Federal Permit Application for Vessels Fishing in the Ex

Southeast Region Permit Family of Forms

Federal Permit Application for Vessels Fishing in the Exclusive Economic Zone (EEZ) - 2019_06_17

Smoothhound shark permit

OMB: 0648-0205

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Instructions for the Federal Permit Application for Vessels
Fishing in the Exclusive Economic Zone (EEZ)

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:
What Sections do I complete?
Complete all applicable sections of this application form. All application fields should be typed or printed in ink.
Specifically,
All applicants must fill out Section 1, and Section 2 and/or Section 3.
If the vessel’s USCG documentation or state registration indicates the vessel is owned by one or more individuals,
fill out Section 4.
If the vessel’s USCG documentation or state registration indicates the vessel is owned by one or more
businesses, fill out Section 5.
If the vessel is leased and the permit(s) will be issued to the lessee(s), complete Section 6.
If the vessel is owned by a business which is owned by another business, in addition to completing Section 5,
complete Section 7. In Section 7, provide information about all businesses that are parent companies of
businesses that own the vessel.
If the vessel is leased by a business which is owned by another business, in addition to completing Section 6,
complete Section 7. In Section 7, provide information about all businesses that are parent companies of
businesses that lease the vessel.
If the vessel is owned or leased by a business, in addition to completing Section 5 and/or 6, complete Section 8.
In Section 8, provide information about all individuals that are owners or officers of businesses listed in Section 5,
Section 6, and/or Section 7.
Complete Section 9 if the any owners of the businesses listed in Section 5, Section 6, or Section 7 hold an
ownership percentage less than 1%. This is not common.
Applicants of Historical Captain Endorsements for Gulf of Mexico Charter/Headboat permits, or designated
operator (income qualifier) for Commercial Spiny Lobster Permits, complete section 10
Applicants requesting a Sea Bass Pot endorsement or Golden Crab permit fill out Section 11.
All applicants must fill out Section 12, and Section 13.
See pages 3-6 for information about specific sections of this application.

What is the fee?
The application fee is $25 for one fishery and $10 for each additional fishery, as described in the table below. This
application fee is collected to cover the administrative cost of processing the application, and is non-refundable.
For Gulf of Mexico Charter/Headboat permits only, there is an additional, non-refundable $10 fee for each decal. The fee to
replace one or more permits issued to a vessel is $18. NMFS will not refund money for denied permits. A check or money
order payable to the U.S. TREASURY must accompany each application.
Permits
1 = $25 2 = $35

3 = $45

4 = $55

5 = $65

6 = $75

7 = $85

8 = $95

9 = $105

10 = $115

11 = $125

Gulf of Mexico Charter/headboat Decals
1 = $10 2 = $20

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

What about reporting compliance?
NMFS will not renew or transfer a permit until all reporting requirements for the permit being renewed or transferred have
been met (e.g., logbooks, the MRIP For-Hire telephone survey, etc.). To avoid delays, applicants are encouraged to comply
with all reporting requirements before submitting a permit application.


Send Coastal and Pelagic logbook report(s) to National Marine Fisheries Service, Research Management Division,
Logbook Program, P.O. Box 491500, Key Biscayne, FL 33149-9915. Please direct questions concerning reporting
Coastal and Pelagic reporting requirements to the Southeast Research Management Division at (305) 361-4581. You
can also check the status for these logbooks online at https://grunt.sefsc.noaa.gov/vrsr/VesselReportingStatus.jsp.



Send Gulf of Mexico Shrimp Landing Reports and Gulf Shrimp Vessel & Gear Characterization forms to Rebecca Smith,
NMFS Galveston Laboratory, 4700 Avenue U, Galveston, TX 7755; also, Gulf Shrimp applicants need to ensure compliance with the cELB program. See www.galvestonlab.sefsc.noaa.gov/ELB/FAQ/elbresponsibilities.html for details. For
information about all Gulf of Mexico Shrimp data collection programs contact Rebecca Smith at the NMFS Galveston
Laboratory (409)-766-3783.

 Vessels selected for the For Hire headboat survey should contact Mr. Ken Brennan of the NMFS Southeast Fisheries
Science Center at (252) 728-8618 for information about required reports.

