Change of Information Form for Federal Fisheries Permits

Instructions for the Change of Information Form
for Federal Fisheries Permits

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.

General Instructions:
The owner /lessee of a vessel with a permit, a person with an operator permit, or a dealer with a permit must notify the
SERO Permit Office within 30 days after any change in the application information. The permit is void if any change in the
information is not reported within 30 days.
Changes to application information may be provided to the SERO Permit Office with this form, or by a letter or other
format written notification. This application form is provided as a convenience. Other written notification, as long as it
includes all necessary information to identify the information change and the authority of the requester, will also be
accepted.
The SERO Permits office cannot accept change of information requests over the phone.

What Sections do I complete?
Complete all applicable sections of this application form. Specifically,
Complete Section 1 to help us identify the permits affected by the change(s). E.g. if you are changing mailing
address of a permit holder, a vessel owner or lessee, an officer or shareholder of a vessel owner or lessee, or an
officer or shareholder of a dealer; identify the vessel number or dealer number of the permits affected.
If the change of information affects a mailing or physical address you may provide the updated information in
Section 2. If it does not involve a mailing or physical address, please describe the change in Section 1, or attach
separate documentation.
A signature is required from all applicants.

What if I don’t use this form?
Changes to application information may also be provided by other written documentation. If providing other documentation,
be sure it is clear what information is being changed, and the information change request is signed by somebody authorized
to change the information. (e.g. the Permit Holder of a vessel or dealer permit, or an officer or owner of a business that holds
a vessel or dealer permit, or the operator of an operator card.)

What is the fee?
There is no fee to update application information.

What Supporting Documentation is Required?
For limited entry vessel permits, if the change of information is to any information printed on the face of the permit,
include the original permit. An updated permit will be issued which reflects the change of information.

Where do I send requests to change application information?
Mail the changes in application information and any necessary supporting documentation to: National Marine Fisheries
Service (F/SER14), 263 13th Avenue South, St. Petersburg, FL 33701.
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 5 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

CHANGE OF INFORMATION FORM
FOR FEDERAL FISHERIES PERMITS
FOR OFFICE USE ONLY
Reviewer’s Initials and Date
Expiration Date

FOR OFFICE USE ONLY
Check or Money Order Number

Application ID

SCAN DATE AND INITIALS
Federal regulations require permit holders to notify the Permits Office of any information change concerning the vessel and/or permit
owner within 30 days of a change. Failure to notify the Permits Office of the change - especially an address change - may adversely
impact permit(s). If you need additional forms, photocopy this blank form as many times as needed and fill out one for each individual/
business. Mark the box that applies to whom the change is for. The form must be signed by the individual named on the form or by an
officer or shareholder if the change is for a business. There are no fees required to change/correct the information in sections 1 or 2.

SECTION 1 - VESSEL OR DEALER INFORMATION
NOTE: This form is only for changing information about your current vessel. Changing the vessel itself requires an application for transfer or new permits.

USCG Document Number or State Registration Number

Vessel Name

Name of Dealer

Briefly tell us what information has changed

SECTION 2 - VESSEL OWNER, DEALER, OR PERMIT HOLDER INFORMATION
This entity is a:

Vessel Owner or

Permit Holder (if not the vessel owner) or

Dealer

MAILING RECIPIENT - All mail about the permit(s) will go to this individual.
Last Name or Business Name

First Name

Individual Tax Identification Number (SSN)
OR
Federal Employer Tax Identification Number
(FEIN)

Middle Name

Date of Birth or Business Filed (MM/DD/YYYY)

Apt #

Mailing Address

City

Suffix - Jr, Sr, etc.

Area Code

Phone Number

State

County/Parish

Zip Code

Country

State

County/Parish Zip Code

Country

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

Apt #

City

Valid E-Mail Address

SECTION 3 - SIGNATURE OF INDIVIDUAL REQUESTING THE CHANGE
Applicant Signature

Date

Print Name

Position in Business

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CH2019.1P Form Revision 06/03/2019