Vessel Monitoring System Certification Statement for Atl

OMB #0648-0372
Expires X/XX/20XX

Vessel Monitoring Systems Certification Statement
for Atlantic Highly Migratory Species Fisheries
INSTRUCTIONS: This form should be completed and signed by the owner and the qualified marine
electrician that installed the VMS unit on the vessel named below. The completed form should be sent to
NOAA Office of Law Enforcement, 263 13th Avenue South, Suite 109, St. Petersburg, Florida 33701. This
Vessel Monitoring Systems (VMS) Certification Statement for the Highly Migratory Species (HMS) Fisheries
is provided by the National Marine Fisheries Service (NOAA Fisheries) pursuant to the regulatory
requirements of 50 C.F.R. § 635.69. This certification statement is applicable for the VMS providers currently
approved for use in HMS fisheries.
A qualified marine electrician must follow the manufacturer’s installation procedures when installing or reinstalling a NOAA Fisheries-approved VMS unit. The vessel owner is responsible for all installation and
activation costs. After completion of the installation and activation, the owner should confirm that NOAA
Fisheries is receiving position reports by calling NOAA Office of Law Enforcement in St. Petersburg, Florida,
at, 800-758-4833 or by sending an e-mail to [email protected].

Vessel Name:___________________ U.S Coast Guard Documentation Number:_______________
Installing marine electrician or dealer (name, address, and telephone number):
_________________________________________________________________________________
_________________________________________________________________________________
Date of Installation (mm/dd/yyyy):__________________
VMS Enhanced Mobile Transceiver Unit (E-MTU):
Manufacturer name:_________________________________________________________________
Model:___________________________________________________________________________
Manufacturer serial number (S/N):_____________________________________________________
Communication network serial number (ISN):____________________________________________
VMS Mobile Communications Service Provider (MCSP)
Communications provider name:________________________________
Communications ID number assigned by service provider:____________________
Once the VMS E-MTU was installed, did the electrician/dealer, or the owner and/or operator of the
vessel verify with NOAA OLE VMS Program personnel that position data was being received?
Yes No
Certification:
In accordance with 50 C.F.R. § 635.69(d), as a qualified marine electrician, I hereby certify that the
VMS system on the vessel named above has been installed in compliance with applicable procedures.
Vessel Owner/Operator’s Name: ______________________________________________
Vessel Owner/Operator’s Signature___________________________ Date: ____________
Installer’s Name:___________________________________________________________
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OMB #0648-0372
Expires X/XX/20XX

Installer’s Signature:________________________________________ Date:____________
Under the provisions of the Paperwork Reduction Act of 1995 (PL 104-13) and the Privacy Act of 1974 (PL 93-579), you are advised that disclosure of
the information requested in the Vessel Monitoring System (VMS) certification statement is mandatory for the purpose of managing the Atlantic HMS
fisheries. The certification statement is used to ensure proper operation of the VMS unit. Confidentiality of the information provided will be treated in
accordance with NOAA Administrative Order 216-100. It is the policy of the National Marine Fisheries Service not to release confidential data, other
than in aggregate form, as the MSA protects the confidentiality of those submitting data. Whenever data are requested, NMFS ensures the information
identifying the pecuniary business activity of a particular individual is not identified.
A Federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply
with an information collection subject to the requirements of the Paperwork Reduction Act of 1995 unless the information collection has a currently
valid OMB Control Number. The approved OMB Control Number for this information collection is 0648-0372. Without this approval, we could not
conduct this information collection. Public reporting for this information collection is estimated to be approximately 4 hours per installation, including
the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the
information collection. The burden for submission of this certification statement is estimated at 5 minutes per response. All responses to this
information collection are mandatory. Send comments regarding this burden estimate or any other aspect of this information collection, including
suggestions for reducing this burden to the NMFS, Office of Law Enforcement, 8484 Georgia Avenue, Suite 415, Silver Spring, MD 20910.

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