Reef fish permit consolidation application

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

APPLICATION TO CONSOLIDATE GULF
OF MEXICO REEF FISH PERMITS

FOR OFFICE USE ONLY
Reviewer’s Initials and Date

FOR OFFICE USE ONLY
Application ID

SCAN DATE AND INITIALS

To consolidate two Gulf of Mexico Reef Fish Permits into one:
1) Enter the permit number of the permit you will retain as Permit 1, e.g. RR-311.
2) Enter the permit number of the permit you will not retain as Permit 2., e.g. RR-420.
3) Sign the form. Note: The owner(s) of both permits must be exactly the same, and all owners must sign this form.
4) Mail or deliver the signed form AND the original permits to be consolidated to the NMFS Permit Office.
To consolidate more than one Gulf of Mexico Reef Fish Permit - complete, sign, and submit this form for each individual permit to be
consolidated.

SECTION 1 - PERMIT DESIGNATION
Permit 1 - the permit you want to keep

Permit 2 - the permit you want to consolidate

SECTION 2 - SIGNATURE - REQUIRED
The undersigned hereby acknowledges that by consolidating Permit 2 into Permit 1, all landings associated with Permit 2 will be
associated with Permit 1 from this point forward. This action cannot be undone - Permit 2 may never be restored.
The undersigned also certifies under penalty of perjury that the foregoing information is true and correct (28 USC 1746; 18 USC 1621;
18 USC 1001, 16 USC 1857).
If the permit holder is a company, an officer or share holder authorized to represent the permit holder, he/she must sign the form, and
indicate their position in the company.
Date

Applicant Signature(s)

Print Name

Position(s) in Company

Public reporting burden for this collection of information is estimated to average 5 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 ofmarine 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 retaina 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 “forhire” 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 ofinformation displays a currently valid OMB Control Number..

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RRC2017.1P Last Form Revision: 04/06/2017