QS Permit/Account Application Form

OMB Control No. 0648-0620, Expires on: 1/31/2026

QS PERMIT/ACCOUNT
APPLICATION FORM
PACIFIC COAST GROUNDFISH
INDIVIDUAL FISHING QUOTA

UNITED STATES DEPARTMENT OF COMMERCE
National Oceanic and Atmospheric Administration
National Marine Fisheries Service, West Coast Region
Fisheries Permits Office
7600 Sand Point Way NE, Bldg. 1
Seattle, WA 98115-0070
Phone (206) 526-4353 Fax (206) 526-4461
www.westcoast.fisheries.noaa.gov

INSTRUCTIONS
This form must be completed and submitted to the National Marine Fisheries Service (NMFS) at the address given
above to apply for a quota share (QS) permit and account. To complete the application process, any Economic
Data Collection surveys due from the QS permit applicant must be deemed complete by the NOAA/Northwest
Fisheries Science Center and the QS permit applicant must submit a complete trawl identification of ownership
interest form. A QS permit is effective upon approval by NMFS.
Section A – QS Permit Applicant Information
The applicant must provide their full name as it will appear on the permit, as well as date of birth (for individuals) or
tax identification number (if a business entity). Please provide the business mailing address, phone number, fax
number and email address. NMFS will mail all pertinent information, including the user ID and password for the QS
account and all renewals information, to the address of record.
Section B – Applicant Eligibility Certification
Applicants must certify their eligibility to own a QS permit, as outlined at 50 CFR 660.140 (d)(2)(i). Please read the
criteria carefully and respond to the question at the bottom of the section by checking the appropriate box.
Section C – Certification of Applicant
The applicant or authorized representative must sign and date the form. By signing and dating the form, the
applicant or authorized representative certifies that all information set forth in the form is true, correct and complete
to the best of the applicant’s knowledge or belief. The form will not be considered without the applicant or authorized
representative’s signature. NMFS may request that the authorized representative for a business entity include a
copy of the corporate resolution or other document authorizing the individual to sign and certify on behalf of the
business entity.
Supplemental Documentation
The applicant must submit a complete trawl identification of ownership interest form.

Quota Share Permit Application Form – Page 1 of 3

OMB Control No. 0648-0620, Expires on: 1/31/2026
UNITED STATES DEPARTMENT OF COMMERCE
National Oceanic and Atmospheric Administration
National Marine Fisheries Service, West Coast Region
Fisheries Permits Office
7600 Sand Point Way NE, Bldg. 1
Seattle, WA 98115-0070

QS PERMIT/ACCOUNT
APPLICATION FORM
PACIFIC COAST GROUNDFISH
INDIVIDUAL FISHING QUOTA

Phone (206) 526-4353 Fax (206) 526-4461
www.westcoast.fisheries.noaa.gov

Section A – QS Permit Applicant Information
2. TIN (if business) or DOB (if person)

1. Legal Name of Quota Share Permit Applicant

3. Business Mailing Address

4. Business Phone Number

Street or PO Box
5. Business Fax Number (optional)

City

State

Zip Code

6. Business Email

Section B – Applicant Eligibility Certification
The applicant must be eligible to own a QS permit. Please review the eligibility requirements as outlined below
[and at 50 CFR 660.140 (d)(2)(i)], and respond to the following question.
Only the following persons are eligible to own QS permits:
(A) A United States citizen, that is eligible to own and control a U.S. fishing vessel with a fishery endorsement
pursuant to 46 U.S.C. 12113 (general fishery endorsement requirements and 75 percent citizenship requirement
for entities);
(B) A permanent resident alien, that is eligible to own and control a U.S. fishing vessel with a fishery
endorsement pursuant to 46 U.S.C. 12113 (general fishery endorsement requirements and 75 percent
citizenship requirement for entities); or
(C) A corporation, partnership, or other entity established under the laws of the United States or any State,
that is eligible to own and control a U.S. fishing vessel with a fishery endorsement pursuant to 46 U.S.C. 12113
(general fishery endorsement requirements and 75 percent citizenship requirement for entities). However, there
is an exception for any entity that owns a mothership that participated in the west coast groundfish fishery during
the allocation period and is eligible to own or control that U.S. fishing vessel with a fishery endorsement pursuant
to sections 203(g) and 213(g) of the AFA.
Is the QS permit applicant eligible to own a QS permit, consistent with one eligibility criteria as given above?

 YES

NO

Quota Share Permit Application Form – Page 2 of 3

Section C – Certification of Applicant

Under penalties of perjury, I hereby declare that I, the undersigned, am authorized to certify this application on behalf of the applicant and
completed this form, and the information contained herein is true, correct, and complete to the best of my knowledge and belief.
Signature of Authorized Representative

Date

Printed Name of Authorized Representative

WARNING STATEMENT: A false statement on this form is punishable by permit sanctions (revocation, suspension, or modification) under 15
CFR Part 904, a civil penalty up to $100,000 under 16 USC 1858, and/or criminal penalties including, but not limited to, fines or imprisonment
or both under 18 USC 1001.
PRIVACY ACT STATEMENT: Some of the information collection described above is confidential under section 402(b) of the Magnuson-Stevens
Act and under NOAA Administrative Order 216-100, Protection of Confidential Fisheries Statistics. TIN or DOB, business phone number, fax
number, and email, and applicant eligibility criteria are not released to the public.
The information collected is part of a Privacy Act System of Records, COMMERCE/NOAA #19, Permits and Registrations for United States
Federally Regulated Fisheries. An amended notice was published in the Federal Register on August 7, 2015 (80 FR 47457) and became
effective on September 15, 2015 (80 FR 55327).
PRA STATEMENT: Public reporting burden for this collection of information is estimated to average 0.50 hours per response, including the time
for reviewing the 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 NOAA/National
Marine Fisheries Service, West Coast Region, Attn: Assistant Regional Administrator, Sustainable Fisheries Division, 7600 Sand Point Way NE,
Seattle, WA 98115. 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.

Quota Share Permit Application Form – Page 3 of 3