Federal Limited Access General Category Scallop Permit A

U.S. Department of Commerce
NOAA/National Marine Fisheries Service
Northeast Permit Operations
One Blackburn Drive
Gloucester, MA 01930-2298
Tel: (978) 281-9370

Application for
Federal Limited Access
General Category Scallop Permits
DATE, 2008

Please see attachment for application instructions
Section 1 - Owner and Vessel Information
Name of Vessel:

Northeast Federal
Vessel Permit Number:

Owner Name:
Street Address:

USCG Documentation Number or
State Registration Number:

City:
State
Zip Code:

Section 2 - Fishery Information
Gear Codes:

120-Purse
Seine

210-Beach Seine

220-Boat Seine

310-Bottom Trawl

320-Midwater Trawl

330-Other Trawl

410-Dredge

700-Gill/Entanglling
nets

800-Pots & Traps

911-Hand Lines

912-Rod & Reel

913-Tub Trawl

1010-Harpoons

920-Longlines or
Setlines

1200-Other Gears

1400-Diving Gear

Fishery:

Categories [read attached instructions before checking off
categories.]:

General
Category
Scallop

___ Individual Fishing Quota
___ Northern Gulf Of Maine
___ Incidental Catch

Gear Codes: please write in
the gear codes from the list
above that you intend to fish
with.

Section 3 - Owner’s Signature
_____ Issue with Requested
Changes Above
No Longer Own Vessel
Vessel Sold
Vessel Destroyed

I, the undersigned, am the owner or legally authorized agent of the owner of the vessel
named in Section 1 above. I affirm, subject to the penalties provided in 18 USC 1001,
that all information that I have given in obtaining this permit is true and correct.
Signature: _______________________________________________
Print Name:______________________________________________
Date: ___________________________________________________

To avoid delay in processing, please include all information requested.
Any information submitted by any person to obtain a permit is not confidential, and may be disclosed upon
request.

OMB Control No.: 0648-0491
Expiration Date: 08/31/2010

Instructions - Northeast Federal Fisheries

Initial Application for General Category Scallop Limited Access Permit
This is your Initial Vessel Permit Application for Federal General Category Scallop Limited Access
permit that are required by DATE. If you wish to apply for this permit, and you have already
renewed your vessel’s permit(s) for the 2008 permit year, verify and complete all sections, and
return this application to the address on the front of this form.
If you wish to apply for this permit, and your vessel has not been issued a permit for the 2008
permit year, you must:
1. Verify and complete the Federal General Category Scallop Limited Access application
and return it along with a copy of the vessel’s unexpired Coast Guard Documentation or
State Registration.
If your vessel is owned by a corporation, Partnership, or LLC, you must also submit:
2. A list, signed and dated, of the names and addresses of all corporate officers and
shareholders owning twenty-five (25) percent or more of the corporation.
3. Or a current copy of the Partnership Agreement and a list of the names and addresses of all
partners.
_________________________________________________________________________________
SECTION 1: VESSEL/OWNER INFORMATION: Enter information only for items that have changed or
are incorrect
_________________________________________________________________________________
SECTION 2: FISHERY INFORMATION
Category:
You must also submit documentation that the vessel meets the eligibility criteria for the
permit category as outlined in the attached letter. Documentation will be reviewed
against these criteria only for the categories you have selected. BE CERTAIN TO
INDICATE THE LIMITED ACCESS CATEGORY FOR WHICH YOU WISH TO HAVE
THIS VESSEL EVALUATED.
CPH:

A person who does not currently own a fishing vessel, but who has owned a qualifying
vessel that has not been replaced, should apply for a Confirmation of Permit History
(CPH) to document limited access eligibility. CPH applications must be requested by
calling 978-281-9315.

Gear Code:

You must select at least one gear code or multiple gear codes from those listed on the
front of this form.

SECTION 3: OWNER’S SIGNATURE AND INSTRUCTIONS
Please sign the form. Unsigned or incomplete applications will be returned. Your signature is
an affirmation under penalty of perjury, that all the information provided in obtaining this permit is
true [18 USC 1001].
PAPERWORK REDUCTION ACT STATEMENT: Public reporting burden for this collection of information is estimated to average 30 minutes per
Individual Fishing Quota application and 15 minutes per Northern Gulf of Maine and Incidental Catch applications, including the time for reviewing
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 the Assistant Regional
Administrator, Sustainable Fisheries Division, NOAA National Marine Fisheries Service, One Blackburn Drive, Gloucester, MA 01930.
All data will be kept confidential. 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.

OMB Control No.: 0648-0491
Expiration Date: 08/31/2010