Pacific Transshipment Declaration Form

FOR OFFICE USE ONLY:

FORM UNIQUE IDENTIFIER:

LOCATION DESCRIPTOR (HS, EEZ, etc.)

OMB No: 0648-0649

Expires: XX/XX/XXXX

PACIFIC TRANSSHIPMENT DECLARATION FORM
LOCATION OF TRANSSHIPMENT:
(If at port, enter the PORT NAME; if at sea, give latitude and longitude of position in decimal form, to 0.1 degrees)

Section 1: OFFLOADING VESSEL
VESSEL NAME:

Section 2: RECEIVING VESSEL

DATE(S) OF TRANSSHIPMENT:
(MM/DD/YYYY) – (MM/DD/YYYY)

Section 3: OBSERVER (for Transshipments AT SEA only)

VESSEL NAME:

The information in this box is provided to verify the presence of the named observer and does
not represent the observer’s concurrence with the information provided on this form. The
observer may choose not to sign this form.

OFFICIAL NUMBER:

NAME OF VESSEL OPERATOR:
OFFICIAL NUMBER:

OBSERVER NAME:
QUANTITY OF FISH PRODUCT ALREADY ON BOARD THE RECEIVING VESSEL PRIOR TO THIS
TRANSSHIPMENT, BROKEN DOWN BY AREA OF CAPTURE:

SIGNATURE (IF ON BOARD):

Amount:
Amount:

DATE (MM/DD/YYYY):

NAME OF VESSEL OPERATOR:
Unit of Measurement::_________ RFMO Area: ___________________
Unit of Measurement::________ RFMO Area: ___________________

□ WCPFC Authorized □ IATTC Authorized

Section 4: TRANSSHIPMENT DETAILS (if additional rows needed, use back side of form)
SPECIES: Enter name of the species or one of the following codes: SKJ: skipjack tuna, YFT: yellowfin tuna, BET: bigeye tuna, ALB: albacore
WEIGHT: WW: whole weight, GG: gilled & gutted, GX: gutted, headed & tailed, HG: headed & gutted, GT: gilled, gutted & tailed, GO: gutted only, not gilled, FL: filleted, LO: loins
GEAR: PS: Purse seines, DL: Drifting longlines, PL: Poles and lines, HOVL: Hand operated vertical lines (non-squid), DN: Driftnets, TL: Trolling lines, HP: Harpoons, MVL: Mechanized vertical lines (non-squid), OT: Other type(s) of gear

SPECIES

FR – FRESH
FZ - FROZEN
DR - DRIED

FORM OF
PRODUCT
(insert weight
codes as
shown above)

QUANTITY TRANSSHIPED
ESTIMATED
NUMBER OF FISH
WEIGHT AND UNIT
(if longline-caught)
OF MEASUREMENT

FISHING GEAR USED TO
TAKE THE FISH (insert gear
code as shown above)

GEOGRAPHIC LOCATION OF FISH CATCHES
I - Inside WCPFC Area
Circle One: EEZ
O - Outside WCPFC Area, (if O,
(Country of capture)
specify if in the IATTC Area)
or HS (High Seas)

If you indicate EEZ, write in the
country of capture

EEZ or HS
EEZ or HS
EEZ or HS
EEZ or HS

Section 5: U.S. VESSELS WITH RECEIVING VESSEL PERMITS TRANSSHIPPING LONGLINE-CAUGHT FISH

EEZ or HS
Section 6: U.S. SPTT-LICENSED PURSE SEINE VESSEL INFORMATION

BROKER OR SHIPPING AGENT AND CONTACT INFORMATION:

TRIP NO.:

TRIP START DATE:

PORT OF LANDING:

DESTINATION OF FISH:

TO BE PROCESSED AT:

Section 7: FOR TRANSSHIPMENTS IN THE IATTC CONVENTION AREA
DEPARTURE DATE (MM/DD/YYY/HOUR):

LOCATION OF DEPARTURE (PORT NAME):

TRANSSHIPMENT START DATE (MM/DD/YYYY/HOUR)

RETURN DATE (MM/DD/YYYY/HOUR):

LOCATION OF RETURN (PORT NAME):

TRANSSHIPMENT END DATE (MM/DD/YYYY/HOUR)

AGENT’S NAME:

FLAG AND RADIO CALL SIGN OF OFFLOADING VESSEL:

FLAG AND RADIO CALL SIGN OF RECEIVING VESSEL:

I certify that the above information is complete and accurate to the best of my knowledge
OWNER or OPERATOR NAME:

Indicate if owner of operator of:

□ Offloading Vessel □ Receiving Vessel

SIGNATURE:_______________________________________________________________

DATE: _________________________________________________

Section 4: TRANSSHIPMENT DETAILS - CONTINUED
SPECIES: Enter the name of the species or one of the following codes: SKJ: skipjack tuna, YFT: yellowfin tuna, BET: bigeye tuna, ALB: albacore tuna
WEIGHT: WW: whole weight, GG: gilled & gutted, GX: gutted, headed & tailed, HG: headed & gutted, GT: gilled, gutted & tailed, GO: gutted only, not gilled, FL: filleted, LO: loins
GEAR: PS: Purse seines, DL: Drifting longlines, PL: Poles and lines, HOVL: Hand operated vertical lines (non-squid), DN: Driftnets, TL: Trolling lines, HP: Harpoons, MVL: Mechanized vertical lines (non-squid), OT: Other type(s) of gear

SPECIES

FR – FRESH
FZ - FROZEN
DR - DRIED

FORM OF
PRODUCT
(insert weight
codes as
shown above)

QUANTITY TRANSSHIPED
NUMBER OF
ESTIMATED WEIGHT
FISH
AND UNIT OF
(if longlineMEASUREMENT
caught)

GEOGRAPHIC LOCATION OF FISH CATCHES
FISHING GEAR USED TO
TAKE THE FISH (insert gear
code as shown above)

I - Inside WCPFC Area
O - Outside WCPFC Area, (if O,
specify if in the IATTC Area)

Circle One: EEZ
(Country of Capture)
or HS (High Seas)
EEZ or HS
EEZ or HS
EEZ or HS
EEZ or HS
EEZ or HS
EEZ or HS
EEZ or HS
EEZ or HS
EEZ or HS
EEZ or HS
EEZ or HS
EEZ or HS
EEZ or HS
EEZ or HS
EEZ or HS
EEZ or HS
EEZ or HS
EEZ or HS
EEZ or HS
EEZ or HS
EEZ or HS

If you indicate EEZ, write in the
country
of capture