NOAA Fisheries Service Federal Application for Gulf of M

Southeast Region IFQ Programs

0551 7 IFQ Online Account Application_020521

IFQ Online Account Application

OMB: 0648-0551

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OMB Control No. 0648-0551 Exp. Date: 5/31/2021

U.S. DEPT OF COMMERCE, NOAA
NMFS Catch Shares Program, F/SER29
263 13th Avenue South
St. Petersburg, FL 33701-5511
Toll Free 866-425-7627 (8 a.m. - 4:30 p.m. ET)
727-824-5305 (8 a.m. - 4:30 p.m. ET)
https://SECatchShares.fisheries.noaa.gov/

NOAA FISHERIES SERVICE
FEDERAL APPLICATION
FOR CATCH SHARES
ONLINE ACCOUNT

FOR OFFICE USE ONLY
Reviewer's Initials and Date ___________________________
Sanction Case Number if Sanctioned and date held
__________________________________________________
Date Sanction Released and Initials _____________________

Application ID

APPLICATION INSTRUCTIONS
1. Current Catch Share participants need to complete this application to certify they are or are NOT a United States citizen or a permanent resident

alien.
2. This application is to establish a Catch Share Online account for new participants and update account information for existing participants.
However, a valid commercial permit for Gulf reef fish and allocation are required to possess (at and after the time of the advance notice of
landing), land or sell Gulf reef fish subject to this Catch Share program.
3. Follow the instructions at the top of each section. Make sure all the information is correct then sign and date the application below. The Catch
Share applicant signing the application must be an account holder listed in section 1 and a United States citizen or permanent resident alien.
4. Mail your completed application to: U.S. Department of Commerce, NOAA, National Marine Fisheries Service F/SER29, 263 13th Avenue
South, St. Petersburg, FL 33701-5505.
Public reporting burden for this collection of information is estimated to average 13 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/SER2, 263 13th Avenue South, St. Petersburg, FL 33701-5505.
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 uses. Responses to this collection are required to
obtain or retain a Catch Shares online account under the Magnuson-Stevens Act. Non-confidential information will be released via a NOAA Fisheries
Service website. Non-confidential information means: name, address, city, state, zip code, etc. 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.

SIGNATURE OF APPLICATION
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). Knowingly supplying false information for the purpose of obtaining a Catch Shares Online Account is a violation of Federal law
punishable by a fine and/or imprisonment. Please note: The individual signing below MUST be either the Catch Shares account holder OR must be
one of the officers or shareholders that is a United States citizen or permanent resident alien listed in section 2 of this application.

Applicant Signature ________________________________ Position in Company (if applicable) ___________________________
Print Name_______________________________________ Date ____________________ UserID ____________
(if applicable)

Last form revision 02/05/2021

1. CATCH SHARES ONLINE ACCOUNT HOLDER INFORMATION
1) Check the appropriate box below if the applicant is a new or existing Catch Shares online account holder. Provide the USER ID for an existing
account holder.
2) Complete this page for all Catch Shares online account holders. If the account holder is a business, enter the Federal ID number and date the
business filed with the state. If the account holder is an individual, enter their Social Security Number and date of birth.
3) Check the appropriate box below to certify that the applicant IS or IS NOT a United States citizen or permanent resident alien.

4) If the Catch Shares account is held by a business, please also complete Section 2 on page 4.
Check the appropriate box below:
NEW Catch Shares online account holder
EXISTING Catch Shares online account holder and provide the Catch Shares Online account holder’s UserID: ________________

E-mail address: _________________________________________________________________________________________________

CATCH SHARES ONLINE ACCOUNT HOLDER INFORMATION
Check one: Individual/Sole Proprietorship
Other _________________

Joint Ownership

Partnership

Corporation

Certify Citizenship Status:
The applicant IS a United States citizen or permanent resident alien OR this Business was properly established by the laws of the
United States or any state of the United States.
The applicant IS NOT a United States citizen or permanent resident alien OR this Business was not properly established by the laws
of the United States or any state of the United States.
What is this individual’s sex?

Male

Female

In this individual of Hispanic, Latino, or Spanish origin?
What is this individual’s race?

White

Yes

American Indian or Alaska Native

Black or African American

Prefix

Asian American

Last Name or Business Name

Native Hawaiian or Other Pacific Islander
Other: ____________________________

First Name

If you are operating under a different name,
what is your Doing Business As (DBA) name?
Mailing Address
Apt/Suite

Middle Name

Suffix

City

State

County/Parish

Zip Code

Country

City

State

County/Parish

Zip Code

Country

Physical Address
Check if same as mailing address

Tax ID number (FED ID or SSN)

Apt/Suite

Date of Birth or Date Business Filed (mm/dd/yyyy)

Area Code

Select one:

Primary Phone Number

Home

Work

Cell

ADDITIONAL CATCH SHARES ONLINE ACCOUNT HOLDER INFORMATION
1) Only complete this page for all additional Catch Shares online account holders. If the account holder is a business, enter the Federal ID number and
date the business filed with the state. If the account holder is an individual, enter their Social Security Number and date of birth.
2) Check the appropriate box below to certify that the applicant IS or IS NOT a United States citizen or permanent resident alien.

