Application for A80 Quota Share

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Revised: 11/06/2018 OMB Control No. 0648-0565 Expiration Date: 03/31/2019

	Application for Amendment 80 Quota Share (QS)			U.S. Department of Commerce/NOAA National Marine Fisheries Service (NMFS) Restricted Access Management Program (RAM) P.O. Box 21668 Juneau, AK 99802-1668 (800) 304-4846 toll free / 586-7202 in Juneau (907) 586-7354 fax
This application must be completed and received by NMFS no later than 1700 hours Alaska local time (A.l.t.) on October 15, or if sent by U.S. mail, postmarked by that time, for the applicant to be considered for initial issuance of Amendment 80 QS to participate in the program during the next calendar year. Only applicants that are determined to be eligible under 50 CFR 679.90(a)(2) will receive an initial allocation of Amendment 80 QS.
Indicate whether you are applying as (select only one): The owner of an Amendment 80 vessel as defined in 50 CFR 679.2 and listed in Table 31 to 50 CFR Part 679. Review and complete blocks A, B, and C. Sign and date Block E. The holder of an Amendment 80 License Limitation Program (LLP) license originally assigned to an Amendment 80 vessel that is no longer able to be used in the Amendment 80 Program due to the actual total loss, constructive loss, or permanent ineligibility of that vessel. Review and complete Blocks A, B, and D. Sign and date Block E. Refer to application instructions for a list of Amendment 80 vessels and Amendment 80 LLP licenses.
BLOCK A -- APPLICANT IDENTIFICATION
1. Applicant Name:			2. Tax ID number:				3. NMFS Person ID:
4. Permanent Business Mailing Address:
5. Business Telephone Number:		6. Business Fax Number:				7. E-mail Address:
8. Is Applicant an Individual U.S. Citizen? YES NO					If YES, Enter Date of Birth:
9. Is Applicant a U.S. Corporation, Partnership, Association, or Other Business Entity? YES NO					If YES, Enter the Date of Incorporation:
10. Is Applicant a Successor-In-Interest to a Deceased Individual or to a Non-Individual No Longer In Existence? YES NO					If YES, attach evidence of death or dissolution.

BLOCK B -- AGREEMENT WITH AMENDMENT 80 OFFICIAL RECORD
I AGREE with the Amendment 80 Official Record Summary sent to me by NMFS. If you check this box, you are accepting the Amendment 80 Official Record. Proceed to Block E, sign the application, and return the application to NMFS. I DO NOT AGREE with the Amendment 80 Official Record Summary sent to me by NMFS. Sign Block E, attach additional pages outlining the nature of your disagreement and provide documentation supporting your claims. I DID NOT RECEIVE an Amendment 80 Official Record Summary from NMFS. I believe that I am eligible to receive an initial allocation of Amendment 80 QS. Complete Blocks C and/or D as applicable. Sign Block E and provide documentation supporting your claims. Regardless of your agreement or non-agreement with the Official Record, if you are applying for QS as the holder of an Amendment 80 LLP license originally assigned to an Amendment 80 vessel that cannot participate in the program due to the actual total loss, constructive loss, or permanent ineligibility of that vessel, you must complete Block D and provide the required documentation described in that block.
BLOCK C – OWNER OF AMENDMENT 80 VESSEL
For an applicant claiming Amendment 80 legal landings associated with an Amendment 80 vessel, enter the following information for each Amendment 80 vessel. You may be required to provide documentation, such as an abstract of title or U.S. Coast Guard Certificate of Documentation, establishing your ownership of each Amendment 80 vessel for which you are applying for Amendment 80 QS.
Vessel Name:	LLP Number:	ADF&G Number:	USCG Number:
Vessel Name:	LLP Number:	ADF&G Number:	USCG Number:
Vessel Name:	LLP Number:	ADF&G Number:	USCG Number:

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BLOCK D – HOLDER OF AMENDMENT 80 LLP LICENSE

The holder of an Amendment 80 LLP license may only receive an initial allocation of Amendment 80 QS if an Amendment 80 vessel(s) originally assigned to the Amendment 80 LLP license(s) is no longer able to participate in the Amendment 80 Program due to actual total loss, total constructive loss, or is permanently ineligible to receive a fishery endorsement under 46 U.S.C. 12108. If the Amendment 80 vessel does not fit these requirements, the Amendment 80 QS derived from that vessel’s catch must be applied for by the owner of the vessel.

