Reef Fish VMS certification and checklist

OMB No. 0648-0544

Approval Expires 10/31/12

Vessel Monitoring System (VMS) Installation and Activation Certification

For the Reef Fish Fishery of the Gulf of Mexico

PLEASE COMPLETE THIS FORM BY
PROVIDING ALL REQUESTED INFORMATION

Fishing Vessel (F/V) Name:

Vessel state registration number or U.S. Coast Guard documentation number:

Installing marine electrician or dealer (name, address, and telephone number):

Date of Installation (mm/dd/yyyy):

VMS Mobile Transceiver Unit (MTU)

Manufacturer name:

Model:

Manufacturer Serial Number (S/N):

Communication network serial number (ISN):

VMS Mobile Communications Service Provider (MCSP)

Communications provider name:
Communications ID number assigned by service provider:

Did the manufacturer/vendor provide VMS MTU operating instructions? Yes  No 

Did the manufacturer/vendor provide training on the use of the VMS MTU? Yes  No 

Once the VMS MTU was installed, did the electrician/dealer, or the owner and/or operator of the vessel verify with NOAA OLE VMS Program personnel that position data was being received? Yes  No 

In accordance with 50 C.F.R. §622.9(a)(2), as the owner or operator of a vessel participating in the Gulf of Mexico Reef Fish fishery, I hereby certify that the VMS unit on my vessel has been installed and the communication services activated, and receipt of position data has been verify by NOAA OLE VMS Program personnel, in compliance with the applicable procedures of this installation and activation form.

Vessel owner name:

Vessel owner signature: Date:

Vessel operator name:
Vessel operator signature: Date:

Submit this certification, when completed, to the NOAA/NMFS, Office of Law Enforcement, Southeast Division VMS Program, 263 13th Avenue South, Suite 109, St. Petersburg, FL 33701.

Under the provisions of the Paperwork Reduction Act of 1995 (PL 104-13) and the Privacy Act of 1974 (PL 93-579), you are advised that disclosure of the requested information is mandatory for the purposes of managing the Gulf of Mexico Reef Fish fishery. The requested information is used to ensure proper operation of the VMS unit. Confidentiality of the information provided will be treated in accordance with NOAA Administrative Order 216-100. The public reporting burden for this collection of information is estimated to be 15 minutes for completion and submission of the statement certifying compliance with the installation and activation checklist. The estimates of public reporting burden for this collections of information includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Written comments regarding the burden-hour estimate or other aspects of this collection-of-information requirement, or suggestions for reducing this burden should be sent to Anik Clemens, NMFS, Southeast Regional Office, 263 13th Avenue South, St. Petersburg, FL 33701.