International Dolphin Conservation Program vessel permit

OMB Control No. 0648-0387
Expires: XX/XX/20XX

VESSEL PERMIT APPLICATION
$25.00 Fee

Species Sought: Yellowfin and Other Tuna and Tuna-like Species
The collection of information is mandated by the Marine Mammal Protection Act (16 U.S.C. 1371) and by implementing regulations contained at 50 CFR §216.24(b)(1). The
information supplied on this form will be used by the National Marine Fisheries Service to authorize the incidental take and to alert vessel owners of applicable rules and
regulations regarding the permit for the taking of marine mammals incidental to commercial purse seine fishing for yellowfin tuna in the eastern tropical Pacific Ocean. The
name of the vessel and owner, official number, tonnage, carrying capacity and business address supplied on this form may be released under the Freedom of Information Act.
All other information supplied on this form are considered proprietary and therefore subject to data confidentiality restriction of National Oceanic and Atmospheric
Administration Administrative Order 216-100.

1. VESSEL INFORMATION

a. NAME OF VESSEL:

b. OFFICIAL NUMBER:

d. CARRYING CAPACITY:

c. TONNAGE:

e. MAXIMUM VESSEL SPEED:

(short or metric tons)

(knots)

f. FEDERAL, STATE, AND COMMERCIAL FISHING LICENSES:
(include type, identification numbers, and expiration dates)

g. TYPES OF PROCESSING EQUIPMENT:

2. OWNER INFORMATION
I hereby certify that the above-named vessel, bearing the official number indicated, is owned as follows. (State the nature of ownership, e.g.,
corporation, partnership, joint venture, etc., after the owner's name.):

OWNER'S NAME:
BUSINESS ADDRESS:
TELEPHONE:
FAX:
EMAIL:

3. VESSEL PERMIT HOLDER INFORMATION
THE VESSEL PERMIT WILL BE ISSUED TO THE OWNER IDENTIFIED IN BLOCK 2. PROVIDE THE FOLLOWING INFORMATION IF THE PERMIT IS
TO BE ISSUED TO THE MANAGING OWNER INSTEAD OF THE OWNER:
MANAGING OWNER'S NAME
BUSINESS ADDRESS:
TELEPHONE:
FAX:
EMAIL:

4. OPERATOR INFORMATION
NAME OF PERMITTED OPERATOR:

5. MARINE MAMMAL SAFETY INFORMATION
Does the above-named vessel intend to make intentional purse seine sets on marine mammals to capture tuna?

YES

NO

Dolphin Safety Panel

YES

NO

Dolphin Safety Panel Markers

YES

NO

Dolphin Safety Panel Hand Holds are securely fastened

YES

NO

Dolphin Safety Panel Corkline Hangings are securely fastened

YES

NO

An operational Dolphin Safety Light capable of producing 140,000 lumens

YES

NO

Minimum of 3 speedboats equipped with towing bridles or towing posts

YES

NO

At least two Operational Facemasks, Snorkels, or Viewboxes

YES

NO

Operational Raft

YES

NO

IF YES, IS THE VESSEL EQUIPPED WITH THE FOLLOWING DOLPHIN SAFETY GEAR?

6. VESSEL CONTACT PERSON
THE FOLLOWING PERSON HAS THE AUTHORITY TO DEAL WITH NMFS ON BEHALF OF THE VESSEL:
a. NAME:

b. RELATIONSHIP TO VESSEL OWNER
OR MANAGING OWNER (specify):

BUSINESS ADDRESS:
TELEPHONE:
FAX:
EMAIL:

7. PERSON COMPLETING THIS APPLICATION
a. NAME:

b. RELATIONSHIP TO VESSEL OWNER OR
MANAGING OWNER:

I agree to release to the National Marine Fisheries Service (NMFS) all records made by Inter-American Tropical Tuna Commission observers during fishing
trips aboard the vessel under this permit and furnish the international observer program with all release forms required to authorize the observer data to be
provided to NMFS. Under penalty of perjury, I declare that the information in this application is true and complete.

_____________________________________
SIGNATURE OF THE PERSON COMPLETING THIS APPLICATION

DATE

Public reporting burden for this collection of information is estimated to average 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 collection of information. Send comments regarding this burden estimate or any other
aspect of this collection of information, including suggestions for reducing this burden, to Permits Office, West Coast Region, National Marine Fisheries Service, 501 West
Ocean Boulevard, Suite 4200, Long Beach, California, 90802-4213, (562) 980-4238.
The collection of this information is authorized under the Marine Mammal Protection Act. In order to manage U.S. fisheries, the NOAA National Marine Fisheries Service
(NMFS) requires the use of permits or registrations by participants in the United States. Information on NOAA Fisheries permit applicants and renewing holders includes
vessel owner contact information, date of birth, 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. 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. Furnishing this information is voluntary; however, failure to provide
complete and accurate information will prevent the determination of eligibility for a permit.
The National Marine Fisheries Service may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a current and valid
OMB Control number.