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pdfOMB CONTROL NO. 0648-0204
Expiration Date: xx/xx/xxxx
UNITED STATES DEPARTMENT OF COMMERCE
National Oceanic and Atmospheric Administration
NATIONAL MARINE FISHERIES SERVICE
West Coast Region Permits Office
501 West Ocean Boulevard, Suite 4200
Long Beach, California 90802-4213
COASTAL PELAGICS FISHING LIMITED ENTRY PERMIT
PERMIT RENEWAL/PERMIT TRANSFER/CHANGE OF ADDRESS
OR REPLACEMENT OF LOST PERMIT
ACTION DESIRED (Check appropriate box):
[ ] RENEWAL Complete applicant (1) Current vessel information (2)
Attach a copy of the vessels most recent documentation with vessel dimensions (i.e. Coast Guard documentation, marine survey, tonnage certificate).
[ ] PERMIT TRANSFER Complete applicant (1) Current vessel information (2) New permit owner (3) New vessel information (4)
Attach a copy of the vessels most recent documentation with vessel dimensions (i.e. Coast Guard documentation, marine survey, tonnage certificate).
[ ] PERMIT CHANGE OF ADDRESS Complete applicant (1) Current vessel information (2). Put new address in new owner (3).
[ ] REPLACEMENT OF LOST PERMIT Complete applicant (1) Current vessel information (2).
(1) APPLICANT INFORMATION
Name of current permit owner
Permit Number
Address
Phone No.
Signature
Date
(2) VESSEL INFORMATION
Permit Fixed Gross Tonnage
Vessel Name
Official Number (Coast Guard)
Overall Length (ft)*
State Official Number
Breadth (ft)
Depth (ft)
Calculated Gross Tonnage**
*Overall Length (ft) is the horizontal distance between the outboard side of the foremost part (bow) of the hull and the outboard side of the
aftermost part (stern) of the hull.
**Gross tonnage (GT) means gross tonnage as determined by the formula in 46 CFR 69.209(a) for a vessel not designed for sailing (.67 x length x
breadth x depth/100). A vessel’s length, breadth, and depth are those specified on the vessel’s certificate of documentation issued by the U.S. Coast
Guard or state.
This form is intended to be used for all transfers of limited entry permits to either a new vessel and/or a new owner. If two or more
permits are being applied to a larger vessel, more than one form will be needed. Please refer to the implementing regulations at 50
CFR 660.514 for details.
COASTAL PELAGICS FISHING PERMIT APPLICATION - Page Two
(3) NEW PERMIT OWNER
Name of intended permit owner
Address
Phone No.
Signature
Date
(4) NEW VESSEL INFORMATION
Vessel Name
Official Number (Coast Guard)
Overall Length (ft)*
State Official Number
Breadth (ft)
Depth (ft)
Calculated Gross Tonnage**
Comparable capacity means gross tonnage as determined by the formula in 46 CFR 69.209(a) for a vessel not designed for sailing, plus 10 percent
of the vessel’s calculated gross tonnage.
*Overall Length (ft) is the horizontal distance between the outboard side of the foremost part (bow) of the hull and the outboard side of the
aftermost part (stern) of the hull.
**Gross tonnage (GT) means gross tonnage as determined by the formula in 46 CFR 69.209(a) for a vessel not designed for sailing (.67 x length x
breadth x depth/100). A vessel’s length, breadth, and depth are those specified on the vessel’s certificate of documentation issued by the U.S. Coast
Guard or state.
********
Warning: 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 as a federal crime under 18 USC 1001.
The purpose of this information collection is to limit the number of vessels fishing for coastal pelagic species according to the provisions of the
Fishery Management Plan for Coastal Pelagic Species, which was approved by the Secretary of Commerce and implemented by federal regulations
on December 15, 1999 (64 FR 69888). The information on this form is mandatory for owners of vessels who wish to participate in the limited entry
fishery, and is required by 50 CFR 660.512. 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.
Paperwork Reduction Act - Public reporting burden for this collection is estimated to average 30 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 West Coast Region, NMFS, 501 West Ocean Blvd., Suite 4200, Long Beach, California 90802-4213.
File Type | application/pdf |
File Title | I:\CPS DB\cps_application_without_ssn.wpd |
Author | csf |
File Modified | 2016-07-13 |
File Created | 2010-01-25 |