gov/permits

FEDERAL PERMIT APPLICATION FOR
AN ANNUAL DEALER PERMIT
FOR OFFICE USE ONLY
Reviewer’s Initials and Date
Check or Money Order Number
and Amount
SERO Dealer Number
Non Compliance Hold Date
Non Compliance Cleared Date
Expiration Date

FOR OFFICE USE ONLY

SCAN DATE AND INITIALS

Application ID
Include a copy of the State Wholesale/Dealer license for each state where product will be first received from the commercial fisherman/vessel. The name shown on your
State Wholesale License(s) and your Federal Dealer permit must match in ownership. Please provide the name below as it appears on the State Wholesale License. The date
formed refers to the date in which the corporation or business was formed (the date the business was filed for with the Secretary of State in the state where the business was
formed). The FEIN is the number that was provided to you by the IRS (if applicable).

SECTION 1 - DEALER INFORMATION (PERMIT HOLDER)
Provide the name below as it appears on the state wholesale or dealer license.
Yes

Do you use a DBA
name?

1a. Dealer’s Name as it appears
on the State Wholesale License
Area Code

If yes, What is the DBA name?

Phone Number

No

E-Mail Address (REQUIRED)

If the dealer is a Business:
Dealer is
(check one):

S Corporation

Cooperative

Other _____________

C Corporation

Limited Liability Co.

Partnership

Tax ID Number (FEIN)

What is this
individual’s
race?

YES

Date Business Formed (MM/DD/YYYY)

Is this individual a United States Citizen
or permanent resident alien?

If the dealer is an Individual:
What this individual’s
Sex?

Was this Business properly established
by the laws of the United States or any
state of the United States?

Male

YES

Is this Individual of Hispanic, Latino, or Spanish origin?

Female

NO

White

American Indian or Alaska
Native

Native Hawaiian or Other Pacific Islander

Black or African American

Asian American

Other _______________

First Name

Middle Name

Last Name

Tax ID Number (SSN)

No

Yes

Suffix - Jr, Sr, etc.

Date of Birth (MM/DD/YYYY)

1.b. REQUIRED—Address Information for either Business Or Individual Dealer:
Mailing Address

Apt #

City

State

County/Parish

Zip Code

Country

State

County/Parish

Zip Code

Country

Check box if the Physical Address is the same as the mailing address.
Physical Address (PO Box not acceptable)

Apt #

City

1

D2017.4P - Form Revision 03/21/2017

NO

SECTION 2 - PERMITS
Indicate which permit(s) you are applying for by checking the box adjacent to the corresponding fishery. Also indicate if this is a new or renewal
of a permit.
NEW

RENEW

FEE SCHEDULE

Gulf of Mexico and South Atlantic Dealer (GSAD)

1 Permit = $50.00

Domestic Atlantic Swordfish (SD)
(Includes the Gulf of Mexico and the U.S. Caribbean)

2 Permits = $62.50

Atlantic Shark (SK)
(Includes the Gulf of Mexico and U.S. Caribbean)

3 permits = $75.00

Applicants for an Atlantic Shark Dealer permit must provide a copy of the unexpired Shark Identification Workshop Certificate for each
facility listed below OR have a copy of the unexpired certificate on file with the permits office at the time of application.

SECTION 3 - RECEIVING FACILITIES
List the names and physical addresses for facilities where product is received (fish is off loaded from the fishing vessels). Please copy this page as needed to
provide information on all facilities where fish are received. If you receive product in different states, you must provide a copy of your valid State Wholesale
License for each state.

