Federal Permit Application for Vessels Fishing for Wreck

Instructions for the Federal Permit Application for Vessels
Fishing for Wreckfish off the South Atlantic States

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:
Who can obtain a wreckfish permit?
To obtain a commercial vessel permit for wreckfish:


The applicant must be a wreckfish shareholder; and either the shareholder must be the vessel owner or the
owner or operator must be an employee, contractor, or agent of the shareholder.



A commercial permit for South Atlantic snapper-grouper must have been issued to the vessel.

For more information about the wreckfish ITQ program, contact the Sustainable Fisheries Division LAPP/DM Branch at
(727) 824-5305.

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.
If the vessel’s USCG documentation or state registration indicates the vessel is owned by one or more individuals,
fill out Section 3.
If the vessel’s USCG documentation or state registration indicates the vessel is owned by one or more
businesses, fill out Section 4.
If the vessel is leased and the permit(s) will be issued to the lessee(s), complete Section 5.
If a vessel is owned or leased by a business which is owned by another business, or if the wreckfish shareholder
is a business which is owned by another business, provide information about all businesses’ parent companies in
Section 6.
If a vessel is owned or leased by a business or the wreckfish shareholder is a business, in addition to completing
Section 2b, 4 and/or 5b, complete Section 7 to provide information about all individuals that are owners or officers
of the businesses, or parent companies to businesses, that own or lease the vessel or are the wreckfish s
All applicants must fill out Section 8 and Section 9.
See pages 3-6 for information about specific sections of this application.

What is the fee?
The application fee is $50. This application fee is collected to cover the administrative cost of processing the application,
and is non-refundable.
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.

Where do I send the application?
Mail the complete application, payment, and all required supporting documentation to: National Marine Fisheries
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.
1

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.

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.
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.

A few words about renewals…
• Any change to the identity of the entities that own or lease the vessel are the wreckfish shareholders, or a change
to the vessel to which the permits will be issued, means that the wreckfish permit cannot be renewed. In those
instances, a new wreckfish permit may be obtained.

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.

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APPLICAT

SECTION 2 -- Wreckfish Shareholder Information

 Enter the Wreckfish Shareholder’s Certificate Number in the field provided at the top of Section 2.
 If the Wreckfish Shareholder is an individual, complete section 2a to include the Wreckfish shareholder’s full
name, Individual Tax ID number (SSN), date of birth, phone number, physical address, mailing address, sex, and
race/ethnicity information.
o Indicate if the individual is a United States citizen or permanent resident alien. Note, this information
will not affect the shareholder’s eligibility to obtain a permit.
 If the Wreckfish Shareholder is a business, complete section 2b to include the Wreckfish shareholder’s business
name, Federal Employer Tax ID number (FEIN), date the business was formed, physical and mailing address,
and business type.
o 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 the shareholder’s 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).

APPLICATION SECTION 3 -- 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 3 for all owners listed. Complete Section 3a for an individual
owner. Also fill out Section 3b if the vessel is jointly owned by another individual. Photocopy Section 3 as
necessary to provide information for all individuals that own the vessel.
 For each owner, include the owner’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 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 4 -- 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 4a for a single business owner. Also fill out Section
4b 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

3

APPLICATION SECTION 5 – LEASE Information
If the vessel is leased by one or more individuals, fill out section 5A. 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 5B. 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 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 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.

Company A

Company B

APPLICATION SECTION 6 –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, lessees, and Wreckfish shareholders listed in section 2b, 4a, 4b, or 5b. 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 or Wreckfish certificate.


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.

4

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, lessees, and wreckfish shareholders as listed in section 2b, 4a, 4b, 5b, and
6. 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 and Wreckfish certificate.
 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).
 Complete Section 7C if a business listed in Section 2b, 4a, 4b, 5b, and 6 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%.
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 – 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 10 – SIGNATURE FOR APPLICATION
The application must be signed and dated by the wreckfish shareholder. If the wreckfish shareholder is a
business, an officer or owner of the business 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 55 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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6

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 FOR WRECKFISH
OFF THE SOUTH ATLANTIC STATES
FOR OFFICE USE ONLY
Reviewer’s Initials and date
Check or Money Order Number
Non Compliance Hold date
Non Compliance Cleared date
Expiration date

FOR OFFICE USE ONLY
SCAN DATE AND INITIALS

Application ID

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

Fuel Data

FIBERGLASS

DIESEL

STEEL

GASOLINE

WOOD

OTHER
(DESCRIBE)

CEMENT

USCG DOCUMENTED VESSELS ONLY
Gross Tons
Net Tons

OTHER
(DESCRIBE)

Product Storage
(check all that
apply)
ON ICE IN
HOLD, FISH
BOX, ICE
CHEST,
COOLER,
ETC
FREEZER

Fuel Capacity -

LIVE WELL

Total Gallons

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

1

W2019.1 Revision date 06/03/2019

SECTION 2 - WRECKFISH SHAREHOLDER INFORMATION
Complete Section 2a on this page for an individual that is a Wreckfish Shareholder. Complete section 2b for a Business that is a Wreckfish
Shareholder. Photocopy this page as needed to provide information on all shareholders. Select only ONE mailing recipient.
Shareholder’s Certificate Number:

Section 2a: Individual as a Shareholder.
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

NO

Suffix - Jr, Sr, etc.

Middle Name

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 2b: Business as a Shareholder: Complete this section if a business is a wreckfish shareholder.
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:

2

YES
NO

SECTION 3 - INDIVIDUAL VESSEL OWNER(S) INFORMATION
Section 3a: 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 3a
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 3b: 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 3b
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:

3

SECTION 4 – BUSINESS VESSEL OWNER(S) INFORMATION
Section 4a: 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

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.

Email

Cell Phone number and provider:

Section 4b: 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 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:

4

YES
NO

SECTION 5 –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 5a: 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 5a
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 5b: 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 7.
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 - 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 6a: 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 6b: 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:

6

YES
NO

SECTION 7 - BUSINESS OFFICERS AND INDIVIDUAL OWNERS

Complete this section by providing information on all individual officers and owners that own 1% or more of any business listed in sections 2b, 4, 5b, and 6. Copy
this section as needed.

Section 7a: 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 7b: 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:

7

SECTION 8 - OFFICER/OWNER INFORMATION FOR BUSINESS(ES) THAT OWN OR LEASE THE VESSEL (cont.)
7c. Minor Owner Information
MINOR OWNERS - Check here if one or more owners individually holds shares that is less than 1% of the total business shares.
TOTAL PERCENTAGE of the business shares held by minor owners.

SECTION 8 - 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 9 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 9 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 9 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.

Next page

No

If yes, go to question 4B. If no, you
are done. Go to Section 9 of the
application.

8

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 9 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 9 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 9 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 9 of the
application.

SECTION 8 - 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 9 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 9 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 9 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 9 of the
application.

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 9 of the application.

SECTION 9 - SIGNATURE FOR APPLICATION - REQUIRED
If the Wreckfish Shareholder is not the vessel owner, the undersigned certifies and documents that the vessel owner or operator is an
employee, contractor or agent of the shareholder.
Applicant Signature

Position in Business

Date

Print Name

Designated Operator
Signature

Date

9