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pdfRev.: 08/25/2006
OMB Control No.: 0648-0460; Expiration Date: 12/31/2006
Subsistence Halibut
Registration Certificate Application
U.S. Dept of Commerce/NOAA
National Marine Fisheries Service
Restricted Access Management
P.O. Box 21668
Juneau, Alaska 99802-1668
Block A - Type of Subsistence Halibut Registration
Please indicate the type of registration under which you are applying (please mark only one):
[ ] Rural Resident Registration
[ ] Alaska Native Tribal Registration
If you are applying as a resident of an Alaska rural community as defined in 50 CFR 300.65(f)(1) (see
instructions), please complete Block B. Those applying as a member of an Alaska Native Tribe as
defined in 50 CFR 300.65(f)(2) (see instructions), please complete Block C.
Are you applying for a new SHARC or a renewal of an existing SHARC?
[ ] New
[ ] Renewal If a Renewal, enter SHARC number
Block B - Alaska Rural Resident Registration
1. Name of Fisherman: (First, Middle, Last)
2. a. Community of Residence
3. Mailing Address: (Number, Street, City, State, Zip)
b. Dates of residence in this community:
___/___/_____ to ___/___/______
4. Date of Birth
5. Social Security Number* (voluntary)
6. Daytime Telephone Number
7. I certify that I am a Rural Resident as defined at 50 CFR 300.65(f)(1).
Signature of Applicant
Date
*Privacy Act Statement: The Northern Pacific Halibut Act of 1982 and Federal regulations at 50 CFR parts 300.60 through
300.66 authorize collection of this information. Your Social Security Number (SSN) is confidential and is protected under the
Privacy Act. Disclosure of your SSN is voluntary. The primary purpose for requiring the SSN is to verify the identity of
individuals/entities doing business with the government as required by the Debt Collection Improvement Act of 1996 (Public
Law 104-134).
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Block C - Alaska Native Tribal Registration
1. Name of Fisherman: (First, Middle, Last)
2. Name of Alaska Native Tribe
3. Community of Residence
4. Mailing Address: (Street, City, State, Zip Code)
5. Date of Birth:
6. Social Security Number* (voluntary)
7. Daytime Telephone Number
8. I certify that I am a member of an Alaska Native Tribe as defined at 50 CFR 300.65(f)(2).
Signature of Applicant
Date:
*Privacy Act Statement: The Northern Pacific Halibut Act of 1982 and Federal regulations at 50 CFR parts 300.60 through
300.66 authorize collection of this information. Your Social Security Number (SSN) is confidential and is protected under the
Privacy Act. Disclosure of your SSN is voluntary. The primary purpose for requiring the SSN is to verify the identity of
individuals/entities doing business with the government as required by the Debt Collection Improvement Act of 1996 (Public
Law 104-134).
PUBLIC REPORTING BURDEN STATEMENT
Public reporting burden for this collection of information is estimated to average 10 minutes 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 aspect
of this collection of information, including suggestions for reducing the burden, to Sue Salveson, Assistant Regional
Administrator, Sustainable Fisheries Division, Alaska Region, NMFS, P.O. Box 21668, Juneau, AK 99802-1668.
ADDITIONAL INFORMATION
Before completing this form please note the following: 1) The NMFS may not conduct or sponsor this information request,
and you are not required to respond to this information request, unless the form displays a currently valid OMB control
number; 2) This information is being used to monitor the Alaska Subsistence Halibut Program; 3) Federal regulations at
50 CFR part 300.60 through 300.66 require and authorize NMFS to manage the Subsistence Halibut Program in Alaska;
4) Submission of this information is required of all persons seeking to participate in directed fishing for Pacific halibut
under the Subsistence Halibut Program; 5) Except for the social security number (SSN), which is voluntary, this
information is mandatory and is required to monitor the Subsistence Halibut Program under the Northern Pacific Halibut
Act of 1982; 6) The birthdate and SSN are confidential and are protected under the Privacy Act; and 7) Disclosure of your
SSN is voluntary. The primary purpose for requiring the SSN is to verify the identity of individuals/entities doing business
with the government as required by the Debt Collection Improvement Act of 1996 (Public Law 104-134).
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Rev.: 04/05/2005
OMB Control No.: 0648–0460; Expiration Date: 12/31/2006
Instructions for Completing the
SHARC Application
PROGRAM INFORMATION
The subsistence fishery for Pacific halibut in waters in and off Alaska is authorized by Federal
regulations at 50 CFR Part 300 and provides for eligible persons to conduct subsistence halibut fishing in
Convention waters off Alaska.
