Federal Permit Application for Southeast Region Issued O

Southeast Region Permit Family of Forms

8 0205 O2021.2x Operator Card 2021_11_30 ab

OMB: 0648-0205

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Instructions for the Federal Permit Application for Southeast Region
Issued Operator Card
Rev 08/30/2021
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:
South Atlantic Rock Shrimp permits are not valid when underway for fishing in the Atlantic EEZ unless the operator or
a crewmember on board the vessel holds a valid Operator Card.

What Sections do I complete?
All applicants must fill out Section 1, and Section 2. All fields should be typed or printed in inkw

What is the fee?
The application fee is $50 and is non-refundable. A check or money order payable to the U.S. TREASURY must
accompany each application. There is an $18 fee to replace a lost Operator Card.

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

What supporting documentation do I need?
Photograph: Provide two (2) passport style photographs of the applicant. The photographs must be:
In color.
Printed on photo quality paper.
2 x 2 inches (51 x 51 mm) in size.
Sized such that the head is between 1 inch and 1 3/8 inches (between 25 and 35 mm) from the bottom of the
chin to the top of the head.
• Taken within the last 6 months to reflect your current appearance
Payment: Include a signed check or money order for $50 made out to the US Treasury.
•
•
•
•

APPLICATION SECTION 1 –OPERATOR INFORMATION.
• Provide the operator’s full name, 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 an Operator Card.
• Provide an email address, your Operator card will be emailed to you when complete for you to print and
carry.
• Provide the applicant’s place of birth.
• Provide the applicant’s current height, weight, eye color, and hair color.

APPLICATION SECTION 2 – SIGNATURE FOR APPLICATION
The applicant must sign the application in section 2.
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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 Burden Statement - 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 0648-0205. Without this approval, we could not
conduct this survey or information collection. Public reporting for this information collection is estimated to be
approximately 30 minutes per response, including the time for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed, and completing and reviewing the information collection. All responses to
this information collection are required to obtain benefits. Send comments regarding this burden estimate or any other
aspect of this information collection, including suggestions for reducing this burden to the: PRA Officer, National Marine
Fisheries Service, F/SER26, 263 13th Avenue South, St. Petersburg, FL 33701.
Privacy Act Statement - Authority: The collection of this information is authorized under the Magnuson-Stevens Fishery
Conservation and Management Act (16 U.S.C 1801 et seq.), the High Seas Fishing Compliance Act, the Tuna
Conventions Act of 1950, the Antarctic Marine Living Resources Convention Act, the Western and Central Pacific
Fisheries Convention Implementation Act (16 U.S.C. 6901 et seq.), the Marine Mammal Protection Act, the Endangered
Species Act and the Fur Seal Act. The authority for the mandatory collection of the Tax Identification Number (TIN) is 31
U.S.C. 7701.
Purpose: In order to manage U.S. fisheries, the National Marine Fisheries Service (NMFS) requires the use of permits
or registrations by participants in the United States. Information on NMFS permit applicants and renewing holders
includes vessel owner contact information, date of birth, TIN and vessel descriptive information. Permit holder
information may be used as sampling frames for surveys, as part of Fishery Management Council (FMC) analysis to
support FMC decisions.
Routine Uses: The Department will use this information to determine permit eligibility and to identify fishery participants.
Disclosure of this information is permitted under the Privacy Act of 1974 (5 U.S.C. Section 552a), to be shared within
NMFS offices, in order to coordinate monitoring and management of sustainability of fisheries and protected resources,
as well as with the applicable state or regional marine fisheries commissions and international organizations. Disclosure
of this information is also subject to all of the published routine uses as identified in the Privacy Act System of Records
Notice COMMERCE/NOAA-19, Permits and Registrations for the United States Federally Regulated Fisheries.
Disclosure: Furnishing this information is voluntary; however, failure to provide complete and accurate information will
prevent the determination of eligibility for a permit.

2

OMB Control Number 0648-0205; Expiration Date 01/31/2024

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

FEDERAL APPLICATION FOR
SOUTHEAST REGION ISSUED
OPERATOR CARD
FOR OFFICE USE ONLY
Reviewer’s Initials and Date

FOR OFFICE USE ONLY

Check or Money Order Number

Application ID

Expiration Date

SCAN DATE AND INITIALS

SECTION 1 - VESSEL OPERATOR (CARD OWNER) PERSONAL INFORMATION
Are you a United States Citizen or permanent resident alien?
Is this Individual of Hispanic, Latino, or Spanish origin?
What is this
individual’s
race?

YES

NO
What is this
individual’s Sex?

No

Yes

Male

Female

White

American Indian or Alaska
Native

Native Hawaiian or Other Pacific Islander

Black or African American

Asian American

Other _______________

First Name

Last Name

Individual Tax ID Number (SSN)

Middle Name

Date of Birth (MM/DD/YYYY)

Mailing Address

Apt #

Area Code

City

Suffix - Jr, Sr, etc.

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

Email Address - REQUIRED
Birth Place (City, State, Country)

Weight (lbs)

If you are clean shaven or balding,
indicate your actual hair color.

Hair Color

Eye Color

Height (ft & in)

Brown

Green

Brown

Blonde

Blue

Hazel

Black

Red

Grey

Other

Grey

Other

White

SECTION 2 - SIGNATURE - REQUIRED
Applicant Signature

Print Name

Date

1
O2021.2x Form Revision 08/30/2021


File Typeapplication/pdf
AuthorMichael Arn
File Modified2021-11-30
File Created2020-05-11

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