Mothership Annual Report

OMB Control No. 0648-0663; Expiration Date: 12/31/2016

MS COOP PROGRAM
COST RECOVERY
ANNUAL REPORT

UNITED STATES DEPARTMENT OF COMMERCE
National Oceanic and Atmospheric Administration
National Marine Fisheries Service, West Coast Region
Fisheries Permits Office
7600 Sand Point Way NE, Bldg. 1
Seattle, WA 98115-0070

PACIFIC COAST GROUNDFISH
TRAWL RATIONALIZATION PROGRAM

Phone (206) 526-4353

Fax (206) 526-4461

www.nwr.noaa.gov

INSTRUCTIONS: Each fish buyer, as defined at 50 CFR 660.111 for the Mothership (MS) Coop Program, must
submit this annual report containing the information listed below for the fishing year for all groundfish each fish
buyer purchased from fish sellers in that year. This form must be completed in its entirety and submitted to the
National Marine Fisheries Service (NMFS) at the address given above by March 31 each year.
Fish Buyer Name(s)
Owner of vessel registered to MS permit: _______________________________________________________
Operator of vessel registered to MS permit: _____________________________________________________
Owner of the MS permit registered to that vessel: ________________________________________________
MS Permit Number: ________________________________________________________________________

Total Weight Bought (in lbs) =
Total Ex-vessel Value Paid =
Total Fee Amount Collected =
Month

Weight
Bought (lbs)

Ex-vessel
Value

Fee Amount
Collected

Date Disbursed
to NMFS

May
June
July
August
September
October
November
December
Total:

$

$

WARNING STATEMENT: A false statement on this form is punishable by permit sanctions (revocation, suspension, or modification) under 15 CFR Part 904, a
civil penalty up to $100,000 under 16 USC 1858, and/or criminal penalties including, but not limited to, fines or imprisonment or both under 18 USC 1001.
PRIVACY ACT STATEMENT: Some of the information collection described above is confidential under section 402(b) of the Magnuson-Stevens Act and under
NOAA Administrative Order 216-100, Protection of Confidential Fisheries Statistics. Business phone number, fax number, and email are not released to the public.
The information collected is part of a Privacy Act System of Records, COMMERCE/NOAA #19, Permits and Registrations for United States Federally Regulated
Fisheries. A notice was published in the Federal Register on April 17, 2008 (73 FR 20914) and became effective on June 11, 2008 (73 FR 33065).
PRA STATEMENT: The trawl cost recovery program is required by the Magnuson-Stevens Act [16 USC §§ 1853a(e), 1854(d)(2)]. This collection of information is
mandatory as specified at 50 CFR 660.115. This collection of information accompanies and documents payment of fees due for that program. Public reporting
burden for this form is estimated to average one hour 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, including suggestions for reducing this burden, to NOAA/National Marine Fisheries Service, West Coast Region, Attn: Assistant Regional
Administrator, Sustainable Fisheries Division, 7600 Sand Point Way NE, Seattle, WA 98115. 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.