Fisheries Certificate of Origin

CAPTAIN=S STATEMENT

Fishing Vessel Name:
Fishing Vessel Trip Dates
Trip Start Date:
Trip End Date:
Fishing Vessel Flag:
Area Fish was Harvested:

I,

(print name)

, as captain of the above named

fishing vessel, hereby certify that no purse seine net or other fishing
gear was intentionally deployed on or used to encircle dolphins
during the fishing trip and that no dolphins were killed or seriously
injured in the sets or other gear deployments in which the tuna
were caught. I also certify that I have completed the National
Marine Fisheries Service Tuna Tracking and Verification Program’s
dolphin-safe captain’s training course.

Captain=s signature

Date signed