Subsistence Halibut Special Permits Application

07/16/2004

OMB Control No.: 0648–0512
Expiration Date: 02/09/2008

Subsistence Halibut
Special Permits
Application

U.S. Dept of Commerce/NOAA
National Marine Fisheries Service
Restricted Access Management
P.O. Box 21668
Juneau, Alaska 99802-1668
Telephone: 1-800-304-4846
FAX: 907-586-7354

Block A - Type of Subsistence Halibut Special Permit Requested
Please indicate the type of permit for which you are applying (please mark only one):
[ ] Community Harvest Permit

[ ] Ceremonial Permit

Are you applying for a new permit or a renewal of an existing permit?

[ ] Educational Permit

[ ] New

[ ] Renewal

If a Renewal, enter permit number
Block B - Subsistence Halibut Community Harvest Permit
1. Name of Alaska Native tribe or community

2. Community Halibut Permit Coordinator
Name (First, Middle, Last)
Mailing Address (Number, Street, City, State, Zip Code)

Daytime Telephone Number

Block C - Subsistence Halibut Ceremonial Permit
1. Name of Alaska Native tribe or community

2. Ceremonial Halibut Permit Coordinator
Name (First, Middle, Last)
Mailing Address (Number, Street, City, State, Zip Code)

3. Describe occasion of cultural or ceremonial significance

Daytime Telephone Number

07/16/2004

OMB Control No.: 0648–0512
Expiration Date: 02/09/2008

Block D - Subsistence Halibut Education Permit
1. Name of Alaska Native Tribe

2. Educational Halibut Permit Instructor
Name (First, Middle, Last)

Daytime Telephone Number

Mailing Address (Number, Street, City, State, Zip Code)

3. Educational Institution or Organization
Mailing Address (Number, Street, City, State, Zip Code)

Daytime Telephone Number

4. Course Description (add extra sheet if necessary)

5. Demonstrate enrollment of qualified students

6. Describe minimum attendance requirements

7. Describe standards for the successful completion of the educational program

8. Describe standards for successful completion of the course

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 implement the Alaska Subsistence Halibut Program; 3) Federal law and
regulations require and authorize NMFS to manage subsistence halibut programs in Alaska; 4) Submission of this
information is mandatory for any tribe participating in subsistence fishing for Pacific halibut under the Ceremonial or
Educational Permit Programs; 5) This information is used to monitor the subsistence halibut program under the Northern
Pacific Halibut Act of 1982; 6) Responses to this information request are not confidential.

07/16/2004

OMB Control No.: 0648–0512
Expiration Date: 02/29/2008

INSTRUCTIONS
Subsistence Halibut
Special Permits Application

The Halibut Subsistence Fishery 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.
Alaska Native Tribe means, for purposes of the subsistence fishery for Pacific halibut in waters in and
off Alaska, a federally recognized Alaska Native tribe that has customary and traditional use of halibut.
Block A - Type of Subsistence Halibut Special Permit Requested
Please indicate the type of permit for which you are applying (please mark only one): Community
Harvest Permit,
Ceremonial Permit, or
Educational Permit.
Indicate whether you are applying for a new permit or a renewal of an existing permit.
If a Renewal, enter permit number
Block B - Subsistence Halibut Community Harvest Permit
1. Name of Alaska Native tribe or community
2. Community Halibut Permit Coordinator
Name (First, Middle, Last)
Mailing Address (Number, Street, City, State, Zip Code)
Daytime Telephone Number
Block C - Subsistence Halibut Ceremonial Permit
1. Name of Alaska Native tribe or community
2. Ceremonial Halibut Permit Coordinator

Name (First, Middle, Last)
Mailing Address (Number, Street, City, State, Zip Code)
Daytime Telephone Number
3. Describe occasion of cultural or ceremonial significance
Block D - Subsistence Halibut Education Permit
1. Name of Alaska Native Tribe
2. Educational Halibut Permit Instructor
Name (First, Middle, Last)
Daytime Telephone Number
Mailing Address (Number, Street, City, State, Zip Code)
3. Educational Institution or Organization
Mailing Address (Number, Street, City, State, Zip Code)
Daytime Telephone Number
4. Course Description (add extra sheet if necessary)
5. Demonstrate enrollment of qualified students
6. Describe minimum attendance requirements
7. Describe standards for the successful completion of the educational program
8. Describe standards for successful completion of the course

Mail application to:
Restricted Access Management
NMFS, Alaska Region
P.O. Box 21668
Juneau, AK 99802-1668
If you have questions, call: 1-800-304-4846 or FAX: 907-586-7354.