What supporting documentation do I need?
Documentation or state registration: Include a copy of the vessel’s valid USCG Documentation or, if not required to
be USCG Documented include a copy of the vessel’s valid State Registration, with the application.
Payment: Include a check or money order made out to the US Treasury. See “What is the Fee” on page 1 of these
instructions for more information. Include a separate check or money order if requesting Floy tags for Golden Crab or
Sea Bass pots.
Lease Agreement: Include a copy of the current lease agreement if the vessel is leased, rented, or leased-to-own.
The lease must identify the vessel, the individual(s) or business(es) leasing the vessel, and the vessel owners as listed
on the vessel’s USCG Certificate of Documentation or, if not documented, the State Registration. The lease
agreement must include a lease start date, and lease expiration date. The lease must run for a minimum of 7 months
from the date your application is received. The lease may extend for many years if the lessee and lessor anticipate a
long-term arrangement. Both the vessel owner(s) and the lessee(s) must sign and date the lease agreement.
Original Permits: When transferring limited entry permits from one vessel to another, or from one owner or lessee to
another owner or lessee, include the original permits being transferred.
 Except when transferring a permit to the same vessel owner(s) and lessee(s) (as applicable), the permit holder listed
on the face of the permit must sign the back of the permit as the seller. If the permit holder is a business or
organization, an officer or owner of the permit holder must sign the back of the permit as the seller. The seller’s
signature must be notarized.
 When transferring a Gulf of Mexico Charter/headboat permit, even to the same vessel owner(s) /lesee(s), the
transferor must sign the back to affirm removal of the charter/headboat decal.
 If the transfer is not for a Gulf of Mexico Charter/ headboat permit, and the vessel owner(s)/lessee(s) will remain the
same, the permit does not need to be signed.
Highly Migratory Species (HMS) Workshop Certificate:
 To renew a Shark or Swordfish Directed or Incidental permit, include a copy of a valid Protected Species Safe
Handling, Release, and Identification Workshop Owner’s Certificate issued to the vessel owner.
 To transfer Shark or Swordfish Directed or Incidental permits, include a copy of either a valid Owner or Operator’s
Protected Species Safe Handling, Release, and Identification Workshop Certificate issued to the vessel owner.
Florida Saltwater Products License: To obtain a lobster tailing permit, if the vessel will not obtain or already possess
a valid commercial spiny lobster permit, include a copy of a Florida Saltwater Products License with crawfish
endorsement issued to the vessel or to the applicant.
Miscellaneous or uncommon documents: To transfer a Snapper Grouper Unlimited permit to an immediate family
member, documentation proving the familial relationship will be required. To transfer a permit pursuant to will/probate
of a deceased permit holder, copies of the will and court order will be required. For these sorts of unusual transfer
transactions, we recommend you contact the Permits Office toll free at (877) 376-4877 to discuss the details of your
particular situations.
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A few words about transfers and renewals…
• Any change to the identity of the entities that own or lease the vessel, or to the vessel to which permits are issued,
means the permit cannot be renewed. If the permit is a limited entry permit, it may be transferred to the new vessel or
vessel owner(s) and lessee(s). If the permit is open access, a new permit may be obtained.
• Various restrictions apply to the renewal or transfer of limited entry permits and endorsements. Consult the
applicable US Code of Federal Regulations, available online at sero.nmfs.noaa.gov/sustainable_fisheries/policy_branch/
• A vessel owner with moratorium Gulf of Mexico Coastal Migratory Pelagic Charter/Headboat and/or a Reef Fish
Charter/Headboat permit(s) that transfers the permit(s) to another vessel owner or to another vessel, must remove the
Federal Charter/Headboat decal from the vessel.
• With the exception of Sea Bass Pot endorsements and Golden Tilefish endorsements, NMFS cannot transfer expired
permits/endorsements to a new permit holder. For all other limited entry permits, an applicant may transfer a permit only
when the seller(s) signature is notarized BEFORE the expiration date, and the applicant submits an application to
transfer the permit before the permit terminates, which is the date one year following the expiration date of the permit (or
6 months following the expiration date of a Golden Crab permit) and as printed on the face of the permit. An applicant
may transfer a Sea Bass Pot endorsement or Golden Tilefish endorsements only when the seller(s) signature is
notarized and the application is submitted BEFORE the termination date of the endorsements.

APPLICATION SECTION 1 – VESSEL INFORMATION.
Complete all portions of Section 1.
 Enter the Official Number and the length of the vessel as they appear on the U.S. Coast Guard Certificate of
Documentation, or the State Registration certificate for a vessel without USCG documentation.
 Provide the Hull Identification Number (HIN) if available. The HIN is a unique number assigned by the boat builder.
Most HINs are shown on the state registration or USCG documentation.
 For Highly Migratory Species (HMS) applicants only:
o An International Maritime Organization (IMO) number is required for all vessels longer than 20 meters
(65 feet 8 inches) applying for HMS commercial shark, swordfish or Atlantic Tuna longline permits.
o If applying for a HMS commercial swordfish, shark, or Atlantic Tuna Longline permit without a vessel,
write “NO VESSEL” in the field for USCG Official Number.
o Shark and Swordfish directed and incidental permit applicants must indicate whether the vessel fishes
with or carries on board longline and gillnet gear.
 For For-Hire vessel applicants only:
o Indicate if the vessel is an uninspected vessel authorized to use a “6-pack” license, or a USCG
inspected vessel, and if so, the passenger capacity of the vessel.

APPLICATION SECTIONS 2 AND 3 – Permits Requested.
Indicate the fishery and transaction type of the permits requested. For renewal and transfer requests of
limited entry permits, indicate the permit number in the space provided.
Commercial Spiny Lobster Income Qualification: NMFS requires an Income Qualification Affidavit with each
application for a Commercial Spiny Lobster permit, as proof of meeting permit income qualification requirement of the
Commercial Spiny Lobster fishery. Additional income qualification documentation may be required upon request.
SPINY LOBSTER INCOME REQUIREMENTS
Percentage of earned income At least 10%
Source of earned income

Sale of catch

Time frame for qualification

Year prior to application

Additionally, Lobster Tailing applicants must either obtain a Commercial Spiny Lobster permit or provide a copy of a
valid Florida Saltwater Product License with a crawfish endorsement, issued to the vessel or the applicant.

