HMS permit renewal application, completely prefilled

U.S. DEPARTMENT OF COMMERCE
NATIONAL OCEANIC AND ATMOSPHERIC
ADMINISTRATION NATIONAL MARINE FISHERIES SERVICE
PERMITS OFFICE
501 WEST OCEAN BLVD, SUITE 4200
Permit
LONG BEACH, CA 90802

OMB#: 0648-0204
APPROVAL EXPIRES: xx/xx/xxxx

Application Fee: $30

Pacific Highly Migratory Species
Vessel Permit Application
SECTION 1 VESSEL INFORMATION (please print legibly or type)
USCG DOC. OR STATE REGISTRATION NUMBER

VESSEL NAME

HOME PORT AND STATE

USCG DOCUMENTED HAIL PORT AND STATE

RADIO CALL SIGN

DOES THIS VESSEL HAVE AN OPERATIONAL VMS?

YES

REGISTERED LENGTH (FT.)

HOLD CAPACITY (SHORT TONS, 1 ST=2,000 LBs)

REFRIGERATION TYPE

PROPULSION TYPE

ICE______ BRINE______
HORSEPOWER

GAS______ DIESEL______
YEAR BUILT

OTHER______

NO

REGISTERED DEPTH (FT.)

REGISTERED BREADTH (FT.)

SPRAY BRINE______

GROSS TONS

BLOWER/BLAST______ OTHER______
HULL MATERIAL

LOCATION BUILT

CREW SIZE (INCLUDING OFFICERS)

VESSEL FLAG

PREVIOUS VESSEL NAMES

NET TONS

EFFECTIVE DATES

SECTION 2 SELECT THE TYPE OF GEAR TO BE AUTHORIZED BY THE HMS PERMIT
COMMERCIAL:

RECREATIONAL:

HARPOON

PURSE SEINE

TROLL/JIG

BAITBOAT

DRIFT GILLNET

LONGLINE

CHARTER VESSEL
PASSENGER CAPACITY__________

SECTION 3 VESSEL OWNERSHIP INFORMATION
PERMIT HOLDER and/or COMPANY NAME
BUSINESS ADDRESS

DATE CORPORATION FILED
CITY

BUSINESS TELEPHONE

BUSINESS FAX

SSN/EIN
STATE

BUSINESS CELL PHONE

ZIP

BUSINESS E-MAIL

MANAGING OWNER NAME LAST FIRST

MIDDLE

SUFFIX

DATE OF BIRTH (MONTH/DAY/YEAR)

SECOND OWNER NAME LAST

FIRST

MIDDLE

SUFFIX

DATE OF BIRTH (MONTH/DAY/YEAR)

THIRD OWNER NAME LAST

FIRST

MIDDLE

SUFFIX

DATE OF BIRTH (MONTH/DAY/YEAR)

IS EACH HOLDER OF THIS PERMIT A U.S. CITIZEN (INCLUDING ALL MEMBERS OF AN ASSOCIATION OR JOINT VENTURE)?

IF THE VESSEL IS OWNED BY A TRUST,

PARTNERSHIP, OR CORPORATION, THE PERMIT HOLDER IS AN "ELIGIBLE OWNER" AS DESCRIBED ON PAGE TWO OF THIS FORM.

YES

NO

SECTION 4 COLOR PHOTOGRAPH OF VESSEL (Select one delivery method)
ELECTRONIC PHOTOGRAPH EMAILED SEPERATELY TO [email protected]

PAPER PHOTOGRAPH ENCLOSED WITH THIS APPLICATION

SECTION 5 SIGNATURE (All applications must be signed and dated)
I certify that the above information is complete, true, and correct to the best of my knowledge and belief.
OWNER'S SIGNATURE:

NAME: (Print legibly or type)

1

DATE:

