Application to replace Amandemtn 80 Vessel

Revised: 12/23/2013 OMB Control No. 0648-0565 Expiration Date: 01/31/2016

APPLICATION FOR AMENDMENT 80 VESSEL REPLACEMENT	United States Department of Commerce National Oceanic and Atmospheric Administration National Marine Fisheries Service (NMFS) , Alaska Region Restricted Access Management (RAM) P.O. Box 21668 Juneau, Alaska 99802-1668 Telephone: (800) 304-4846 toll free or (907) 586-7202 Juneau FAX: (907) 586-7354

BLOCK A -- IDENTIFICATION OF THE AMENDMENT 80 VESSEL BEING REPLACED
1. Vessel Name:		2. ADF&G Vessel Registration No.:
3. USCG Documentation No.:	4. Amendment 80 QS permit No.:		5. Last year in which vessel harvested or processed groundfish in an Amendment 80 fishery
6. Applicant’s name:		7. NMFS Person ID:
8. Business Mailing Address: [ ] Permanent [ ] Temporary
9. Business Telephone No.:	10. Business Fax No.:		11. Business E-Mail Address:
12. Indicate one: [__] Vessel was lost at sea [__] Vessel is permanently ineligible to participate [__] Not applicable

BLOCK B -- IDENTIFICATION OF THE AMENDMENT 80 REPLACEMENT VESSEL
1. Vessel Name:				2. ADF&G Vessel Registration No.:
				3. USCG documentation number
4. Is the vessel classed? [__] YES [__] NO		5. Is the vessel loadlined? [__] YES [__] NO
6. If the replacement vessel cannot be classed and loadlined, does the vessel meet the requirements of the USCG Alternative Compliance and Safety Agreement (ACSA)? [__] YES [__] NO
7. Was the vessel built in the United States? [__] YES [__] NO
8. Has the vessel ever been rebuilt? [__] YES [__] NO If YES, was it rebuilt in the United States? [__] YES [__] NO
9. Owner Name:			10. NMFS Person ID:
11. Business Mailing Address: [ ] Permanent [ ] Temporary
12. Business Telephone No.:	13. Business Fax No.:		14. Business E-Mail Address:

NOTE: Persons holding QS for a vessel that has been deemed ineligible for use under 46 USC 12108 and are applying to replace that vessel must provide evidence to NMFS that ineligibility has been established through U.S. Coast Guard or MARAD documentation. Written documentation is needed to establish that an ineligible vessel cannot reenter the fishery and that replacement vessels should be permitted to replace the ineligible vessels.

BLOCK C -- APPLICANT SIGNATURE AND CERTIFICATION
Under penalties of perjury, I hereby declare that I, the undersigned, completed this application, and the information contained herein is true, correct, and complete to the best of my knowledge and belief. If representative, attach authorization.
1. Signature	2. Date
3. Printed Name	4. Title

_______________________________________________________________________________________

PUBLIC REPORTING BURDEN STATEMENT

Public reporting burden for this collection of information is estimated to average 2 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 aspect of this collection of information, including suggestions for reducing the burden, to NOAA, National Marine Fisheries Service, Alaska Region, Attn: Assistant Regional Administrator, Sustainable Fisheries Division, 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 mandatory and is required to manage commercial fishing effort in the GOA and BSAI under

50 CFR 679 and under 402(a) of the Magnuson-Stevens Act (16 U.S.C. 1801, et seq.); 3) Responses to this information request are confidential under section 402(b) of the Magnuson-Stevens Act as amended in 2006. It is also confidential under NOAA Administrative Order 216-100, which sets forth procedures to protect confidentiality of fishery statistics.

_____________________________________________________________________________________________________

INSTRUCTIONS

APPLICATION FOR AN AMENDMENT 80 REPLACEMENT VESSEL

The owner of an Amendment 80 vessel may replace such vessel for any purpose. The replacement vessel will be eligible to participate in the Amendment 80 fisheries in the same manner as the original vessel; moreover, the owner of the replacement vessel is responsible for all monitoring, enforcement, permitting , recordkeeping and reporting, prohibitions, and general sideboard measures that apply to Amendment 80 vessels in the GOA or BSAI.

A vessel will be approved by the Regional Administrator as an Amendment 80 vessel following the submission and approval of a completed application for an Amendment 80 Replacement Vessel, provided that only one replacement vessel is used as a replacement for any one replaced vessel at a given time and that the replacement vessel:

♦ Does not exceed 295 feet length overall (LOA)

♦ Was built in the United States and, if ever rebuilt, rebuilt in the United States

♦ Is classed and loadlined or meets the requirements of the USCG Alternative Compliance and Safety Agreement

GENERAL INFORMATION

Note: It is important that all blocks are completed and all necessary documents are attached. Failure to answer any of the questions, provide attachments, or to sign the application could result in delays in the processing of your application.

♦ Complete a separate application for each vessel. Application forms and instructions are also available on the NMFS, Alaska Region website at https://alaskafisheries.noaa.gov.

♦ To demonstrate vessel ownership you must provide:

○ For U.S. Coast Guard (USCG) Documented Vessels, a copy of the USCG Abstract of Title or Certificate of Documentation

○ For undocumented vessels, a copy of the State of Alaska vessel license or registration.