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APPLICATION SECTION 4 -- Individuals that own the vessel.
If the U.S. Coast Guard Certificate of Documentation or State Registration indicates the vessel is owned by
one or more individuals, complete Section 4 for all owners listed. Complete Section 4a for an individual
owner. Also fill out Section 4b if the vessel is jointly owned by another individual. Photocopy Section 4
as necessary to provide information for all individuals that own the vessel.
 For each owner, provide the owner’s full name, Individual Tax ID number (SSN), date of birth, phone number,
physical and mailing address, sex, and race/ethnicity information.
 Indicate if the owner is a United States citizen or permanent resident alien. Note, this information will not affect
eligibility to obtain a permit.
 Provide an email address or SMS mobile phone number to receive digital updates about your permit and
application status (when available).If there is more than one vessel owner, and the vessel is not leased, select a
single Primary Mailing Recipient to whom all correspondence about this application and requested permits will be
sent.
APPLICATION SECTION 5 -- Businesses that own the vessel.
If the U.S. Coast Guard Certificate of Documentation or the State Registration is a business, provide
information for all businesses listed. Complete section 5a for a single business owner. Also fill out Section
5b if the vessel is jointly owned by another business.
 NMFS will not issue permits to a business with an INACTIVE status with the applicable Secretary of State.
 Provide the business’s full name, Federal Employer Tax ID number (FEIN), date the business was formed, phone
number, physical and mailing address, and business type.
 Indicate if the business was established by the laws of the United States or any state of the United States. Note,
this information will not affect eligibility to obtain a permit.
 Provide an email address or SMS mobile phone number to receive digital updates about your permit and
application status (when available).
 If there is more than one vessel owner, and the vessel is not leased, select a single Primary Mailing Recipient to
whom all correspondence about this application and requested permits will be sent.
 For a brief definition of applicable business types, see our frequently asked questions at
http://sero.nmfs.noaa.gov/operations_management_information_services/constituency_services_branch/permits/
permit_faq/index.html
APPLICATION SECTION 6 – LEASE Information
If the vessel is leased by one or more individuals, fill out section 6A. Copy this section as necessary to
provide information about all individuals that lease the vessel.
 For each individual lessee, include the lessee’s full name, Individual Tax ID number (SSN), date of birth, phone
number, physical address, mailing address, sex, and race/ethnicity information.
 Indicate if the lessee is a United States citizen or permanent resident alien. Note, this information will not affect
eligibility to obtain a permit.
 Provide an email address or SMS mobile phone number to receive digital updates about your permit and
application status (when available).
 If there is more than one vessel lessee, select a single Primary Mailing Recipient to whom all correspondence
about this application and requested permits will be sent.
If the vessel is leased by one or more businesses, fill out section 6B. Copy this page as necessary to
provide information about all businesses that lease the vessel
 For each business that leases the vessel, provide the business’s full name, Federal Employer Tax ID number
(FEIN), date the business was formed, phone number, physical address, mailing address, and business type.
 Indicate if the business was established by the laws of the United States or any state of the United States. Note,
this information will not affect eligibility to obtain a permit.
 Provide an email address or SMS mobile phone number to receive digital updates about your permit and
application status (when available).
 If there is more than one vessel lessee, select a single Primary Mailing Recipient to whom all correspondence
about this application and requested permits will be sent.
 For a brief definition of applicable business types, see our frequently asked questions at
http://sero.nmfs.noaa.gov/operations_management_information_services/constituency_services_branch/permits/
permit_faq/index.html
A SPECIAL NOTE ABOUT LEASES: There is no provision in the federal regulations to lease permits. Permit holders may
lease a vessel and obtain permits on the vessel as the lessee. Note that vessel owners and lessees cannot independently
hold permits for the same vessel at the same time.
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Company A

Company B

APPLICATION SECTION 7 –Businesses that Own Businesses
Complete this section for any business that owns more than 1% of any business within the ownership
hierarchy of vessel owners or lessees listed in section 5a, 5b, or 6b. For every business, the sum of
ownership, by either individuals or other businesses, must total 100%. Photocopy this section as
necessary to provide information about all businesses within the ownership hierarchy of the vessel.
•
For each business, provide the business’s full name, Federal Employer Tax ID number (FEIN),
date the business was formed, phone number, physical and mailing address, and business type.
•
Indicate if the business was established by the laws of the United States or any state of the
United States. Note, this information will not affect eligibility to obtain a permit.

 Provide an email address or SMS mobile phone number to receive digital updates about your permit and
application status (when available).
 For a brief definition of applicable business types, see our frequently asked questions at
http://sero.nmfs.noaa.gov/operations_management_information_services/constituency_services_branch/permits/
permit_faq/index.html
Example: If a vessel’s USCG documentation indicates that the vessel is owned by Company A, and Company A
is owned by Company B. Provide information about Company A in section 5 and Company B in section 7.
APPLICATION SECTION 8 –Businesses Officers and Individual Owners
Complete this section for any individual that owns more than 1% of any business within the ownership
hierarchy of vessel owners or lessees, as listed in section 5a, 5b, 6b, or 7. For every business, the
sum of ownership, by either individuals or other businesses, must total 100%. Photocopy this section
as necessary to provide information about all businesses within the ownership hierarchy of the vessel
 For each individual owner or officer, include the entity’s full name, Individual 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 a permit.
 Provide an email address or SMS mobile phone number to receive digital updates about your permit and
application status (when available).
Example: If a vessel’s USCG documentation indicates that the vessel is owned by Company A, provide
information about all owners and officers of Company A. If Company A is also owned in whole or part by
Company B, complete section 8 to provide information about all individual owners and officers of Company A and
Company B.
Photocopy this section as necessary to provide information about all businesses and their respective owners and
officers that comprise the ownership hierarchy of the vessel.
APPLICATION SECTION 9 – Minor shareholders
This section is left blank for most applicants. Complete Section 9 if a business listed in Section 5a, 5b, 6b, or 7
has owners that individually own less than 1% of the business. Provide the total percentage of ownership which is
individually held by owners who own less than 1%.
APPLICATION SECTION 10 -- Historical Captain or Designated Operator (Income Qualifer)
This section does not apply for most applications. Only complete this section for
1) Gulf of Mexico Charter/Headboat permits with a Historical Captain endorsement, or
2) Commercial Spiny Lobster permit for which the income qualification requirement has been met the fishing
income of a Designated Operator. A Designated Operator is a vessel operator who is neither a vessel owner nor
lessee listed in Section 4a, 4b, 6a, nor an officer of a business that owns or leases the vessel as listed in 7a.
 For each historical captain or designated operator, include the individual’s full name, Individual tax ID number
(SSN), date of birth, phone number, physical and mailing address, and gender/ethnicity information.
 Indicate if the individual is a United States citizen or permanent resident alien. Note, this information will not
affect eligibility to obtain a permit.
 Provide an email address or SMS mobile phone number to receive digital updates about your permit and
application status (as available).
 Note that Designated Operators must ALSO sign the application in Section 11.
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APPLICATION SECTION 11 - Sea Bass pots or Golden Crab pots
Complete this section only if you fish with pots in the snapper-grouper fishery or traps in the golden crab
fishery off the southern Atlantic states.
 The Sea Bass pot fishery requires tags be ordered through NMFS. Trap Tags for the golden crab fishery do not
need to be ordered through NMFS.
 To order tags from Floy Tag Inc through NMFS, complete this section and include a separate check or money
order for pot or trap tags ($2.00 per tag) payable to FLOY TAG INC. Floy Tag Inc. will ship all Floy Tag orders to
you directly; NMFS will not send tags with the permit package.
APPLICATION SECTION 12 – Small Business or Organization Certification
This section is required for ALL applicants. Your revenue and employment estimates for the most recent complete
calendar year your business or organization was active should include the revenues and employees of ALL affiliated
businesses or organizations. In general, businesses or organizations are affiliated with each other when one
business or organization controls or has the power to control another business or organization, or a third party
controls or has the power to control both. Specifically, businesses or organizations are considered to be affiliated if
they have 50% or more ownership in common. For e.g., if the same individual or individuals own or co-own multiple
businesses, those businesses would be considered affiliated and thus should be treated as a single operation for the
purpose of estimating annual gross revenues and employment.
APPLICATION SECTION 13 – SIGNATURE FOR APPLICATION
If the vessel is leased, a lessee or a lessee’s representative must sign the application as the applicant. If
the vessel is not leased, a vessel owner or an owner’s representative must sign the application as the
applicant.
If the vessel has a Designated Operator/Income Qualifier for Commercial Spiny Lobster permits, the
Designated Operator must also sign and date the application.
The following flowchart describes how to identify who needs to sign the application.
Is there a
Designated
Operator in
Section 8?
Yes
No