List each Amendment 80 LLP license number for which you are applying for Amendment 80 QS, and the name, ADF&G registration number, and USCG documentation number of the Amendment 80 vessel originally assigned to each license.

ATTACHMENTS

Attach clear and unambiguous documentation in written form that the Amendment 80 vessel has suffered an actual total loss, total constructive loss, or is permanently ineligible to receive a fishery endorsement under 46

U.S.C. 12108.

If the holder of the LLP license is not the same person(s) who owns the Amendment 80 vessel, attach a copy of the express terms of a written contract held by the applicant that clearly and unambiguously indicates that the owner of the Amendment 80 vessel that has suffered an actual total loss, total constructive loss, or is permanently ineligible to receive a fishery endorsement under 46 U.S.C. 12108 has transferred all rights and privileges to use Amendment 80 legal landings and any resulting Amendment 80 QS or exclusive harvest privilege from that Amendment 80 vessel to the person holding the Amendment 80 LLP license originally assigned to that Amendment 80 vessel.

Amendment 80 LLP Number	Amendment 80 Vessel Originally Assigned
	Name of Vessel	ADF&G Number	USCG Number

BLOCK E -- APPLICANT CERTIFICATION
The applicant must sign and date the application certifying that all information is true, correct, and complete to the best of his/her knowledge and belief. If the application is completed by an authorized representative, attach authorization to application.
Under penalties of perjury, I declare that I have examined this application, and to the best of my knowledge and belief, the information presented here is true, correct, and complete.
1. Signature of Applicant or Authorized Representative:	2. Date Signed:
3. Printed Name of Applicant or Authorized Representative; if representative, attach authorization.

PUBLIC REPORTING BURDEN STATEMENT

Public reporting burden for this collection of information is estimated to average 2 hours per response, including the time for reviewing the instructions, searching the existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to: Assistant Regional Administrator, Sustainable Fisheries Division, NOAA National Marine Fisheries Service, Alaska Region, P.O. box 21668, Juneau, AK 99802-1668.

ADDITIONAL INFORMATION

Before completing this form, please note the following: 1) Notwithstanding any other provision of 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;

2) This information is mandatory and is required to manage commercial fishing efforts under 50 CFR part 679 and under section 402(a) of the Magnuson-Stevens Act (16 U.S.C. 1801, et seq.) as amended by Public Law 109-479; 3) Responses to this information request are confidential under section 402(b) of the Magnuson-Stevens Act. They are also confidential under NOAA Administrative Order 216-100, which sets forth procedures to protect confidentiality of fishery statistics.

PRIVACY ACT STATEMENT

Authority: The collection of this information is authorized under the Magnuson-Stevens Fishery Conservation and Management Act, 16 U.S.C. 1801 et seq.

Purpose: NMFS uses the information provided in this application to determine eligibility for the applicant to receive Amendment 80 quota share (QS) and permit. An A80 QS permit authorizes the QS holder to participate in an A80 fishery. The primary purpose for requesting the SSN/TIN is for the collection and reporting on any delinquent amounts arising out of such person’s relationship with the government pursuant to the Debt Collection Improvement Act of 1996 (Public Law 104-134). Personal information is confidential and protected under the Privacy Act (5 U.S.C. 552a). Business information may be disclosed to the public.

Routing Uses: Disclosure of this information is subject to the published routine uses identified in the Privacy Act System of Records Notice COMMERCE/NOAA-19, Permits and Registrations for the United States Federally Regulated Fisheries. NMFS posts some information from this form on its public website (https://alaskafisheries.noaa.gov/). In addition, NMFS may share information submitted on this application with other State and Federal agencies or fishery management commissions, including staff of the North Pacific Fishery Management Council and Pacific States Marine Fisheries Commission.