♦ Type or print legibly in ink.

♦ Retain a copy of completed application for your records.

Submit the completed application

By mail to: Alaska Region, NOAA Fisheries (NMFS)

Restricted Access Management (RAM)

P.O. Box 21668

Juneau, AK 99802

By fax to: 907-586-7354

Or, hand deliver to: Federal Building

709 W. 9th Street, Suite 713

Juneau, AK 99801

Items will be sent to you by first class mail, unless you provide alternate instructions and include a prepaid mailer with appropriate postage or a corporate account number for express delivery. Additional information is available from RAM, as follows:

Telephone (toll free): 800-304-4846 (press “2”)

Telephone (in Juneau): 907-586-7202 (press “2”)

Website: http://www.alaskafisheries.noaa.gov/ram/default.htm

E-Mail: RAM.Alaska@noaa.gov

COMPLETING THE APPLICATION

BLOCK A -- IDENTIFICATION OF THE AMENDMENT 80 VESSEL BEING REPLACED

1. Vessel Name. Enter the complete vessel name as displayed in the official documentation.

2. ADF&G Vessel Registration No. Enter the 5-digit Alaska Department of Fish and Game (ADF&G) vessel registration number (example: 51233).

3. USCG Documentation No. Enter U.S. Coast Guard (USCG) documentation number (example: 566722).

4. Amendment 80 QS permit No.

5. Last year in which vessel harvested or processed groundfish in an Amendment 80 fishery

6. Applicant’s Name. Enter the full name(s) of the owner(s) of the vessel.

Note: If there is more than one owner, list the principal owner first. The permit will be issued to the first owner listed, with et al. notation. The permit MUST be issued to the owner of the vessel, not to operators or lessees.

7. NMFS Person ID. NMFS will supply this number, if you do not already have one.

8. Permanent Business Mailing Address. Indicate whether address is permanent or temporary. Enter your complete permanent business mailing address, including street or P.O. Box, state, and zip code. Your permit will be sent to this address, unless otherwise notified.

Temporary Business Mailing Address: Address you want the permit sent if somewhere other than to the permanent address. Include street or P.O. Box number, city, state, and zip code

9-11. Business Telephone No., Fax No., and e-mail Address. Enter the business telephone number, including area code, business fax number, and business e-mail address (if available) that are used by the vessel owner. It is very important that you provide a number where we can contact you, or where we can leave messages for you. If questions arise concerning your application, and we are unable to contact you, issuance of your permit will be delayed.

12. Indicate status of vessel: whether lost at sea, permanently ineligible to participate, or not applicable.

BLOCK B -- IDENTIFICATION OF THE AMENDMENT 80 REPLACEMENT VESSEL

1. Vessel Name. Enter the complete vessel name as displayed in the official documentation.

2. ADF&G Vessel Registration No. Enter the 5-digit Alaska Department of Fish & Game (ADF&G) vessel registration number (example: 51233).

3. USCG documentation number. Enter U.S. Coast Guard (USCG) documentation number

(example: 566722).

4. Indicate YES or NO whether the vessel is classed.

5. Indicate YES or NO whether the vessel is loadlined.

6. If the replacement vessel cannot be classed and loadlined, indicate whether the vessel meets the requirements of the USCG Alternative Compliance and Safety Agreement (ACSA)

NOTE: Persons holding QS for a vessel that has been deemed ineligible for use under 46 USC 12108 and are applying to replace that vessel must provide evidence to NMFS that ineligibility has been established through U.S. Coast Guard or MARAD documentation. Written documentation is needed to establish that an ineligible vessel cannot reenter the fishery and that replacement vessels should be permitted to replace the ineligible vessels.

7. Indicate YES or NO whether the vessel was built in the United States.

8. Indicate YES or NO whether the vessel was ever rebuilt.

If YES, indicate whether it was rebuilt in the United States.

9. Owner Name. Enter the full name(s) of the owner(s) of the vessel

Note: If there is more than one owner, list the principal owner first. The permit will be issued to the first owner listed, with et al. notation. The permit MUST be issued to the owner of the vessel, not to operators or lessees.

10. NMFS Person ID. NMFS will supply this number, if you do not already have one.

11. Permanent Business Mailing Address. Indicate whether address is permanent or temporary. Enter your complete permanent business mailing address, including street or P.O. Box, state, and zip code. Your permit will be sent to this address, unless otherwise notified.

Temporary Business Mailing Address: Address you want the permit sent if somewhere other than to the permanent address. Include street or P.O. Box number, city, state, and zip code

12-14. Business Telephone No., Fax No., and e-mail Address. Enter the business telephone number, including area code, business fax number, and business e-mail address (if available) that are used by the vessel owner. It is very important that you provide a number where we can contact you, or where we can leave messages for you. If questions arise concerning your application, and we are unable to contact you, issuance of your permit will be delayed.

BLOCK C -- APPLICANT SIGNATURE AND CERTIFICATION

The applicant must provide printed name, signature, and date signed.

If completed by an authorized representative, attach proof of authorization and state title.

Application for Amendment 80 Vessel Replacement

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