Yes

Is the vessel
leased?

Is the vessel
leased by a
business or
organization?

The Designated
Operator must sign and
date the application.
AND...
No

No

Is the vessel
owner a business
or organization?

Yes

No

Yes

An officer or owner of
the vessel lessee must
sign and date the
application.

A lessee the vessel
must sign and date the
application.

An officer or owner of
the vessel owner must
sign and date the
application.

An owner of the
vessel must sign and
date the application.

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 50 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.
For Privacy Act information related to SERO Permits and Permit Applications go to goo.gl/1Zwvbh.

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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

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

FEDERAL PERMIT APPLICATION FOR
VESSELS FISHING IN THE EXCLUSIVE
ECONOMIC ZONE (EEZ)
FOR OFFICE USE ONLY
Reviewer Initials and date
Application Check Or Money
Order number and Amount
Floy Tag Check or Money
Order Number and Amount
Non Compliance Hold date
Non Compliance Cleared date

Expiration Date(s)
FOR OFFICE USE ONLY
Application ID

SCAN DATE AND INITIALS

REMEMBER TO SEND A COPY of the current (not expired) United States Coast Guard (USCG) Certificate of Documentation or a copy
of the State Vessel Registration. Do not send the original. If the vessel's state registration does not list all owners, also provide a copy
of the vessel's title, or other documentation from the appropriate state agency, that identifies all vessel owners.

SECTION 1 - VESSEL INFORMATION
Official Number From USCG Certificate Of
Documentation (If the vessel is documented)

Year Built

Length (ft)

Total Horsepower

State Registration Number (as applicable)

Crew Size—Including the Captain,
but not including passengers.
Vessel Name

ALL APPLICANTS—HOLD or FISH BOX CAPACITY: Estimate
How many pounds of product can you bring to the dock with
a full hold or fish boxes (including ice chests)?

Hull Identification Number (HIN)
Hull Material
Hailing Port City

Hailing Port County Or Parish

Hailing Port State

Product Storage
(check all that
apply)

Fuel Data

FIBERGLASS

DIESEL

WOOD

GASOLINE

STEEL

OTHER
(DESCRIBE)

ON ICE IN
HOLD, FISH
BOX, ICE
CHEST,
COOLER,

ALUMINUM

USCG DOCUMENTED VESSELS ONLY
Gross Tons
Net Tons

OTHER
(DESCRIBE)

FREEZER
Fuel Capacity -

LIVE WELL

Total Gallons

International Maritime Organization (IMO) Number
As applicable (see instructions)

This vessel is
used MOSTLY for
(select only one)

Passenger Capacity Data For Charter
Vessels/Headboats Only

Commercial
Fishing
Charter

UNINSPECTED VESSEL - “6-PACK”
USCG INSPECTED VESSEL: Specify

Headboat

Passenger Capacity as listed on the USCG
Certificate of Inspection, not including Capt.
and Crew.

1

For Shark and Swordfish Directed and
Incidental Permit Applicants Only: Does your
vessel fish with, or carry onboard, either
longline or gillnet gear?
Yes

No

Reminder: If yes, include a copy of your
“Protected Species Release,
Disentanglement, and Identification
Workshop Certificate”.

Form V2019.1P - Revision date 06/03/2019

SECTION 2 - OPEN ACCESS PERMITS AND ENDORSEMENTS
Payment Reminder: All applications must include payment of a non-refundable application fee in the form of a check or money order made
payable to the U.S. Treasury. The fee is $25.00 for the first permit and $10.00 for each additional permit or endorsement requested on this
application. A separate decal is now required for each Gulf of Mexico charter/headboat permit. The fee is $10 per decal per permit. The fee
schedule is found with the Gulf of Mexico Charter/headboat permit requests on page 3.
FEE SCHEDULE FOR PERMITS AND ENDORSEMENTS:
Permit:

1: $25

2: $35

3: $45

4: $55

5: $65

6: $75

7: $85

8: $95

9: $105

10: $115

11: $125

12: $135

INSTRUCTIONS: Find the permits in the left column and mark the check box beside that fishery to indicate what transaction(s) you want.

