Catcher/Processor Cooperative Permit Application Form

OMB Control No. 0648-0620; Expires 1/31/2026

CATCHER/PROCESSOR
COOPERATIVE PERMIT
APPLICATION FORM

PACIFIC COAST GROUNDFISH
TRAWL RATIONALIZATION PROGRAM

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 catcher/processor (C/P) cooperative permit. To be an eligible CP cooperative (coop)
entity, a group of C/P-endorsed limited entry permit owners (coop members) must be a recognized entity under
the laws of the United States or the laws of a State and represent all of the coop members. This application must
be postmarked no later than March 17 of the year in which the coop intends to fish. A C/P cooperative permit is
effective upon approval by NMFS.
Section A – Cooperative Contact Information
Please provide the cooperative entity name, tax identification number (TIN), and state that the entity is registered
in, as well as the business mailing address, phone number, fax number, and email address. Also provide the
name of the cooperative manager and their date of birth (DOB).
Section B – Catcher/Processor Endorsed Permits and Vessels
The applicant must provide the permit number for each coop member’s C/P-endorsed limited entry permit, and
the vessel name and USCG vessel documentation number for the vessel registered to each permit.
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 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 provide a copy of the cooperative agreement consistent with the regulations given at
50 CFR 660.160.

Catcher/Processor Cooperative Permit Application Form – Page 1 of 4

OMB Control No. 0648-0620; Expires 1/31/2026

CATCHER/PROCESSOR
COOPERATIVE PERMIT
APPLICATION FORM

PACIFIC COAST GROUNDFISH
TRAWL RATIONALIZATION PROGRAM

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

Section A – Cooperative Contact Information
1. Name of Cooperative Entity

2. Cooperative TIN

3. State Cooperative Entity Registered In

5. Business Phone Number

4. Business Mailing Address

(

Street or PO Box

)

6. Business Fax Number (optional)

(
City

State

8. Name of Cooperative Manager

Zip Code

)

7. Business Email (optional)

9. Cooperative Manager DOB

Catcher/Processor Cooperative Permit Application Form – Page 2 of 4

Section B – Catcher/Processor Endorsed Permits and Vessels
C/P-Endorsed Limited Entry
Permit Number

Vessel Name

USCG Vessel Documentation
Number

GF
GF
GF
GF
GF
GF
GF
GF
GF
GF

Catcher/Processor Cooperative Permit Application Form – Page 3 of 4

Section C – Certification of Applicant and Notary
This section must be completed by a notary to certify that the individual(s) have satisfactorily identified themselves.

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 MagnusonStevens Act and under NOAA Administrative Order 216-100, Protection of Confidential Fisheries Statistics. TIN, DOB, business phone
number, fax number, email and contents of the cooperative agreement 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 2.00 hours per response (with coop
agreement), 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.

Catcher/Processor Cooperative Permit Application Form – Page 4 of 4