Federal Permit Application for Southeast Region Issued O

Southeast Region Permit Family of Forms

Federal Permit Application for Southeast Region Issued Operator Card - 2019_06_17

Dolphin/wahoo operator cards

OMB: 0648-0205

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Instructions for the Federal Permit Application for Southeast Region
Issued Operator Card
Rev 06/03/2019
In addition to the instructions provided herein, applicants with specific questions are encouraged to contact the
Permits Office at (727) 824-5326 or toll free at (877) 376-4877 between 9:00 a.m. and 4:00 p.m. ET, or visit
the SERO Permits website at https://www.fisheries.noaa.gov/permits-and-forms.
Please consult the U.S. Code of Federal Regulations whose guidance for application requirements, permit
eligibilities, and related information will always prevail. NMFS will return incomplete or illegible applications.

General Instructions:
Atlantic Dolphin/Wahoo permits and South Atlantic Rock Shrimp permits are not valid when underway for fishing in the
Atlantic EEZ unless the operator or a crewmember on board the vessel holds a valid Operator Card.

What Sections do I complete?
All applicants must fill out Section 1, and Section 2. All fields should be typed or printed in inkw

What is the fee?
The application fee is $50 and is non-refundable. A check or money order payable to the U.S. TREASURY must
accompany each application. There is an $18 fee to replace a lost Operator Card.

Where do I send the application?
Mail the complete application, payment, and all required supporting documentation to:
NMFS Permits Office (F/SER14)
263 13th Avenue South,
St. Petersburg, FL 33701
To receive an operator card via overnight carrier, enclose a completed, pre-paid air bill and envelope. Please note using
the prepaid overnight delivery option does not expedite application processing; it only expedites delivery of your completed
operator card package.

What supporting documentation do I need?
Photograph: Provide two (2) passport style photographs of the applicant. The photographs must be:





In color.
Printed on photo quality paper.
2 x 2 inches (51 x 51 mm) in size.
Sized such that the head is between 1 inch and 1 3/8 inches (between 25 and 35 mm) from the bottom of the
chin to the top of the head.
 Taken within the last 6 months to reflect your current appearance
Payment: Include a signed check or money order for $50 made out to the US Treasury.
APPLICATION SECTION 1 –OPERATOR INFORMATION.
 Provide the operator’s full name, tax ID number (SSN), date of birth, phone number, physical address,
mailing address, sex, and race/ethnicity information.
 Indicate if the individual is a United States citizen or permanent resident alien. Note, this information will not
affect eligibility to obtain an Operator Card.
 Provide an email address or SMS mobile phone number to receive digital updates about your permit and
application status (when available).
 Provide the applicant’s place of birth.
 Provide the applicant’s current height, weight, eye color, and hair color.

APPLICATION SECTION 2 – SIGNATURE FOR APPLICATION
The applicant must sign the application in section 2.

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KNOWINGLY SUPPLYING FALSE INFORMATION OR WILLFULLY OVERVALUING ANY FISHING INCOME TO OBTAIN A
PERMIT IS A VIOLATION OF FEDERAL LAW PUNISHABLE BY A FINE AND/OR IMPRISONMENT.
Public reporting burden for this collection of information is estimated to average 30 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,
F/SER26, 263 13th Avenue South, St. Petersburg, FL 33701.
The National Marine Fisheries Service requires this information for the conservation and management of marine fishery resources. The data reported
will be used to develop, implement, and monitor fishery management activities for a variety of other uses. Responses to this collection are required to
obtain or retain a fisheries permit under the Magnuson - Stevens Act. Non-confidential information may be released via a NOAA Fisheries website.
Non-confidential information means: Name, Street Address, City, State, Zip Code, Effective Date of Permit, Permit Types, Vessel Name, Vessel
Identification Number, Vessel length, Vessel tonnage (gross and net), Vessel horse power, in the case of a “for hire” vessel the Passenger Capacity,
or individual, corporate and lease holders of permits. All other 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.

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OMB Control Number 0648-0205; Expiration Date 05/31/2020

U.S. Department of Commerce, NOAA
NMFS PERMITS OFFICE, F/SER14
263 13th Avenue South
St. Petersburg, FL 33701
Toll Free 877-376-4877 (9:00 a.m. - 4:00 p.m. ET)
727-824-5326 (9:00 a.m. - 4:00 p.m. ET)
https://www.fisheries.noaa.gov/permits-and-forms

FEDERAL APPLICATION FOR
SOUTHEAST REGION ISSUED
OPERATOR CARD
FOR OFFICE USE ONLY
Reviewer’s Initials and Date

FOR OFFICE USE ONLY

Expiration Date

Application ID

Check or Money Order Number
and Amount

SCAN DATE AND INITIALS

SECTION 1 - VESSEL OPERATOR (CARD OWNER) PERSONAL INFORMATION
Are you a United States Citizen or permanent resident alien?
Are you of Hispanic, Latino, or Spanish origin?
What is your
race?

YES

NO

No

Yes

White

American Indian or Alaska
Native

Native Hawaiian or Other Pacific Islander

Black or African American

Asian American

Other _______________

First Name

Last Name

Individual Tax ID Number (SSN)

Middle Name

Date of Birth (MM/DD/YYYY)

Mailing Address

Apt #

Area Code

City

Suffix - Jr, Sr, etc.

Phone Number

State County/Parish

Zip Code

Country

County/Parish Zip Code

Country

Check box if the Physical Address is the same as the mailing address.
Physical Address (PO Box not acceptable)

Apt #

City

State

OPTIONAL: Check here if you would you like to receive digital updates (texts & emails). Provide your digital contact information belo w.

Cell Phone number and provider:

Email
Birth Place (City, State, Country)

Weight (lbs)

If you are clean shaven or balding,
indicate your actual hair color.

Hair Color

Eye Color

Height (ft & in)

Brown

Green

Brown

Blonde

Blue

Hazel

Black

Red

Grey

Other

Grey

Other

White

SECTION 2 - SIGNATURE - REQUIRED
Applicant Signature

Print Name

Date

1
O2019.1P Form Revision 06/03/2019


File Typeapplication/pdf
AuthorMichael Arn
File Modified2019-07-03
File Created2019-06-06

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