Change of MS/CV Endorsement and Catch History Assisgnmen

OMB Control No. 0648-0620; Expires 01/31/2026

CHANGE OF MS/CV ENDORSEMENT
AND CATCH HISTORY ASSIGNMENT
REGISTRATION 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 change of mothership catcher vessel (MS/CV) endorsement and associated catch
history assignment (CHA) registration. A separate form must be completed for each distinct MS/CV endorsement
and assignment CHA registration change. To complete the application process, any Economic Data Collection
surveys due from the MS/CV-endorsed trawl limited entry permit owner must be deemed complete by the
NOAA/Northwest Fisheries Science Center. Please submit your current MS/CV-endorsed trawl limited entry
permit with the completed application form.
Section A - Current Permit Information
Identify the current trawl limited entry permit and permit owner to which the MS/CV endorsement and CHA are
registered to. List the MS/CV-endorsed permit number and the MS/CV endorsement and CHA ID number, found
on the permit. List the permit owner name as given on the current permit, as well as the tax identification number
(TIN) for business entities or date of birth (DOB) for individuals. Please provide the business mailing address,
phone number, fax number and email address.
Section B - New Permit Information
Identify the new trawl limited entry permit number to which the MS-CV endorsement and CHA will be transferred.
List the permit owner name as given on their current permit, as well as the tax identification number (TIN) for
business entities or date of birth (DOB) for individuals. Please provide the business mailing address, phone
number, fax number and email address.
Section C - Transaction Price Information for MS/CV Endorsement and Catch History Assignment
You must provide price information for the transaction, as specified at §660.140 (g)(2)(iv)(B). Please indicate
whether the transaction was monetary or non-monetary. If this is a monetary transaction, please provide the price.
If this is a non-monetary transaction, please provide further information describing the change in registration of
the MS/CV endorsement and associated CHA.
Section D - Certification of Applicant
The permit owner 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
• Submit your current MS/CV-endorsed limited entry trawl permit with this form.

OMB Control No. 0648-0620; Expires 01/31/2026

CHANGE OF MS/CV ENDORSEMENT
AND CATCH HISTORY ASSIGNMENT
REGISTRATION 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 - Current Permit Information
(Identify the current trawl limited entry permit and permit owner to which
the MS/CV endorsement and catch history assignment are registered to)
1. Permit Number

2. MS/CV Endorsement and CHA ID Number

GF
3. Current Permit Owner Name

4. TIN (if business) or DOB (if person)

5. Business Mailing Address

6. Business Phone

(

Street or PO Box

)

7. Business Fax (optional)

(
City

State

Zip Code

)

8. Business Email (optional)

Section B - New Permit Information
(Identify the new trawl limited entry permit and permit owner to which
the MS/CV endorsement and catch history assignment will be registered to)
1. Permit Number

GF
2. Current Permit Owner Name

3. TIN (if business) or DOB (if person)

4. Business Mailing Address

5. Business Phone

(

Street or PO Box

)

6. Business Fax (optional)

(
City

State

Zip Code

)

7. Business Email (optional)

Section C – Transaction Price Information for MS/CV Endorsement and Catch History Assignment
(Mandatory field)
1. The nature of the transaction was:

□ Monetary

□ Non-Monetary

2. If the transaction was monetary, please provide the selling price of the above listed MS/CV endorsement and
catch history assignment:
$___________________________
3. If the transaction was non-monetary, please describe the nature of the transaction [i.e. registering the
endorsement and catch history assignment to another trawl limited entry permit that I own, or trading it for
shoreside IFQ quota shares or quota pounds (list species and amount), etc.]:

Section D – 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 MagnusonStevens Act and under NOAA Administrative Order 216-100, Protection of Confidential Fisheries Statistics. TIN, DOB, business phone
number, fax number, email and transaction price information 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 0.75 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.