Disclosure: Furnishing this information is voluntary; however, failure to provide complete and accurate information will prevent determination of eligibility for A80 QS and permit.

Instructions

APPLICATION FOR AMENDMENT 80 QUOTA SHARE (QS)

A person who wishes to receive an Amendment 80 QS permit must submit a timely and complete application for Amendment 80 QS. Once an application for Amendment 80 QS is approved by NMFS, no other application for Amendment 80 QS is required.

A completed application to receive an Amendment 80 QS permit must be received by NMFS no later than 1700 hours,

A.l.t., on October 15 or if sent by U.S. mail, postmarked by that time. Applications received after October 15 will be processed; however, those applicants will not be eligible to participate in the Amendment 80 Program during the upcoming calendar year. For example, an applicant who submits an Application for Amendment 80 Quota Share after October 15, 2018, and is found eligible to receive an Amendment 80 QS permit, would not be eligible to participate in the Amendment 80 Program until 2020.

Forms are available on the NMFS Alaska Region website at: https://alaskafisheries.noaa.gov/fisheries-applications

When application is complete, submit by:

Mail to: NMFS Alaska Region

Restricted Access Management (RAM)

P.O. Box 21668

Juneau, Alaska 99802-1668

Deliver to: 709 West 9^th Street, Room 713 Juneau, AK 99801

or fax to: (907) 586-7354

Type or print legibly in ink; retain a copy of completed application for your records.

If you need additional information, contact Restricted Access Management at (800) 304-4846 (Option #2) or

(907) 586-7202 (Option #2).

COMPLETING THE APPLICATION

A completed application must contain the following information: Indicate whether the applicant is applying —

• As the owner of an Amendment 80 vessel (Complete Blocks A, B, C, and E), or

• As the holder of an Amendment 80 License Limitation Program (LLP) license originally assigned to an Amendment 80 vessel that is no longer able to be used in the Amendment 80 Program due to the actual total loss, constructive loss, or permanent ineligibility of that vessel (Complete Blocks A, B, D, and E).

Refer to the following table for name and LLP license originally assigned to that vessel (from Table 31 to 50 CFR Part 679).

Column A Name of Amendment 80 Vessel	Column B USCG Documentation Number	Column C LLP License Number Originally Assigned to the Amendment 80 Vessel
ALASKA JURIS	569276	LLG 2082
ALASKA RANGER	550138	LLG 2118
ALASKA SPIRIT	554913	LLG 3043
ALASKA VOYAGER	536484	LLG 2084
ALASKA VICTORY	569752	LLG 2080
ALASKA WARRIOR	590350	LLG 2083
ALLIANCE	622750	LLG 2905
AMERICAN NO. 1	610654	LLG 2028
ARCTIC ROSE	931446	LLG 3895
ARICA	550139	LLG 2429
BERING ENTERPRISE	610869	LLG 3744
CAPE HORN	653806	LLG 2432
CONSTELLATION	640364	LLG 1147
DEFENDER	665983	LLG 3217
ENTERPRISE	657383	LLG 4831
GOLDEN FLEECE	609951	LLG 2524
HARVESTER ENTERPRISE	584902	LLG 3741
LEGACY	664882	LLG 3714
OCEAN ALASKA	623210	LLG 4360
OCEAN PEACE	677399	LLG 2138
PROSPERITY	615485	LLG 1802
REBECCA IRENE	697637	LLG 3958
SEAFISHER	575587	LLG 2014
SEAFREEZE ALASKA	517242	LLG 4692
TREMONT	529154	LLG 2785
U.S. INTREPID	604439	LLG 3662
UNIMAK	637693	LLG 3957
VAERDAL	611225	LLG 1402

BLOCK A - APPLICANT IDENTIFICATION

1–3. Applicant’s name, Tax ID number, and NMFS person ID; all owners of the vessel or the LLP license must be listed.

