Western Pacific Lobster Sales Report\

O.M.B Number: 0648-0214
Expires: xx/xx/xxxx

PACIFIC ISLANDS CRUSTACEAN
SALES REPORT LOG
NAME OF VESSEL_________________________________
PERMIT NUMBER__________________________________
TO
Paperwork Reduction Act Information
Public reporting burden for this collection is estimated at 5 minutes per response, 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 aspect of this collection of information, including suggestions for reducing this burden, to
Regional Administrator, NMFS Pacific Islands Region, Pacific Islands Regional Office, National Marine
Fisheries Service, 1845 Wasp Blvd. Bldg. 176, Honolulu, Hawaii 96818.
This information is being collected to ensure accurate and timely records about the fishing activity of persons
licensed to participate in fisheries under Federal regulations in the Pacific Islands region. This will enable the
National Marine Fisheries Service and the Western Pacific Fishery Management Council to (a) determine how those
persons would be affected by changes in management; (b) ensure that they are informed about prospective changes
in fishery regulations and the analysis of estimated impacts; and (c) determine whether the objectives of the fishery
program are being achieved by monitoring the fishery and evaluating the impacts on stocks, the fishery participants,
and related businesses. Responses to the collection are required to obtain the benefit of a license for the fishery
involved (ref. 50 CFR 665.13 and 665.14). Data provided concerning the activities and business of the respondents
are handled as confidential under the Magnuson-Stevens Fishery Conservation and Management Act (Sec. 402(b)).
Notwithstanding any other provision of the law, no person is required to respond to, nor shall any person be subject
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.

Vessel Reporting Requirements
The operator of any fishing vessel operating under a Federal Pacific Islands Region lobster or shrimp permit must
submit an accurate and complete report of sales to the National Marine Fisheries Service within 72 hours of each
landing of management unit species, except for fishing in the Pacific Remote Islands Areas, where it is required that
the forms be submitted to the Regional Administrator within 30 days of the end of each fishing trip. Each form must
be signed and dated by the fishing vessel operator. The original form must be submitted (ref. 50 CFR 665.14)
Submit completed logs to:
NOAA Inouye Regional Center
Attn: NMFS/PIFSC/Fishery Monitoring Branch
1845 Wasp Boulevard, Building 176
Honolulu, Hawaii 96818

For questions or additional forms call: (808) 725-5326

OMB Control No. 0648-0214
Expires: xx/xx/20xx

No. 000001
NATIONAL MARINE FISHERIES SERVICE

WESTERN PACIFIC CRUSTACEAN SALES REPORT
Vessel Name_____________________________ Permit Number_____________________
Name of First Level Buyer____________________________________________________
(Fill out a separate form for each buyer)
Business Address
Telephone number: (____)__________________ FAX number: (____)_________________
E-mail address:
All lobsters/shrimp off-loaded to this buyer? (yes/no)__________
Port of Landing__________________ Date of landing_________________
Location of off-load__________________ Date all lobsters/shrimp off-loaded ___________

SALES INFORMATION
Species

Frozen
(lobster tails or whole shrimp)
Sold
Value
Not Sold
(circle
Total
(circle
one)
value of
one)
No. or
No. or
product
Wt. (lbs)
sale ($)
Wt. (lbs)

Sold
(circle
one)
No. or
Wt. (lbs)

Live

Other product form

Value
Total
value of
product
sale ($)

(specify ___________________)
Sold
Value
Not Sold
(circle
Total
(circle
one)
value of
one)
No. or
No. or
product
Wt. (lbs) sale ($)
Wt. (lbs)

Not Sold
(circle
one)
No. or
Wt. (lbs)

Spiny Lobster
(specify)
Slipper Lobster
(specify)
Deepwater
Shrimp (specify)
Octopus
Other (specify)
Other (specify)

PACKING/WEIGHOUT DOCUMENTATION ATTACHED TO THIS REPORT?: YES___/NO___

I certify that the above information is complete and true to the best of my knowledge.
Vessel Captain/operator: (Print name) _________________________
(signature) _________________________ Date: ______________
Please submit to: NMFS Pacific Islands Fisheries Science Center, ATTN: FMB, 1845 Wasp Blvd., Bldg. 176, Honolulu, HI
96818

INSTRUCTIONS FOR COMPLETING THE WESTERN PACIFIC
CRUSTACEAN SALES REPORT
VESSEL NAME: Name of fishing vessel.
PERMIT NUMBER: Western Pacific Crustacean Fishery Permit number.
NAME OF FIRST LEVEL BUYER: Name of the first level buyer, i.e. initial buyer of the
product from the permit holder.
First level buyer means:(1) The first person who purchases, with the intention to resell, management unit
species, or portions thereof, that were harvested by a vessel that holds a permit or is otherwise regulated under
crustacean fisheries in subparts B through E of this part (50 CFR 665); or (2) A person who provides recordkeeping,
purchase, or sales assistance in the first transaction involving MUS (such as the services provided by a wholesale
auction facility).

BUSINESS ADDRESS: Address of first level buyer.
TELEPHONE NUMBER: Business or other contact telephone number of first level buyer
FAX NUMBER: FAX number of the first level buyer.
E-MAIL ADDRESS: e-mail address of first level buyer.
ALL LOBSTERS/SHRIMP OFFLOADED TO THIS BUYER: Yes or No.
PORT OF LANDING: Port of vessel return (e.g., Honolulu, Hilo, Kodiak, Los Angeles, etc.).
DATE OF RETURN: Date of vessel return to port.
LOCATION OF OFF-LOAD: Port of off-load (e.g., Honolulu, Hilo, Kodiak, Los Angeles, etc.).
DATE ALL LOBSTERS/SHRIMP OFF-LOADED: Date of completion of offloading.

SALES INFORMATION
Values should be input into the correct column matching the species and product form.
SPECIES: If species is not listed then fill in the species in the “Other (specify)” box.
Sold (circle one) No. or Wt. (lbs): List total number or weight sold, circle No. or Wt. to indicate
unit of measure.
Not Sold (circle one) No. or Wt. (lbs): List total number or weight not sold, circle unit i.e. No. or
Wt. to indicate unit of measure.
Value: Total value ($) of the product.
PACKING/WEIGHOUT DOCUMENTATION ATTACHED TO THIS REPORT: Circle
Yes or No. If yes, then attach the packing/weighout documentation to this form.
VESSEL CAPTAIN/OPERATOR: Print full name, sign on signature line, date of report
completion.