Check here if a location where you receive product from fishermen is the same as the physical address from section 1 or for
sole proprietor’s in section 2. If checked, you do not need to re-list that location here.
1. Facility Name

Physical Address (PO Box not acceptable)

Area Code

Apt #

City

State

2. Facility Name

Physical Address (PO Box not acceptable)

City

State

Apt #

City

State

4. Facility Name

Physical Address (PO Box not acceptable)

Apt #

City

State

Physical Address (PO Box not acceptable)

Apt #

City

State

Physical Address (PO Box not acceptable)

Apt #

City

State

2

Country

Zip Code

Country

Zip Code

Country

Phone Number

County/Parish

Area Code

6. Facility Name

Zip Code

Phone Number

County/Parish

Area Code

5. Facility Name

Country

Phone Number

County/Parish

Area Code

Zip Code

Phone Number

County/Parish

Area Code

3. Facility Name

Physical Address (PO Box not acceptable)

County/Parish

Area Code

Apt #

Phone Number

Zip Code

Country

Phone Number

County/Parish

Zip Code

Country

SECTION 4 - BUSINESSES THAT OWN THE DEALER
Complete this section for each business that owns 1% or more of the dealer shown in section 1. Copy this section as needed.

Section 4a: Business owner:
Business for which this business is an owner of:
Percent of Business Owned:
Type of
business:

S Corporation

Cooperative

Other_______________

C Corporation

Limited Liability Co.

Partnership

Was this Business properly established by
the laws of the United States or any state
of the United States?

YES
NO

Registered Name of Business

Tax ID Number (FEIN)

Date Business Formed (MM/DD/YYYY)

Mailing Address

Apt #

City

Area Code

Phone Number

State

County/Parish

Zip Code

Country

State

County/Parish Zip Code

Country

Check box if the Physical Address is the same as the mailing address.
Physical Address (PO Box not acceptable)

Apt #

City

OPTIONAL: Check here if you would you like to receive digital updates (texts & emails). Provide your digital contact information below.

Cell Phone number and provider:

Email
Section 4b: Additional Business owner:
Business for which this business is an owner of:
Percent of Business Owned:
Type of
business:

S Corporation

Cooperative

Other_______________

C Corporation

Limited Liability Co.

Partnership

Was this Business properly established by
the laws of the United States or any state
of the United States?

Registered Name of Business

Tax ID Number (FEIN)

Mailing Address

Date Business Formed (MM/DD/YYYY)

Apt #

City

Area Code

Phone Number

State

County/Parish

Zip Code

Country

State

County/Parish Zip Code

Country

Check box if the Physical Address is the same as the mailing address.
Physical Address (PO Box not acceptable)

Apt #

City

OPTIONAL: Check here if you would you like to receive digital updates (texts & emails). Provide your digital contact information below.

Email

Cell Phone number and provider:

3

YES
NO

SECTION 5 - BUSINESS OFFICERS AND INDIVIDUAL OWNERS (Cont.)
Complete this section by providing information on all individual officers and owners that own 1% or more of any business listed in section 1 (the dealer) and/or
section 4 (businesses that own the dealer). Copy this section as needed to provide information about ALL officers and shareholders.

Section 5b: Individual Officer/Owner:
Business for which this individual is an officer/owner of:
Position Held - Check ALL That Apply
Vice President
President/CEO
Percent of Business Owned:
What this individual’s
Sex?
What is this
individual’s
race?

Male

Secretary

Treasurer

Director/ Manager

Shareholder

Other
YES

Is this individual a United States citizen or permanent resident
Is this Individual of Hispanic, Latino, or Spanish origin?

Female

Yes

White

American Indian or Alaska
Native

Native Hawaiian or Other Pacific Islander

Black or African American

Asian American

Other _______________

Last Name

Tax ID Number (SSN)

Mailing Address

Middle Name

First Name

Date of Birth (MM/DD/YYYY)

Apt #

City

Area Code

NO
No

Suffix - Jr, Sr, etc.

Phone Number

State

County/Parish

Zip Code

Country

State

County/Parish Zip Code

Country

Check box if the Physical Address is the same as the mailing address.
Physical Address (PO Box not acceptable)

Apt #

City

OPTIONAL: Check here if you would you like to receive digital updates (texts & emails). Provide your digital contact information below.

Email

Cell Phone number and provider:

Section 5b: Minor Shareholders: Complete this section by providing information on all individual officers and owners that own less than
1% of any business listed in section 1 (the dealer) and/or section 4 (businesses that own the dealer).

MINOR OWNERS - Check here if one or more owners (individual OR business) holds shares that are less than 1% of the total business shares.
TOTAL PERCENTAGE of the business shares held by minor owners.

