Voluntary Community Impact Report or IPQ Holder Report ( N or S Response Report) - Instruction

Revised: 05/21/2014

OMB Control No. 0648-0514

Voluntary
Community Impact Report or
IPQ Holder Report
(N or S Response Report)

Expiration Date:

U.S. Dept. of Commerce/NOAA
National Marine Fisheries Service
Restricted Access Management
P.O. Box 21668
Juneau, AK 99802-1668
(800) 304-4846 toll free /
(907) 586-7202 in Juneau
(907) 586-7354 fax

In response to the North or South Region Delivery Exemption Report, community entities and
IPQ holders may submit a Community Impact Report or IPQ Holder Report to NMFS. This
report, by either title, is voluntary and may take any format. The report is basically a response to
the North or South Region Delivery Exemption Report and would provide NMFS with a
contrasting viewpoint. In addition, these reports provide documentation needed by NMFS to
evaluate efficacy of privately administered contracts.
There is no form for this report. The report may be submitted by mail, by fax, or by courier.
By mail to

NMFS Alaska Region
Regional Administrator
c/o Restricted Access Management Program
P.O. Box 21668
Juneau, AK 99802-1668

By fax to

(907) 586-7354

By courier to

NMFS
Room 713
709 West 9th Street
Juneau, AK 99801

Paperwork Reduction Act 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
0648-0514. Without this approval, we could not conduct this information collection. Public reporting for
this information collection is estimated to be approximately 2 hours 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 Assistant Regional
Administrator, Sustainable Fisheries Division, NMFS Alaska Region, P.O. Box 21668, Juneau, AK
99802-1668.