OPEN ACCESS COMMERCIAL PERMITS

NEW

RENEW

NEW

RENEW

ATLANTIC DOLPHIN/WAHOO (ADW) An Operator Card is required
SPINY LOBSTER (LC) (Not required for the EEZ off Florida)
SPINY LOBSTER TAILING (LT) You must have an LC permit OR provide your FL SPL information below.
SPANISH MACKEREL (SM)
ROCK SHRIMP - CAROLINAS ZONE (RSCZ) An Operator Card is required
SOUTH ATLANTIC PENAEID SHRIMP (SPA)
GULF ROYAL RED SHRIMP ENDORSEMENT (GRRS) You must have a valid Gulf of Mexico Shrimp permit
HMS COMMERCIAL CARIBBEAN SMALL BOAT PERMIT (CCSB) Valid only in U.S. Caribbean (Puerto Rico and USVI)
SMOOTH HOUND SHARK (SHS)

OPEN ACCESS CHARTER/HEADBOAT PERMITS
ATLANTIC CHARTER/HEADBOAT FOR DOLPHIN/WAHOO (CDW) An Operator Card is required
SOUTH ATLANTIC CHARTER/HEADBOAT FOR COASTAL MIGRATORY PELAGICS (CHS)
SOUTH ATLANTIC CHARTER/HEADBOAT FOR SNAPPER-GROUPER (SC)

SPINY LOBSTER INCOME QUALIFICATION AFFIDAVIT
An Income Qualification Affidavit is required with each application: “50CFR622.400 An applicant must provide the following
information: (vi) A sworn statement by the applicant for a vessel permit certifying that at least 10 percent of his or her earned income
was derived from commercial fishing, that is, sale of the catch, during the calendar year preceding the application. “ Knowingly
supplying false information or willfully overvaluing any fishing income for the purpose of obtaining a permit is a violation of Federal law
punishable by a fine and/or imprisonment. The affidavit below fulfills this requirement to obtain a Spiny Lobster Permit

The following information applies to my income qualification for the Spiny Lobster fishery:
I, ___________________________________________ , hereby declare under penalty of perjury that the foregoing information is
true and correct (28 USC 1746; 18 USC 1621; 18 USC 1001; 16 USC 1857). I agree to provide the necessary documentation to
prove that I met the earned income requirement when so requested by the National Marine Fisheries Service.

Executed on ___________(date signed). Printed Name ______________________

Signature ____________________________

Business Name (if Applicable) ____________________________Type of business (if Applicable) ____________________________
Position In Business (if Applicable) ____________________
FOR LOBSTER TAILING PERMIT APPLICANTS ONLY
LOBSTER TAILING APPLICANTS: To obtain a lobster tailing permit you must possess a Florida Saltwater Products License (SPL) with
Restricted Species and Crawfish endorsements. If you do not have a Florida SPL with Restricted Species and Crawfish Endorsements, you
must possess or simultaneously obtain a valid Federal Spiny Lobster (LC) permit.

You must provide a copy of your Florida SPL if you do not have a Federal Spiny Lobster (LC) permit
Saltwater Products License Number

Crawfish Endorsement Number

Saltwater Products License
Expiration Date

2

SECTION 3 - LIMITED ACCESS/MORATORIUM PERMITS AND ENDORSEMENTS
Payment Reminder: All applications must include payment of a non-refundable application fee in the form of a check or money order
made payable to the U.S. Treasury. Please refer to the fee schedule in section 2 of the application.,
INSTRUCTIONS: Find the permits in the left column and mark the check box beside that fishery to indicate what transaction(s) you want.

PERMIT
NUMBER TRANSFER

LIMITED ACCESS COMMERCIAL PERMITS

RENEW

KING MACKEREL (KM)
GILLNET FOR KING MACKEREL (GN)

GULF OF MEXICO SHRIMP (SPGM)
GULF OF MEXICO COMMERCIAL REEF FISH (RR)
EASTERN GULF OF MEXICO REEF FISH BOTTOM LONG LINE ENDORSEMENT (RRLE)
ROCK SHRIMP (SOUTH ATLANTIC EEZ) (RSLA) An Operator Card is required
SOUTH ATLANTIC GOLDEN CRAB (GC)
SOUTH ATLANTIC UNLIMITED SNAPPER-GROUPER (EXCLUDING WRECKFISH) (SG1)
SOUTH ATLANTIC 225 LB TRIP LIMIT SNAPPER-GROUPER (EXCLUDING WRECKFISH) (SG2)
SOUTH ATLANTIC SEA BASS POT ENDORSEMENT (SBPE)
SOUTH ATLANTIC GOLDEN TILEFISH ENDORSEMENT (GTFE)

SWORDFISH DIRECTED (SFD)
SWORDFISH HANDGEAR (SFH)
SWORDFISH INCIDENTAL (SFI)
SHARK DIRECTED (SKD)
SHARK INCIDENTAL (SKI)
ATLANTIC TUNA LONGLINE (ATL) Must have either SFI or SKI and either SFD or SKD

PERMIT
NUMBER

LIMITED ACCESS CHARTER/HEADBOAT PERMITS

Fee Schedule for Charter Decals: 1 Decal - $10 2 Decals - $20.
Note: Decal fees are in addition to normal permit fees. See fee Schedule at the top of section 2.
GULF CHARTER/HEADBOAT FOR COASTAL MIGRATORY PELAGIC FISH (CHG)
GULF CHARTER/HEADBOAT FOR REEF FISH (RCG)
HISTORICAL CAPTAIN GULF CHARTER/HEADBOAT FOR COASTAL MIGRATORY PELAGIC FISH (HCHG)

HISTORICAL CAPTAIN GULF CHARTER/HEADBOAT FOR REEF FISH (HRCG)

3

TRANSFER

RENEW

SECTION 4 - INDIVIDUAL VESSEL OWNER(S) INFORMATION
Section 4a: Primary or Sole Owner: Complete this section if there is one or more individual shown on the USCG documentation, State
Registration or title as the registered owner of the vessel. Select only ONE mailing recipient.
Is this individual a United States Citizen
or permanent resident alien?

