Intitial Dealer Permit Application Form 2020

United States Department of Commerce National Oceanic and Atmospheric Administration National Marine Fisheries Service

Greater Atlantic Regional Fisheries Office 55 Great Republic Drive

Gloucester, MA 01930

Phone: (978) 282-8438

Fax: (978) 281-9161

Federal Greater Atlantic Seafood Dealer

Initial Dealer Permit Application

Section 1 – Dealer Information

Email Address _____________________________ Applying as a business? Yes __ No __

Dealer Name ________________________________ Owner Name ____________________________________

Mailing Address _____________________________________________Telephone ___________ Fax _________

Physical Address ____________________________________________ Alt. Telephone ____________________

**Vessel Name (if applicable) _______________ **Vessel Hull Number (if applicable) ____________________

**See enclosed application instructions under “Section 1 – Dealer information” for an explanation.

If regulated species are purchased or received for commercial purposes at more than one place of business, each address must be listed. List those additional addresses on the back of this form in Section 1A.

Section 2 – Species

Select the species for which you wish to be permitted to purchase by placing an (X) on the appropriate line(s).

__ Atlantic Bluefin Tuna	__ Mackerel, Squid, Butterfish	__ Atlantic Herring At Sea Dealer
__ Other Atlantic Tunas*	__ Mackerel At Sea Processor	__ Spiny Dogfish
__ Surfclam/Ocean Quahog – Dealer	__ Scup	__ Tilefish
__ Surfclam/Ocean Quahog– Processor	__ Black Sea Bass	__ Atlantic Deep Sea Red Crab
__ Summer Flounder	__ Monkfish	__ Skate
__ Atlantic Sea Scallop	__ Atlantic Bluefish	__ Atlantic Hagfish
__ Northeast Multispecies	__ Atlantic Herring Dealer	__ Jonah Crab
__ American Lobster	__ Atlantic Herring Processor

*Yellowfin, Bigeye, Skipjack, Albacore

Section 3 – Owner Name and Signature

I affirm, subject to the penalties provided in 18 USC 1001, that all information I have given in obtaining this permit is true and correct.

Print Name ____________________ Signature ________________________ Date _______________________

See the APPLICATION CHECKLIST on the back of this form to ensure that your application is complete. Incomplete applications will not be processed.

Revised December 5, 2019 OMB# 0648-0202 Expiration Date October 31, 2022

SECTION 1A - ADDITIONAL DEALER INFORMATION.

If regulated species are purchased or received for commercial purposes at more than one place of business, each address must be listed below. If you have more than two additional addresses, write the additional addresses on a plain sheet of paper and attach it to this application.

Company Address

Street:

City: State: Zip:

Telephone:

Company Address

Street:

City: State: Zip:

Telephone:

APPLICATION CHECKLIST

*Application signed and dated.

*Owner Form completed (Both Section A and Section B), signed and dated.

* If applying as a business, included a copy of one of the following:

Certificate of Incorporation; or,

Articles of Organization; or,

Annual Report

Owner name, business officers and members, address, phone number, fax number, and permit information may be released via a NOAA Fisheries website. All other data submitted will be handled as confidential material in accordance with NOAA Administrative Order 216-100, Protection of Confidential Fishery Statistics.

The Paperwork Reduction Act requires potential respondents for a dealer/processor permit be notified of certain information regarding their rights and the burden associated with applying for a Federal dealer/processor permit. One of the regulatory steps taken by the National Marine Fisheries Service (NMFS) to carry out conservation and management objectives is the requirement of a permit for users of the resources. All the fisheries included on this application require a permit to purchase, or otherwise receive for transport for a commercial purpose, other than solely for transport on land, species harvested by the owner or operator of a fishing vessel issued a Federal fisheries permit for these species. Section 303(b)(1) of the Magnuson-Stevens Fishery Conservation and Management Act (MSFCMA) specifically recognizes the need for permit issuance.

The purpose and use of permits is to: (1) register fish dealers and processor, (2) list the characteristics of dealer/processor operations, (3) exercise influence over compliance (e.g. withhold issuance pending collection of unpaid penalties and / or required reports), (4) provide a mailing list for the dissemination of important information to the industry, (5) provide a universe for data collection samples, and (6) obtain first purchase information on landings to evaluate the biological, economic and social implications of management measures.

Notwithstanding any other provision of the law, no person is required to respond to, nor shall any person be subject 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. Public reporting burden for this collection of information is estimated to average 15 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining data needed, and completing and reviewing the information. Send comments regarding this burden estimate or suggestions for reducing this burden to: National Marine Fisheries Service, Permit Office, 55 Great Republic Drive, Gloucester, MA 01930-2276.

OMB# 0648-0202 Expiration Date October 31, 2022