Application for allocation transfer

OMB Control No. 0648-0551; Approval Expires: 1-31-2018

Application for Allocation Transfer
Instructions: This application must be completed and signed by both the transferor and transferee. Once signatures from both the transferor and transferee are
completed, the form can be scanned and emailed to [email protected], or mailed to Catch Share Support, National Marine Fisheries Service,
Sustainable Fisheries Division, F/SER29, 263 13th Avenue South, St. Petersburg, FL 33701.

Type of Transfer (Check only one)
From my Shareholder Account to another Shareholder’s Account

From my Shareholder Account to another Shareholder’s Vessel Account

Transferor (From)
Account UserID: __________________ Account Name: _______________________________________________ Phone Number: _______________________
Transferee (To)
Account UserID: __________________ Account Name: _______________________________________________ Phone Number: _______________________
Transfer Details
Share Category: __________________
Pounds (gutted weight): ____________
Price Per Pound: __________________

Share Category: __________________
Pounds (gutted weight): ____________
Price Per Pound: __________________

Share Category: __________________
Pounds (gutted weight): ____________
Price Per Pound: __________________

The undersigned affirm the allocation transfer is pursuant to 50 CFR 622.21 and 622.22. Until this document is signed and made available to NOAA’s National Marine Fisheries Service, Southeast
Regional Office, the transfer of said allocation is pending. The undersigned understands once the transfer of said allocation is completed, the transferor’s allocation will be reduced and the
transferee’s allocation will be increased by the amount authorized to be transferred above. The undersigned certifies under penalty of perjury that the foregoing information is true and correct (28
U.S.C. 1746; 18 U.S.C. 1621; 18 U.S.C. 1001, 16 U.S.C. 1857). Knowingly supplying false information for the purpose of transferring allocation is a violation of federal law punishable by a fine
and/or imprisonment. NOAA’s National Marine Fisheries Service can disapprove this transfer if any portion of this agreement is found to be incorrect. Please note: The individual signing below
MUST be either the IFQ account holder OR must be one of the officers or shareholders in the corporation named on the account.
_____________________________________________________

Transferor Signature

________________

Date

_____________________________________________________

Transferee Signature

________________

Date

Public reporting burden for this collection of information is estimated to average 3 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, Southeast Regional Office, 263 13th Ave S, St. Petersburg, FL 33701. All 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.