Request for Atlantic Surfclam or Ocean Quahog ITQ Alloca

OMB Control No. 0648-0240 Expiration Date: XX/XX/20XX

U .S. Department of Commerce NOAA/National Marine Fisheries Service 55 Great Republic Drive Gloucester, MA 01930-2298 Tel: (978) 282-8483

Application to Transfer Surfclam / Ocean Quahog Individual Transferable Quota (ITQ) Fishing Year YYYY January 1, YYYY – December 31, YYYY

Section A – Type of Transfer Requested
 Temporary Transfer of Cage Tags
 Permanent Transfer of ITQ Quota Share	 Transfer quota share including all cage tags for the current fishing year
	 Transfer quota share only, not cage tags for the current fishing year (transfer is effective for the following fishing year)

Section B – Transfer Details
	Beginning Tag Number	Ending Tag Number	Total Tags
Tag Series 1:
Tag Series 2:
Tag Series 3
Additional transaction details
Total price paid, including all fees:
Broker fees, if applicable:
Is this transfer part of a long-term (more than 1 year) contract?  No  Yes Contract duration: ______ Note: Temporary tag transfers only apply to the current fishing year. Any future transfer would require a separate transfer application.
Is the contract based on a fixed price, or a market-based flexible price?  Fixed price  Flexible price  NA
Specify any other conditions on this transfer (e.g. harvester must sell clams to a specific processor, right of first refusal on future transfers, etc.).

Section C – Transferor (Seller) Certification
Name of Permit Holder:	ITQ Permit Number:
Under penalty of perjury, I hereby declare that I, the undersigned, am authorized to certify this application on behalf of the transferor and completed this form, and the information contained is true, correct, and complete to the best of my knowledge and belief.
Signature:	Date:
Print Name:

Section D – Transferee (Buyer) Certification
Name of Permit Holder:	ITQ Permit Number:
Under penalty of perjury, I hereby declare that I, the undersigned, am authorized to certify this application on behalf of the transferee and completed this form, and the information contained is true, correct, and complete to the best of my knowledge and belief.
Signature:	Date:
Print Name:

To avoid delay in processing, please include all information requested.

PAPERWORK REDUCTION ACT STATEMENT: Public reporting burden for this collection of information is estimated to average 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 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, 55 Great Republic Drive, Gloucester, MA 01930.

Permit holder name, address, phone, and permit information will be released via a NOAA Fisheries website. All other data submitted will be handled as confidential in accordance with 16 U.S.C. 1881 and NOAA Administrative Order 216-100, Protection of Confidential Fisheries Statistics. 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.

Instructions – Application to Transfer Surfclam / Ocean Quahog ITQ

If you wish to transfer surfclam or ocean quahog ITQ by temporary lease of cage tags or permanent transfer of quota share, both parties must be issued a current ITQ permit for the appropriate fishery. To obtain a surfclam or ocean quahog ITQ permit, submit a completed ITQ permit application along with a completed ITQ ownership form. A surfclam or ocean quahog ITQ permit, once issued, will authorize you to participate in an ITQ transfer of either cage tags or quota share.

SECTION A – Type of transfer requested

Temporary transfer: Transfers cage tags but does not affect the underlying quota share.

Permanent transfer: Transfers the underlying quota share, so that future cage tags would be issued to the new quota shareholder. Permanent transfers of quota share may or may not include the cage tags for the current fishing year. Be sure to check the appropriate box.

SECTION B – Transfer Details

Provide details of the allocation to be transferred. Temporary transfers and permanent transfers that include all cage tags should list the full range of tag numbers being transferred. Permanent transfers without the associated cage tags may list a number of tags to be transferred, or a percentage of the transferor’s total quota share. A permanent transfer based on a number of tags will be converted to a quota share percentage based on the current fishing year quota. Future cage tag allocations may change based on any changes to the commercial quota. Additional questions about this transaction have been added to address a request from the Mid-Atlantic Fishery Management Council. Complete all applicable fields. Please note: Tag transfers are only good for the current fishing year. NMFS will not automatically transfer any tags in the future without another completed transfer application, even if you indicate the current tag transfer is part of a multi-year contract.

SECTION C – Transferor Certification

Provide the name and ITQ permit number of transferor. 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].

SECTION D – Transferee Certification

Provide the name and ITQ permit number of the transferee. 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].

When completed, submit the application to the following address:

NOAA’s National Marine Fisheries Service

Greater Atlantic Regional Fisheries Office

Attn: Permits

55 Great Republic Drive

Gloucester, MA 01930

For questions, please call 978-282-8483

SC/OQ ITQ Transfer Application

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