MAILING RECIPIENT - All mail about this permit
will go to the individual listed in Section 4a
What this individual’s
Sex?
What is this
individual’s
race?

Male

Is this Individual of Hispanic, Latino, or Spanish origin?

Female

YES
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

Middle Name

NO

Suffix - Jr, Sr, etc.

If you are operating under a different name,
what is your Doing Business As (DBA) name?
Individual Tax ID Number (SSN)

Date of Birth (MM/DD/YYYY)

Mailing Address

Apt #

City

Area Code

Phone Number

State

County/Parish

Zip Code

Country

State

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

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

Section 4b: Joint Owner. Complete this section if there is more than one individual shown on the USCG documentation, State Registration or
title as the registered joint owner of the vessel. Copy this page as needed to include ALL owners of the vessel.
Is this individual a United States Citizen
or permanent resident alien?

MAILING RECIPIENT - All mail about this permit
will go to the individual listed in Section 4b
What this individual’s
Sex?
What is this
individual’s
race?

Male

Is this Individual of Hispanic, Latino, or Spanish origin?

Female

YES

American Indian or Alaska
Native

Native Hawaiian or Other Pacific Islander

Black or African American

Asian American

Other _______________

Last Name

Middle Name

First Name

No

Yes

White

NO

Suffix - Jr, Sr, etc.

If you are operating under a different name,
what is your Doing Business As (DBA) name?

Individual Tax ID Number (SSN)

Mailing Address

Date of Birth (MM/DD/YYYY)

Apt #

City

Area Code

Phone Number

State

County/Parish

Zip Code

Country

State

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

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

Email

Cell Phone number and provider:

4

SECTION 5 – BUSINESS VESSEL OWNER(S) INFORMATION
Section 5a: Primary or Sole Owner: Complete this section if there is one or more businesses shown on the USCG Documentation, State
Registration or Title as the registered owner of the vessel. Select only ONE mailing recipient.

Type of
business:

S Corporation

Cooperative

Other_______________

C Corporation

Limited Liability Co.

Partnership

Was this Business properly established by
the laws of the United States or any state
of the United States?

YES
NO

MAILING RECIPIENT - All mail about this permit will go to the business listed in Section 5a
Registered Name of Business

Federal Employer Tax ID Number (FEIN)

Mailing Address

Date Business Formed (MM/DD/YYYY)

Apt #

City

Area Code

Phone Number

State

County/Parish Zip Code

Country

State

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

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

Email

Cell Phone number and provider:

Section 5b: Joint Owner: Complete this section if there is another business shown on the USCG Documentation, State Registration or
Title as the registered joint owner of the vessel.
Type of
business:

S Corporation

Cooperative

Other_______________

C Corporation

Limited Liability Co.

Partnership

Was this Business properly established by
the laws of the United States or any state
of the United States?

MAILING RECIPIENT - All mail about this permit will go to the business listed in Section 5b
Registered Name of Business

Federal Employer Tax ID Number (FEIN)

Mailing Address

Date Business Formed (MM/DD/YYYY)

Apt #

City

Area Code

Phone Number

State

County/Parish

Zip Code

Country

State

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

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

Email

Cell Phone number and provider:

5

YES
NO

SECTION 6 –LEASE INFORMATION
If the permit holder is leasing the vessel from the vessel owner in order to assign permits to the vessel, provide the lease information in this section. You must provide a copy of the lease agreement. The term of the lease must be a minimum of 7 months. Please Note: Any permits already
held and assigned to the vessel by the vessel owner will be ended and will not be valid for fishing if the vessel is leased to another permit holder
whose permits are assigned to the vessel.
Lease start date:

Lease end date:

Section 6a: Individual or Joint Lessee: Complete this section if an individual is leasing the vessel from the vessel owner. If more than
one individual is leasing the vessel from the vessel owner. Copy this page as needed to provide information on all lessees.
Is this individual a United States Citizen or
YES
MAILING RECIPIENT - All mail about this permit
NO
permanent resident alien?
will go to the individual listed in Section 6a
What this individual’s
Sex?
What is this
individual’s
race?

Male

Is this Individual of Hispanic, Latino, or Spanish origin?

Female

Yes

White

American Indian or Alaska
Native

Native Hawaiian or Other Pacific Islander

Black or African American

Asian American

Other _______________

Middle Name

First Name

Last Name

No

Suffix - Jr, Sr, etc.

If you are operating under a different name,
what is your Doing Business As (DBA) name?
Individual Tax ID Number (SSN)

Date of Birth (MM/DD/YYYY)

Mailing Address

Apt #

City

Area Code

Phone Number

State

County/Parish

Zip Code

Country

State

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

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

Section 6b: Business Lessee: Complete this section if a business is leasing the vessel from the vessel owner. If a business is leasing the vessel,
officer and owner information for the business must be provided in section 8.
Type of
business:

S Corporation

Cooperative

Other_______________

C Corporation

Limited Liability Co.

Partnership

Was this Business properly established by
the laws of the United States or any state
of the United States?

MAILING RECIPIENT - All mail about this permit will go to the business listed in Section 6b
Registered Name of Business

Federal Employer Tax ID Number (FEIN)

Mailing Address

Date Business Formed (MM/DD/YYYY)

Apt #

City

Area Code

Phone Number

State

County/Parish

Zip Code

Country

State

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

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

Email

Cell Phone number and provider:

6

YES
NO

SECTION 7 - BUSINESSES THAT OWN BUSINESSES
Complete this section for each business that owns 1% or more of a business listed in sections 5a, 5b and 6b. Copy this section as needed.

Section 7a: Business owner:

Business for which this business is an owner of:
Percent of Business Owned:
Type of
business:

S Corporation

Cooperative

Other_______________

C Corporation

Limited Liability Co.

Partnership

Was this Business properly established by
the laws of the United States or any state
of the United States?