General - This information is being collected by the National Marine Fisheries Service to ensure that timely and accurate records are
available concerning the fishing vessels of the U.S. that participate in Pacific Ocean fisheries for highly migratory species, consistent
with the requirements of the Fishery Management Plan for U.S. West Coast Fisheries for Highly Migratory Species. The collection of
information concerning U.S. fishing vessels harvesting tuna in the eastern Pacific Ocean is also necessary for the U.S. to comply with
its obligations as a member of the Inter-American Tropical Tuna Commission.
This permit is required for commercial fishing vessels and recreational charter vessels that harvest any of the species that are included
in the FMP. They are: Billfish/Swordfish: striped marlin (Tetrapturus audax), swordfish (Xiphias gladius); Sharks: common thresher
shark (Alopias vulpinus), shortfin mako or bonito shark (Isurus oxyrinchus), blue shark (Prionace glauca); Tunas: north Pacific albacore
(Thunnus alalunga), yellowfin tuna (Thunnus albacares), bigeye tuna (Thunnus obesus), skipjack tuna (Katsuwonus pelamis), northern
bluefin tuna (Thunnus orientalis); and dorado or dolphinfish (Coryphaena hippurus).
Eligible Owner – The following vessel owners are eligible to hold a Pacific HMS Permit:
(1) An individual who is a citizen of the United States.
(2) An association, trust, joint venture, or other entity if— (A) each of its members is a citizen of the United States; and (B) it is capable of
holding title to a vessel under the laws of the United States or a State.
(3) A partnership if— (A) each general partner is a citizen of the United States; and (B) the controlling interest in the partnership is owned
by citizens of the United States.
(4) A corporation if— (A) it is incorporated under the laws of the United States or a State; (B) its chief executive officer, by whatever title,
and the chairman of its board of directors are citizens of the United States; and (C) no more of its directors are noncitizens than a minority
of the number necessary to constitute a quorum.
(5) The United States Government.
(6) The government of a State.
Instructions
Section 1 - Enter vessel information as it appears on the Coast Guard documentation or, if the vessel is not Coast Guard documented, as
it appears on the state registration certificate, vessel tonnage certificate and/or marine survey.
Home Port - Enter the city and state where the vessel is customarily kept, not necessarily the home port listed on the certificate of
documentation.
Hail Port - Enter the city and state listed on the certificate of documentation
Radio Call Sign - If your vessel has no radio, leave blank
Operational VMS - Global positioning system using satellites to track vessel movements. Required for commercial vessels greater than 24
m (78.74 ft).
Provide all other information required to the best of your ability.
Section 2 - For commercial fishing vessels, mark only gears that the vessel will use to harvest highly migratory species. Indicate only
whether a recreational vessel is a charter or commercial passenger fishing vessel (CPFV). It is not necessary to list any gear for
recreational vessels. Some gears subject to additional requirements prior to approved endorsement.
Section 3 - Each holder of this permit, individual and company, must be a U.S. Citizen.
Enter an Employer Identification Number (EIN) if you have one, and the vessel owners' Social Security Number(s). The owner's date of
birth will be used as an additional identifier and to establish the two-year renewal date for the permit. Enter the month,
day, and year. Contact information for all owners of the vessel is required.
Section 4 - Photograph of vessel. Provide a photograph of the vessel in its current form and appearance with identifying markings visible.
Indicate whether an electronic or paper photograph is being provided. Photographs can be emailed to [email protected]. Include
vessel name and Coast Guard Doc / State Registration number in the subject line.
Privacy Act Statement: Federal Regulations (at 50 CFR Part 660) authorize collection of this information. This information is
used to verify the identity of the applicant(s) and to accurately retrieve confidential records related to federal commercial fishery permits.
Where the requested information is a Social Security Number, disclosure is mandatory in accordance with the Debt Collection Act (31
U.S.C. 7701).
Your Social Security Number (SSN) is confidential and is protected under the Privacy Act. Disclosure of your SSN is mandatory. The
primary purpose for requiring the SSN and EIN is to verify the identity of individuals/entities doing business with the
government as required by the Debt Collection Improvement Act of 1996 (Public Law 104-134).
Paperwork Reduction Act - Public reporting burden for this collection of information is estimated to average 40 minutes per response,
including time for reviewing instructions, searching existing data sources, gathering and maintaining data, and
completing and reviewing the collection of information. 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. Send comments regarding this burden estimate or any other aspect of this collection of information, including
suggestions for reducing this burden, to the Regional Administrator, National Marine Fisheries Service, 501 West Ocean
Blvd., Suite 4200, Long Beach, CA 90802-4213.

Permit application fee: $30.00 payable to "US Department of Commerce - NOAA
Please write your vessel number and name in the memo section of your check.
Mail to: Permits Office, 501 W Oceans Blvd., Suite 4200, Long Beach, CA 90802