Subsistence halibut means halibut caught by a rural resident or a member of an Alaska Native
tribe for direct personal or family consumption as food, sharing for personal or family consumption as
food, or for customary trade.
Eligible persons are:
(1) Rural Residents, or residents of rural places, means a person domiciled in a rural community,
as listed in 50 CFR part 300.65(f)(1) (reprinted as Attachment 1 to this form), who has maintained a
domicile in a rural community for 12 consecutive months immediately preceding the time when the
assertion of residence is made and who is not claiming residency in another state, territory, or country.
(2) Alaska Native tribes, or all identified members of Federally recognized Alaska Native tribes,
means federally recognized Alaska Native tribes that have customary and traditional use of halibut and
that are listed in 50 CFR 300.65(f)(2) (reprinted as Attachment 2 to this form).
COMPLETING THE APPLICATION
Block A – Type of Subsistence Halibut Registration
Check whether you, as an eligible person, are registering for subsistence halibut as an Alaska Rural
Resident or as a member of a federally recognized Alaska Native tribe.
If applying as an Alaska Rural Resident, please complete Block B.
If applying as a member of a federally recognized Alaska Native tribe, complete Block C.
Please indicate whether you are applying for a new SHARC or a renewal of an existing SHARC. If a
renewal, list your current SHARC number in the space provided.
Block B – Alaska Rural Resident Registration
1.
2.
3.
4.
5.
Enter your full name (First, Middle, Last). Please include any suffixes such as Jr., Sr., etc.
Enter your Community of Residence (city and state). This Community must be one of the rural
communities listed in 50 CFR 300.65(f)(1) (see Attachment 1).
Enter your permanent mailing address, including P.O. Box, street, state, and zip code. The SHARC
will be sent to this address.
Enter your date of birth (Month/Day/Year).
Enter your Social Security Number (SSN)* Disclosure is voluntary; in the event it is not provided,
NMFS will assign a unique code that will identify the records.
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*Privacy Act Statement: The Northern Pacific Halibut Act of 1982 and Federal regulations at 50 CFR parts
300.60 through 300.66 authorize collection of this information. Your Social Security Number (SSN) is confidential
and is protected under the Privacy Act. Disclosure of your SSN is voluntary. The primary purpose for requiring the
SSN is to verify the identity of individuals/entities doing business with the government as required by the Debt
Collection Improvement Act of 1996 (Public Law 104-134).
6.
7.
8.
Enter a daytime telephone number, including area code.
Enter your date of birth (Month/Day/Year).
Sign and date the application. You must sign and date the application certifying all information
contained in the application is true, correct, and complete to the best of your knowledge and belief.
The application will be considered incomplete without your signature and will not be processed.
Mail the completed application to:
NMFS, Alaska Region
Restricted Access Management (RAM)
P.O. Box 21668
Juneau, Alaska 99802-1668
Or deliver the completed application to:
Federal Building
709 W. 9th Street, Suite 713
Juneau, Alaska 99801
If you have questions when completing the application, please:
♦
call RAM at (800) 304-4846 (select option 2) or (907) 586-7202 (select option 2),
♦
check our web site at www.fakr.noaa.gov/ram, or
♦
e-mail your questions to RAM.Alaska@noaa.gov.
SPECIAL HANDLING OF CERTIFICATES
Please allow at least 10 days for processing your SHARC. You may FAX your application to us at (907)
586-7354, to expedite processing, or use the alternative methods mentioned below.
If you would like to have your SHARC sent by a method other than regular mail, please attach a note
indicating a method, and follow the appropriate procedure below.
Express Mail. If you would like to have your SHARC sent to you by U.S. Postal Express Mail,
send us an express mail envelope with the correct amount of postage prepaid or send express mail
stamps UNATTACHED to an envelope. NOTE: If the express mail envelope you send is too small
or the postage attached is less than the amount required, your SHARC will be sent to you by regular
U.S. mail.
Other Express Carriers. If you would like to have your SHARC sent to you by a private express
carrier, e.g., Federal Express, UPS, DHL, etc., submit your account number and name of carrier or a
prepaid envelope with the permit application.