YES
NO

Registered Name of Business

Federal Employer Tax ID Number (FEIN)

Date Business Formed (MM/DD/YYYY)

Mailing Address

Apt #

City

Area Code

Phone Number

State

County/Parish

Zip Code

Country

State

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

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

Section 7b: Additional Business owner:

Business for which this business is an owner of:
Percent of Business Owned:
Type of
business:

S Corporation

Cooperative

Other_______________

C Corporation

Limited Liability Co.

Partnership

Was this Business properly established by
the laws of the United States or any state
of the United States?

Registered Name of Business

Federal Employer Tax ID Number (FEIN)

Mailing Address

Date Business Formed (MM/DD/YYYY)

Apt #

City

Area Code

Phone Number

State

County/Parish

Zip Code

Country

State

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

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

Email

Cell Phone number and provider:

7

YES
NO

SECTION 8 - BUSINESS OFFICERS AND BUSINESS OWNERS

Complete this section by providing information on all individual officers and owners that own 1% or more of any business listed in sections 5a, 5b, 6b, and 7. Copy
this section as needed.

Section 8a: Individual Officer/Owner:
Business for which this individual is an officer/owner of:
Position Held - Check ALL That Apply
Vice President
President/CEO
Percent of Business Owned:
What this individual’s
Sex?
What is this
individual’s
race?

Male

Secretary

Treasurer

Director/ Manager

Shareholder

Other
YES

Is this individual a United States citizen or permanent resident
Is this Individual of Hispanic, Latino, or Spanish origin?

Female

No

Yes

White

American Indian or Alaska
Native

Native Hawaiian or Other Pacific Islander

Black or African American

Asian American

Other _______________

Middle Name

First Name

Last Name

Individual Tax ID Number (SSN)

Date of Birth (MM/DD/YYYY)

Mailing Address

Apt #

City

Area Code

NO

Suffix - Jr, Sr, etc.

Phone Number

State

County/Parish

Zip Code

Country

State

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

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

Section 8b: Additional Officer/Owner:
Business for which this individual is an officer/owner of:
Position Held - Check ALL That Apply
President/CEO

Vice President

Percent of Business Owned:
What this individual’s
Sex?
What is this
individual’s
race?

Male

Secretary

Treasurer

Director/ Manager

Shareholder

Other
YES

Is this individual a United States citizen or permanent resident
Is this Individual of Hispanic, Latino, or Spanish origin?

Female

Yes

White

American Indian or Alaska
Native

Native Hawaiian or Other Pacific Islander

Black or African American

Asian American

Other _______________

Last Name

Individual Tax ID Number (SSN)

Mailing Address

Middle Name

First Name

Date of Birth (MM/DD/YYYY)

Apt #

City

Area Code

NO
No

Suffix - Jr, Sr, etc.

Phone Number

State

County/Parish

Zip Code

Country

State

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

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

Email

Cell Phone number and provider:

8

SECTION 9 - OWNER INFORMATION FOR UNNAMED MINOR SHAREHOLDERS OF BUSINESSES
MINOR OWNERS - Check here if one or more owners (individual OR business) holds shares that are less than 1% of the total business shares.
TOTAL PERCENTAGE of the business shares held by minor owners.

SECTION 10 - HISTORICAL CAPTAIN OR DESIGNATED OPERATOR (INCOME QUALIFIER)
This individual is a (check Historical Captain OR Designated Operator):
Historical Captain for Gulf of Mexico Charter/Headboat permits

Designated Operator (Income Qualifier who is not the Permit Holder) for Commercial Spiny Lobster
A Historical Captain MUST sign Section 13 as the applicant.
A Designated Operator MUST sign Section 13 as the operator along with the applicant.
NOTE: All mail about historical Captain Permits will go to the individual listed as the Historical Captain.
YES

Is this individual a United States Citizen or permanent resident alien?
What this individual’s
Sex?
What is this
individual’s
race?

Male

NO

Is this Individual of Hispanic, Latino, or Spanish origin?

Female

Yes

White

American Indian or Alaska
Native

Native Hawaiian or Other Pacific Islander

Black or African American

Asian American

Other _______________

Middle Name

First Name

Last Name

Individual Tax ID Number (SSN)

Date of Birth (MM/DD/YYYY)

Mailing Address

Apt #

City

Area Code

No

Suffix - Jr, Sr, etc.

Phone Number

State

County/Parish

Zip Code

Country

State

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

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

SECTION 11 - SEA BASS POTS OR GOLDEN CRAB TRAPS
COMPLETE THIS SECTION ONLY IF YOU HAVE SEA BASS POTS OR IF YOU HAVE GOLDEN CRAB TRAPS.
Tag cost is $2.00 per tag made payable by check or money order to Floy Tag, Inc.
I need tags for:

Sea Bass Pots

Golden Crab Traps

What color are your Buoys for Sea Bass Pots or Golden Crab Traps?
South Atlantic Sea Bass Pot/Golden Crab Trap Information - You are allowed a MAXIMUM of 35 Sea Bass Pots
Number of
Pots/Traps

Pot or Trap Height
(inches)

Pot or Trap Length
(inches)

Pot or Trap Width
(inches)

9

Mesh Size Height
(inches)

Mesh Size Width
(inches)