4. Permanent business mailing address

5–7. Business telephone number, business fax number, and e-mail address

8. Indicate if the applicant is a U.S. citizen.

If YES, enter his or her date of birth.

8. Indicate if the applicant is a U.S. corporation, partnership, association, or other business entity.

If YES, enter the date of incorporation.

8. Indicate if the applicant is a successor-in-interest to a deceased individual or to a non-individual no longer in existence.

If YES, attach evidence of death or dissolution.

BLOCK B - AGREEMENT WITH AMENDMENT 80 OFFICIAL RECORD

Select the statement in Block B that best represents your agreement with the Amendment 80 Official Record.

• I AGREE with the Amendment 80 Official Record Summary sent to me by NMFS.

• I DO NOT AGREE with the Amendment 80 Official Record Summary sent to me by NMFS. If you received more than one Amendment 80 Official Record Summary, and you do not agree with all Amendment 80 Official Record Summaries sent to you, mark the box that you Do Not Agree, and identify in your attached documentation the Amendment 80 Official Record Summaries with which you disagree.

• I DID NOT RECEIVE an Amendment 80 Official Record Summary from NMFS. If you did not receive an Amendment 80 Official Record Summary, you must complete all blocks on the application that pertain to your situation.

NOTE: if you are applying for QS as the holder of an Amendment 80 LLP license originally assigned to an Amendment 80 vessel that cannot participate in the program due to the actual total loss, constructive loss, or permanent ineligibility of that vessel, you must complete Block D and provide the required documentation described in that block.

BLOCK C - OWNER OF AMENDMENT 80 VESSEL

For an applicant claiming Amendment QS as the owner of an Amendment 80 vessel, enter the following information for each Amendment 80 vessel. You may be required to provide documentation, such as an abstract of title or U.S. Coast Guard (USCG) Certificate of Documentation, establishing your ownership of each Amendment 80 vessel for which you are applying for Amendment 80 QS.

• LLP license numbers held by that person at the time of application

• Vessel name and Alaska Department of Fish & Game (ADF&G) vessel registration number

• USCG documentation number of vessel

BLOCK D - HOLDER OF AMENDMENT 80 LLP

The holder of an Amendment 80 LLP license may only receive an initial allocation of Amendment 80 QS if the Amendment 80 vessel(s) originally assigned to the Amendment 80 LLP license(s) listed above is no longer able to participate in the Amendment 80 Program due to the actual total loss, constructive loss, or permanent ineligibility of the vessel. If the Amendment 80 vessel does not fit these requirements, the Amendment 80 QS derived from that vessel’s catch must be applied for by the owner of the vessel.

List each Amendment 80 LLP license number for which you are applying for Amendment 80 QS, and the name, ADF&G registration number, and USCG documentation number of the Amendment 80 vessel originally assigned to each license.

ATTACHMENTS

• Attach clear and unambiguous documentation in written form that the Amendment 80 vessel has suffered an actual total loss, total constructive loss, or is permanently ineligible to receive a fishery endorsement under 46 U.S.C. 12108.

• If the holder of the LLP license is not the same person(s) who owns the Amendment 80 vessel, attach a copy of the express terms of a written contract held by the applicant that clearly and unambiguously indicates that the owner of the Amendment 80 vessel that has suffered an actual total loss, total constructive loss, or is permanently ineligible to receive a fishery endorsement under 46 U.S.C. 12108 has transferred all rights and privileges to use Amendment 80 legal landings and any resulting Amendment 80 QS or exclusive harvest privilege from that Amendment 80 vessel to the person holding the Amendment 80 LLP license originally assigned to that Amendment 80 vessel.

BLOCK E - APPLICANT CERTIFICATION

The applicant must sign and date the application certifying that all information is true, correct, and complete to the best of his or her knowledge and belief. If the application is completed by a designated representative, then explicit authorization for the designated representative signed by the applicant must accompany the application.

Application for A80 QS ― Page 1 of 11