Catch Shares online account holder’s UserID (if applicable): _____________________________________________

ADDITIONAL CATCH SHARES ONLINE ACCOUNT HOLDER INFORMATION
Check one: Individual/Sole Proprietorship
Other _____________________

Joint Ownership

Partnership

Corporation

Male

Female

In this individual of Hispanic, Latino, or Spanish origin?
What is this individual’s race?

White

Yes

American Indian or Alaska Native

Black or African American
Prefix

Asian American

Last Name or Business Name

Native Hawaiian or Other Pacific Islander
Other: ____________________________

First Name

If you are operating under a different name,
what is your Doing Business As (DBA) name?
Mailing Address
Apt/Suite

Middle Name

Suffix

City

State

County/Parish

Zip Code

Country

City

State

County/Parish

Zip Code

Country

Physical Address
Check if same as mailing address

Tax ID number (FED ID or SSN)

Apt/Suite

Date of Birth or Date Business Filed (mm/dd/yyyy)

Area Code

Select one:

Primary Phone Number

Home

Work

Cell

Catch Shares online account holder’s UserID (if applicable): ____________________________________________

ADDITIONAL CATCH SHARES ONLINE ACCOUNT HOLDER INFORMATION
Check one: Individual/Sole Proprietorship
Other ________________

Joint Ownership

Partnership

Corporation

Male

Female

In this individual of Hispanic, Latino, or Spanish origin?
What is this individual’s race?

Prefix

Yes

White
American Indian or Alaska Native
Black or African American
Asian American

Last Name or Business Name

Native Hawaiian or Other Pacific Islander
Other: ____________________________

First Name

If you are operating under a different name,
what is your Doing Business As (DBA) name?
Mailing Address
Apt/Suite

Middle Name

Suffix

City

State

County/Parish

Zip Code

Country

City

State

County/Parish

Zip Code

Country

Physical Address
Check if same as mailing address

Tax ID number (FED ID or SSN)

Apt/Suite

Date of Birth or Date Business Filed (mm/dd/yyyy)

Area Code

Select one:

Primary Phone Number

Home

Work

Cell

2. OFFICER/SHAREHOLDER INFORMATION FOR
CORPORATION/BUSINESS/LLC THAT HOLD THE CATCH SHARES ONLINE ACCOUNT
1) If this Catch Shares online account is held by a business, then complete this section for EACH officer or partner associated with the
business.
Provide the information for all officers or partners that are shown on your most recent annual report. If your business is structured as a corporation,
identify all shareholders in the corporation that own at least 1% or more of the shares, as well as the percentage of all shares in the corporation held
by each shareholder. Individuals holding less than 1% of the shares (minor shareholders) should not be individually listed. Total shareholders must
equal 100%. For all provide position held in business, name, address, social security number, date of birth, and telephone number.
2) Check the appropriate box below to certify that the applicant is or is NOT a United States citizen or permanent resident alien.

Business name _____________________________________ Federal Tax ID number ________________________

Officer or Shareholder Information
Check all that apply: President/CEO
Shareholder

Vice President

Secretary

Treasurer

Director/Manager

Other __________________

Percent (%) of corporation held: _______________________

Certify Citizenship Status:
The applicant IS a United States citizen or permanent resident alien.
The applicant IS NOT a United States citizen or permanent resident alien.

What is this individual’s sex?

Male

Female

In this individual of Hispanic, Latino, or Spanish origin?
What is this individual’s race?

Prefix

Yes

White
American Indian or Alaska Native
Black or African American
Asian American

Last Name

Mailing Address

Native Hawaiian or Other Pacific Islander
Other: ____________________________

First Name

Middle Name

Suffix

Apt/Suite

City

State

County/Parish

Zip Code

Country

Apt/Suite

City

State

County/Parish

Zip Code

Country

Physical Address
Check if same as mailing address

SSN

Date of Birth (mm/dd/yyyy)

Area Code

Select one:

Primary Phone Number

Home

Work

Cell

_________ MINOR SHAREHOLDERS - Check here if one or more of your shareholders each individually hold shares that total less than 1% of the total shares of the
corporation/business/LLC. For example, there might be three shareholders whose total shares added together is 2% of the total shares but each shareholder
individually only holds 0.66% of the shares.
________ TOTAL PERCENTAGE (%) of corporation/business/LLC held by minor shareholder(s) that individually holds less than 1% of the total shares of the
corporation/business/LLC.