SECTION 12 - SMALL BUSINESS OR ORGANIZATION CERTIFICATION
ALL applicants must complete this section
● For vessels that are leased, complete this section for business(es), including sole proprietorship(s),or organization(s) that
lease the vessel.
● For vessels that are not leased, complete this section for business(es), including sole proprietorship(s), ororganization(s)
that own the vessel (i.e., the business(es), including sole proprietorship(s), or organization(s) that appear on the vessel’s
USCG documentation or state registration).
Information needed to complete this section: Please estimate your annual gross revenues (sales) for the most recent calendar
year your business or organization was active prior to this year. Your primary activity is the activity that generated the greatest
percentage of annual gross revenues in the most recent complete calendar year the business or organization was active. Review
the business/organization descriptions in Boxes 1 through 7 and identify the one that describes the applicant’s primary activity. If
the business is primarily a seafood dealer or processor, estimate the number of employees for the most recent calendar year your
business or organization was active prior to this year. Include all full-time, part-time, and temporary employees in your estimate,
but do not include crew that work on any vessels owned by the business or organization or its affiliates. Your estimates should
account for the revenues and employees of ALL businesses and organizations with which your business or organization is affiliated.
See the instructions at the beginning of the application package for more information about affiliation. If you have questions
about affiliation and how it applies in your case, please call 727-824-5305 and ask for one of our Office’s economists.
How to fill out the form: Start with Box 1. If the answer to the question in Box 1 is “Yes,’’ check “Yes” and answer the questions in
the box to the right and follow the instructions in that box. If the answer to Question 1 is “No,” check “No” and go to Box 2.
Continue this process until you have either: (1) answered “Yes” to ONE of the questions in Boxes 1 through 6 AND the applicable
questions in the boxes to the right, OR (2) answered all questions in Box 7.
Box 1. Is the business primarily involved in
harvesting seafood (commercial fishing)?

1A) Was the business active prior to
this year?

Yes

Yes

No

No

If the answer is yes, go to question 1A to the
right. Otherwise, go to Question 2 below.

If yes, go to question 1B. If no, you
are done. Go to Section 13 of the
application.

Box 2. Is the business primarily involved in
for-hire fishing services (charter, party/
headboat)?

2A) Was the business active prior to
this year?

Yes

No

If the answer is yes, go to question 2A to the
right. Otherwise, go to Question 3 below.

Box 3. Is the business primarily involved in
buying and selling seafood (seafood
dealer/wholesaler)?
Yes

No

Yes

No

If yes, go to question 2B. If no, you
are done. Go to Section 13 of the
application.

3A) Was the business active prior to
this year?
Yes

No

If the answer is yes, go to question 3A to the
right. Otherwise, go to Question 4 below.

If yes, go to question 3B. If no, you
are done. Go to Section 13 of the
application.

Box 4. Is the business primarily involved in
processing seafood (seafood processor)?

4A) Was the business active prior to
this year?

Yes

Yes

No

If the answer is yes, go to question 1A to the
right. Otherwise, go to Question 5 on the next
page.

No

If yes, go to question 4B. If no, you
are done. Go to Section 13 of the
application.

Next page
10

1B) What was the most recent year the
business was active prior to this year?
_____________
Did the business have more than $11 million in
gross receipts in that year? Yes
No
You are done. Go to Section 13 of the
application.

2B) What was the most recent year the
business was active prior to this year?
_____________
Did the business have more than $7.5 million
in gross receipts in that year? Yes
No
You are done. Go to Section 13 of the
application.

3B) What was the most recent year the
business was active prior to this year?
_____________
Did the business have more than 100
employees? Yes
No
You are done. Go to Section 13 of the
application.

4B) What was the most recent year the
business was active prior to this year?
_____________
Did the business have more than 750
employees? Yes
No
You are done. Go to Section 13 of the
application.

SECTION 12 - SMALL BUSINESS OR ORGANIZATION CERTIFICATION
(Continued from previous page)

Box 5. Is the organization an Environmental,
Conservation and Wildlife, or Professional
Non-Profit Organization?
Yes

No

5A) Was the organization active
prior to this year?
Yes

No

If the answer is yes, go to question 5A to the
right. Otherwise, go to Question 6 below.

If yes, go to question 5B. If no, you
are done. Go to Section 13 of the
application.

Box 5. Is the organization some other NonProfit Organization (e.g., business
association)?

6A) Was the organization active
prior to this year?

Yes

Yes

No

If the answer is yes, go to question 6A to the
right. Otherwise, go to Question 7 below.

No

If yes, go to question 6B. If no, you
are done. Go to Section 13 of the
application.

5B) What was the most recent year the
organization was active prior to this year?
_____________
Did the organization have more than $15
Million in gross receipts? Yes
No
You are done. Go to Section 13 of the
application.

6B) What was the most recent year the
business was active prior to this year?
_____________
Did the organization have more than $7.5
Million in gross receipts? Yes
No
You are done. Go to Section 13 of the
application.

If you are here, you have answered NO to Questions 1 thru 6. If you answered one of those questions YES, return to that question and finish
there.
7) The business or organization must be primarily involved in another industry not related to fishing or seafood.
Refer to SBA’s list of NAICS codes (see https://go.usa.gov/xRGvQ) and enter the NAICS code for your primary
activity here:

Based on the applicable SBA size standard, check the appropriate box to indicate if the business or organization is Large or Small and
report the year on which that conclusion was based.
Large

Small

Year:

You are done. Go to Section 13 of the application.

SECTION 13 - SIGNATURE FOR APPLICATION - REQUIRED
The undersigned certifies under penalty of perjury that the foregoing information is true and correct (28 USC 1746; 18 USC 1621;
18 USC 1001, 16 USC 1857). Further, the undersigned certifies that if a spiny lobster tailing permit is requested, the applicant
routinely fishes commercially in Federal waters on trips of up to 48 hours or more and that such fishing activity requires the
separation of the tail and carapace to maintain quality product.
Please note: If the vessel listed in Section 1 is leased, the applicant who signs below must be an individual named as a lessee in
Section 6a, or an officer or shareholder of the lessee as listed in Section 7b, with that individuals information listed in section 8. If
the vessel listed in Section 1 is not leased, the applicant must be an individual named as an owner in Section 4, or an officer or
shareholder of the owner as listed in Section 8.
Applicant Signature
(Vessel Owner from Section 4,
Company Officer Shareholder from Section 8,
OR Lessee From Section 6)

Date

Print Name
Position in Business (Officer or Shareholder
from Section 8)
Designated Operator Signature

Date

(Individual who filled out section 10 for Lobster Permits)

11

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

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