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SECTION 6 - SMALL BUSINESS OR ORGANIZATION CERTIFICATION

(All Applicants must complete this section)
For vessels that are leased, complete this section for business(es)/organization(s)/sole proprietorship(s) that lease the vessel .
For vessels that are not leased, complete this section for the business(es)/organization(s)/ sole proprietorship(s) that own the
vessel (i.e. the business(es)/organization(s) that appear on the vessel’s USCG documentation or state registration).
When proposing regulations, the National Marine Fisheries Service (NMFS) is required to analyze the economic effects of such regulations on small entities (e.g.,
businesses and non-profit organizations). As part of the required analyses, NMFS must determine if permit applicants are large or small entities according to standards established by the Small Business Administration (SBA) and NMFS. Only one standard applies to each business or non-profit organization. The standard is
based on your primary North American Industry Classification System (NAICS) code, which indicates the industry your business or non-profit organization is primarily engaged in. The industry you are primarily engaged in is based on the activity that generated the greatest gross receipts (sales) in the most recent calendar
year. The SBA has also established “principles of affiliation” to determine whether a business concern is “independently owned and operated.” In general, businesses are affiliates of each other when one business controls or has the power to control the other business or a third party controls or has the power to control both.
For this assessment, please estimate your annual gross receipts (sales) OR number of employees (see chart below to determine which estimate you need). Estimates of annual gross receipts must be for all businesses with which you are affiliated. Estimates of the number of employees must include all full, part-time, and
temporary employees of all businesses with which you are affiliated. For example, if two businesses jointly own or lease a vessel, it is highly likely they are affiliated. If you have any questions about affiliation, please contact Mike Travis, SERO Economist, at [email protected] or call 727-209-5982.
Please base your
operations, and specify

1

START

responses on the most recent calendar year for which you have complete data regarding your business’ or organization’s
that calendar year in the appropriate box below

Is the business primarily involved in harvesting seafood (commercial Fishing)?

Yes

Did the business have more than $11 million in annual gross receipts?
Yes

No

Year

You are done.

No
2

Is the business primarily involved in For-hire fishing
services (charter, party/headboat)?

Yes

Did the business have more than $7.5 million in annual gross receipts?
Yes

No

Year

You are done.

No
3
Is the business primarily involved in Buying and selling seafood (seafood dealer/wholesaler)?

Yes

Did the business have more than 100 employees?
Yes

No

Year

You are done.

No
4
Is the business primarily involved in processing seafood (seafood processor)?

Yes

Did the business have more than 750 employees?
Yes

No

Year

You are done.

No
5

Is the organization an Environmental Conservation and
Wildlife, or Professional Non-Profit Organization?

Yes

Did the business have more than $15 million in annual gross receipts?
Yes

No

Year

You are done.

No
6

Is the organization some other Non-Profit Organization
(e.g. business association)?

Yes

Did the business have more than $7.5 million in annual gross receipts?
Yes

No

Year

You are done.

No
7
Then the business
must be primarily
involved in another
industry not related
to fishing or seafood.

Based on the applicable SBA size standard, check the appropriate box to
indicate if the business is a Large or Small business.

Refer to SBA’s list if NAICS codes
(See http://go.usa.gov/cs3jj) and
enter your primary NAICS code
here:

Large
Business

5

Small
Business

Year

You are done
Revised 02/07/2017

SECTION 7 - SIGNATURE FOR APPLICATION - REQUIRED
The undersigned certifies under penalty of perjury that the foregoing information is true and correct (28 U.S.C. section 1746; 18 U.S.C. section
1621; 18 U.S.C. section 1001).
Please note: The applicant who signs below must be the dealer identified in Section 1 unless the dealer is a partnership, corporation, or other
business entity, in which the applicant must be an individual named as an officer or shareholder of the business as listed in Section 4.
Applicant Signature

Date

Printed Name

Position In Company (if applicable)

Payment Reminder:
All applications must include payment of a non-refundable application fee in the form of a check or money order made payable to the U.S.
Treasury. The fee required is $50.00 for the first permit and $12.50 for each additional permit requested with this application.

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