ADDITIONAL OFFICER/SHAREHOLDER INFORMATION FOR
CORPORATION/BUSINESS/LLC THAT HOLD THE CATCH SHARES ONLINE ACCOUNT
1) If this Catch Shares online account is held by a business, then complete this section for EACH officer or partner associated with the business.
Provide the information for all officers or partners that are shown on your most recent annual report. If your business is structured as a corporation,
identify all shareholders in the corporation that own at least 1% or more of the shares, as well as the percentage of all shares in the corporation held
by each shareholder. Individuals holding less than 1% of the shares (minor shareholders) should not be individually listed. Total shareholders must
equal 100%. For all provide position held in business, name, address, social security number, date of birth, and telephone number.
2) Check the appropriate box below to certify that the applicant is or is NOT a United States citizen or permanent resident alien.

Additional Officer or Shareholder Information
Check all that apply: President/CEO
Shareholder

Vice President

Secretary

Treasurer

Director/Manager

Other __________________

Percent (%) of corporation held: _______________________

Certify Citizenship Status:
The applicant IS a United States citizen or permanent resident alien.
The applicant IS NOT a United States citizen or permanent resident alien.

What is this individual’s sex?

Male

Female

In this individual of Hispanic, Latino, or Spanish origin?
What is this individual’s race?

White

Yes

American Indian or Alaska Native

Black or African American

Prefix

Asian American

Last Name

Mailing Address

Native Hawaiian or Other Pacific Islander
Other: ____________________________

First Name

Middle Name

Suffix

Apt/Suite

City

State

County/Parish

Zip Code

Country

Apt/Suite

City

State

County/Parish

Zip Code

Country

Physical Address
Check if same as mailing address

SSN

Date of Birth (mm/dd/yyyy)

Area Code

Select one:

Primary Phone Number

Home

Work

Cell

Additional Officer or Shareholder Information
Check all that apply: President/CEO
Shareholder

Vice President

Secretary

Treasurer

Director/Manager

Other __________________

Percent (%) of corporation held: _______________________

Certify Citizenship Status:
The applicant IS a United States citizen or permanent resident alien.
The applicant IS NOT a United States citizen or permanent resident alien.

What is this individual’s sex?

Male

Female

In this individual of Hispanic, Latino, or Spanish origin?
What is this individual’s race?

White

Yes

American Indian or Alaska Native

Black or African American

Prefix

Asian American

Last Name

Mailing Address

Native Hawaiian or Other Pacific Islander
Other: ____________________________

First Name

Middle Name

Suffix

Apt/Suite

City

State

County/Parish

Zip Code

Country

Apt/Suite

City

State

County/Parish

Zip Code

Country

Physical Address
Check if same as mailing address

SSN

Date of Birth (mm/dd/yyyy)

Area Code

Select one:

Primary Phone Number

Home

Work

Cell

Additional Officer or Shareholder Information
Check all that apply: President/CEO
Shareholder

Vice President

Secretary

Treasurer

Director/Manager

Other __________________

Percent (%) of corporation held: _______________________

Certify Citizenship Status:
The applicant IS a United States citizen or permanent resident alien.
The applicant IS NOT a United States citizen or permanent resident alien.

What is this individual’s sex?

Male

Female

In this individual of Hispanic, Latino, or Spanish origin?
What is this individual’s race?

White

Yes

American Indian or Alaska Native

Black or African American

Prefix

Asian American

Last Name

Mailing Address

Native Hawaiian or Other Pacific Islander
Other: ____________________________

First Name

Middle Name

Suffix

Apt/Suite

City

State

County/Parish

Zip Code

Country

Apt/Suite

City

State

County/Parish

Zip Code

Country

Physical Address
Check if same as mailing address

SSN

Date of Birth (mm/dd/yyyy)

Area Code

Select one:

Primary Phone Number

Home

Work

Cell

SMALL BUSINESS OR ORGANIZATION CERTIFICATION
(All applicants must complete this section)



For vessels that are leased, complete this section for the business(es)/organization(s) that lease the vessel.
For vessels that are not leased, complete this section for the business(es)/organization(s) that own the vessel
(i.e., the business(es)/organization(s) that appear on the vessel’s USCG documentation or state registration).

Business name _____________________________________ Federal Tax ID number ________________________
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 ac-count 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 ques-tions in the boxes to the right, OR (2) answered all questions in Box
7.

SMALL BUSINESS OR ORGANIZATION CERTIFICATION
(Continued from previous page)

File Type	application/pdf
Author	janet.l.miller
File Modified	2021-02-05
File Created	2021-02-05