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Attachment 1: 50 CFR 300.65(f)(1) Rural Resident
A person is eligible to harvest subsistence halibut if he or she is a rural resident of a community with customary
and traditional uses of halibut listed in the following table and has a valid SHARC issued by NMFS:
SUBSISTENCE HALIBUT RURAL RESIDENT
Halibut Regulatory Area 3A
Halibut Regulatory Area 2C
Rural Community
Organized Entity
Rural Community
Organized Entity
Angoon
Municipality
Akhiok
Municipality
Coffman Cove
Municipality
Chenega Bay
Census Designated Place
Craig
Municipality
Cordova
Municipality
Edna Bay
Census Designated Place
Karluk
Census Designated Place
Elfin Cove
Census Designated Place
Kodiak City
Municipality
Gustavus
Census Designated Place
Larsen Bay
Municipality
Haines
Municipality
Nanwalek
Census Designated Place
Hollis
Census Designated Place
Old Harbor
Municipality
Hoonah
Municipality
Ouzinkie
Municipality
Hydaburg
Municipality
Port Graham
Census Designated Place
Hyder
Census Designated Place
Port Lions
Municipality
Kake
Municipality
Seldovia
Municipality
Kasaan
Municipality
Tatitlek
Census Designated Place
Klawock
Municipality
Yakutat
Municipality
Klukwan
Census Designated Place
Metlakatla
Census Designated Place
Meyers Chuck
Census Designated Place
Pelican
Municipality
Chignik Bay
Municipality
Petersburg
Municipality
Chignik Lagoon
Census Designated Place
Point Baker
Census Designated Place
Chignik Lake
Census Designated Place
Port Alexander
Municipality
Cold Bay
Municipality
Port Protection
Census Designated Place
False Pass
Municipality
Saxman
Municipality
Ivanof Bay
Census Designated Place
Sitka
Municipality
King Cove
Municipality
Skagway
Municipality
Nelson Lagoon
Census Designated Place
Tenakee Springs
Municipality
Perryville
Census Designated Place
Thorne Bay
Municipality
Sand Point
Municipality
Whale Pass
Census Designated Place
Wrangell
Municipality
Halibut Regulatory Area 3B
Rural Community
Organized Entity
Halibut Regulatory Area 4A
Rural Community
Organized Entity
Akutan
Municipality
Nikolski
Census Designated Place
Unalaska
Municipality
Halibut Regulatory Area 4B
Rural Community
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Organized Entity
Adak
Census Designated Place
Atka
Municipality
Halibut Regulatory Area 4C
Rural Community
Organized Entity
Levelock
Census Designated Place
Manokotak
Municipality
St. George
Municipality
Mekoryak
Municipality
St. Paul
Municipality
Naknek
Census Designated Place
Napakiak
Municipality
Napaskiak
Municipality
Newtok
Census Designated Place
Nightmute
Municipality
Nome
Municipality
Oscarville
Census Designated Place
Pilot Point
Municipality
Platinum
Municipality
Port Heiden
Municipality
Quinhagak
Municipality
Scammon Bay
Municipality
Shaktoolik
Municipality
Halibut Regulatory Area 4D
Rural Community
Organized Entity
Gambell
Municipality
Savoonga
Municipality
Diomede (Inalik)
Municipality
Halibut Regulatory Area 4E
Rural Community
Organized Entity
Alakanuk
Municipality
Aleknegik
Municipality
Bethel
Municipality
Brevig Mission
Municipality
Chefornak
Municipality
Chevak
Municipality
Sheldon Point
(Nunam Iqua)
Municipality
Clark’s Point
Municipality
Shishmaref
Municipality
Council
Census Designated Place
Solomon
Census Designated Place
Dillingham
Municipality
South Naknek
Census Designated Place
Eek
Municipality
St. Michael
Municipality
Egegik
Municipality
Stebbins
Municipality
Elim
Municipality
Teller
Municipality
Emmonak
Municipality
Togiak
Municipality
Golovin
Municipality
Toksook Bay
Municipality
Good News Bay
Municipality
Tuntutuliak
Census Designated Place
Hooper Bay
Municipality
Tununak
Census Designated Place
King Salmon
Census Designated Place
Twin Hills
Census Designated Place
Kipnuk
Census Designated Place
Ugashik
Census Designated Place
Kongiganak
Census Designated Place
Unalakleet
Municipality
Kotlik
Municipality
Wales
Municipality
Koyuk
Municipality
White Mountain
Municipality
Kwigillingok
Census Designated Place
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File Type | application/pdf |
File Title | C:\PRA\OMB83I pre-ps.WP6.wpd |
Author | rroberts |
File Modified | 2006-09-25 |
File Created | 2006-09-25 |