Drift Gillnet Limited Entry Permit Pre-filled Renewal Fo

UNITED STATES DEPARTMENT OF COMMERCE
National Oceanic and Atmospheric Administration
National Marine Fisheries Service
West Coast Region, Long Beach Fisheries Permits Office
501 W Ocean Blvd., Suite 4200
Long Beach, CA 90802
wcr-permits@noaa.gov

OMB Control No. 0648-0204
ExpiresXX/XX/20XX

PERMIT FEE: $22
DUE: APRIL 30

Drift Gillnet Limited Entry Permit
Pre-filled Renewal Form
Please write-in any changes or corrections

PERMIT NUMBER

PERMIT HOLDER INFORMATION
VESSEL NAME

USCG DOC OR STATE REG. NO.

PERMIT HOLDER NAME
ADDRESS
PHONE NUMBER
ALT PHONE NUMBER
EMAIL ADDRESS

VESSEL OWNER INFORMATION
VESSEL OWNER NAME
ADDRESS
PHONE NUMBER
ALT PHONE NUMBER
EMAIL ADDRESS

SIGNATURE
I certify that the above information is complete, true, and correct to the best of my knowledge and belief.
Name (Print legibly)

Signature

Date

Mail renewal form and processing fee to: NMFS Permits Office, 501 W Ocean Blvd., Suite 4200
Long Beach, CA 90802
Permit application fee: $50.00 Payable to "US Department of Commerce - NOAA
Print the permit number on the check.

Instructions - To make changes, cross out the existing information and write-in necessary changes.
Verify that vessel information is as it appears on the Coast Guard documentation or, if the vessel is not Coast Guard
documented, as it appears on the state registration certificate, vessel tonnage certificate, or marine survey. Sign and date this
renewal form to verify that all information is complete, true, and correct to the best of your knowledge and belief.
Renewal forms are due April 30 to prevent a lapse in eligibility to fish. Any renewals received on or after April 30, must
include documentation that failure to renew was a result of illness, injury, or death of the permit owner. Such medical
evidence may include a notice from a physician or any other documentation NMFS may require.
Failure to renew this permit annually, will result in this permit becoming permanently expired and will not be
available for any future use.
Transfers are allowed every three years. Please contact NMFS for permit transfer requirements and forms.
For assistance, contact the WCR Long Beach Permits Office at 562-980-4238 or e-mail wcr-permits@noaa.gov .

Drift Gillnet Limited Entry Permit Information
A LE DGN permit is required for individuals that harvest HMS species using large mesh DGN gear. Permits are required to be
on board and available for inspection at all times. The owner of this permit is required to be on board. A permit holder may
have any person serve in their place on the assigned vessel for not more than 15 calendar days in any one year, expect that a
longer period may be allowed in the event of serious illness. Documentation from a physician must be submitted to NMFS
with this request.
Highly Migratory Species (HMS) Permit
An HMS permit is required for commercial fishing vessels and recreational charter vessels that harvest any of the species that
are included in the FMP. They are: Billfish/Swordfish: striped marlin (Tetrapturus audax); swordfish (Xiphias gladius). Sharks:
common thresher shark (Alopias vulpinus); shortfin mako or bonito shark (Isurus oxyrinchus); blue shark (Prionace glauca).
Tunas: north Pacific albacore (Thunnus alalunga); yellowfin tuna (Thunnus albacares); bigeye tuna (Thunnus obesus); skipjack
tuna (Katsuwonus pelamis); northern bluefin tuna (Thunnus orientalis). Other: dorado or dolphinfish (Coryphaena hippurus)
Download an HMS permit application at http://www.westcoast.fisheries.noaa.gov/fisheries/migratory_species/
pacific_hms_pemits.html or apply online at http://fisheriespermits.noaa.gov.
WARNING STATEMENT: A false statement on this form is punishable by permit sanctions (revocation, suspension, or modification) under 15 CFR 904, a civil penalty of up to
$100,000 under 16 USC 1858, and as a federal crime under 18 USC 1001.
PAPERWORK REDUCTION ACT - Public reporting burden for this collection of information is estimated to average 10 minutes per response, including time for reviewing
instructions, searching existing data sources, gathering and maintaining data, and completing and reviewing the collection of information. 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. Send comments regarding this burden
estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Regional Administrator, National Marine Fisheries
Service, 501 West Ocean Blvd., Long Beach, CA 90802-4213
PRIVACY ACT STATEMENT Authority: The collection of this information is authorized under the Magnuson-Stevens Fishery Conservation and Management Act, 16 U.S.C 1801 et seq., the High Seas
Fishing Compliance Act, the Tuna Conventions Act of 1950, the Antarctic Marine Living Resources Convention Act, the Western and Central Pacific Fisheries Convention
Implementation Act (WCPFCIA; 16 U.S.C. 6901 et seq), the Marine Mammal Protection Act, the Endangered Species Act and the Fur Seal Act. The authority for the mandatory
collection of the Tax Identification Number (TIN) is 31 U.S.C. 7701.
Purpose: In order to manage U.S. fisheries, the NOAA National Marine Fisheries Service (NMFS) requires the use of permits or registrations by participants in the United
States. Information on NOAA Fisheries permit applicants and renewing holders includes vessel owner contact information, date of birth, TIN and vessel descriptive
information. Permit holder information may be used as sampling frames for surveys, as part of Fishery Management Council (FMC) analysis to support FMC decisions.
Routine Uses: The Department will use this information to determine permit eligibility and to identify fishery participants. Disclosure of this information is permitted under
the Privacy Act of 1974 (5 U.S.C. Section 552a), to be shared within NMFS offices, in order to coordinate monitoring and management of sustainability of fisheries and
protected resources, as well as with the applicable State or Regional Marine Fisheries Commissions and International Organizations. Disclosure of this information is also
subject to all of the published routine uses as identified in the Privacy Act System of Records Notice COMMERCE/NOAA-19, Permits and Registrations for the United States
Federally Regulated Fisheries.
Disclosure: Furnishing this information is voluntary; however, failure to provide complete and accurate information will prevent the determination of eligibility for a permit.
This information collected is part of a Privacy Act System of Records, COMMERCE/NOAA #19, Permits and Registrations for United States Federally Regulated
Fisheries. An amended notice was published in the Federal Register on August 7, 2015 (80 FR 47457) and became effective on September 15, 2015 (80 FR 55327).

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