Federal Limited Entry Deep-Set Buoy Gear Permit Change o

UNITED STATES DEPARTMENT OF COMMERCE
National Oceanic and Atmospheric Administration
National Marine Fisheries Service (NMFS)
West Coast Region, Long Beach Fisheries Permits Office
501 W Ocean Blvd., Suite 4200
Long Beach, CA 90802
wcr-permits@noaa.gov (562)980-4238

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

Federal Limited Entry Deep-Set Buoy Gear Permit Change
of Vessel, Permit Holder, or Vessel Owner Application Form
Please apply online directly at http://fisheriespermits.noaa.gov

SECTION A - ACTION(S) REQUESTED
D Transfer of permit owner (Fill out Sections B, C, D, E, F, G)
Transfer of DSBG LEP can only occur after death of current permit holder.
D Change in vessel assigned to permit (Fill out Sections B, C, D, G)
Permit holders are allowed to change vessels once ever year (April 1 - March 31 ).
D Change in vessel ownership (Fill out Sections B, C, F, G)
Upload a copy of the Coast Guard Vessel documentation or State Vessel Registration identifying new ownership
along with this application at the National Permits System (NPS) website (http://fisheriespermits.noaa.gov).

SECTION B - CURRENT PERMIT OWNER
Current Permit Owner Name ((First, Last, MI) or Business Name)

USCG Doc or State Registration Number

Vessel Name

Tax Identification Number (if business)

Street or PO Box

Date of Birth (if individual)

City, State

Zip Code

Phone (required)

Alternate Phone (optional)

Fax (optional)

Email (required)

SECTION C - CURRENT VESSEL OWNER
Current Vessel Owner Name ((First, Last, MI) or Business Name)

Tax Identification Number (if business)

Street or PO Box

Date of Birth (if individual)

City, State

Zip Code

Phone (required)

Alternate Phone (optional)

Email (required)
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Fax (optional)

SECTION D - CHANGE IN VESSEL NAME ASSIGNED TO PERMIT
CURRENT Vessel Name

USCG Documentation or State Vessel Registration Number

NEW Vessel Name*

USCG Documentation or State Vessel Registration Number

*For the new vessel name, upload a copy of the US Coast Guard Certificate of Documentation or State Vessel Registration Certificate on NPS.

SECTION E - NEW PERMIT HOLDER
New Permit Owner Name (First, Last, MI) or Business Name)

Tax Identification Number (if business)

Street or PO Box

Date of Birth (if individual)

City, State

Zip Code

Phone (required)

Alternate Phone (optional)

Fax (optional)

Email (required)

SECTION F - NEW VESSEL OWNER
New Vessel Owner Name ((First, Last, MI) or Business Name)

Tax Identification Number (if business)

Street or PO Box

Date of Birth (if individual)

City, State

Zip Code

Phone (required)

Alternate Phone (optional)

Fax (optional)

Email (required)

SECTION G - SIGNATURE
New Permit Owner or Owner of Vessel Registered to the Permit: Under penalty of perjury, I hereby declare that I, the
undersigned, am the new permit holder and certify that this permit transfer and the information contained herein is true,
correct, and complete to the best of my knowledge.
Printed Name

Signature

Date

Apply for transfers directly at http://fisheriespermits.noaa.gov
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INSTRUCTIONS
SECTION A - ACTION(S) REQUESTED: Please check the box next to the action(s) requested. Fill out the sections listed for each
action completely on the NPS website.
Note: Limited entry DSBG permits are not transferable, except for a one-time transfer to a family member upon the death or legal
incapacitation of the individual, or a member of the corporation, partnership, or other entity that owns the permit. A family member
would be defined as spouse, domestic partner, cohabitant, child, stepchild, grandchild, parent, stepparent, mother-in-law, father-in-law,
son-in-law, daughter-in-law, grandparent, great grandparent, brother, sister, half-brother, half-sister, step-sibling, brother-in-law, sisterin-law, aunt, uncle, niece, nephew, or first cousin. One-time transfers would also apply to the member of a partnership, corporation, or
other entity. For example, if John Doe is a member of a partnership with John Smith, and John Doe died, John Doe’s ownership interest
could pass to a family member while John Smith’s ownership interest remains unchanged. Changes to ownership, including the
addition of individuals or entities as owners of the permit, would otherwise not be allowed. NMFS would not consider it an ownership
change if shares among the existing owners changes, or if a member of a corporation, partnership, or other entity leaves and is not
replaced.
SECTION B- CURRENT PERMIT HOLDER: Please verify the current permit holder's name and the vessel information for which this permit
is assigned. If no vessel is assigned, indicate "unidentified" for vessel name.
SECTION C- CURRENT VESSEL OWNER: Please provide the vessel owner's name. If no vessel is assigned, write "unidentified."
SECTION D- CHANGE IN VESSEL ASSIGNED TO PERMIT: If you are changing the vessel registered to the permit, please enter the
current vessel name and Coast Guard Documentation or State Registration Number, as well as the new vessel name and Coast
Guard Documentation or State Registration Number to be registered to the permit. The new vessel name and registration
number will appear on the reissued permit. Upload a copy of the Coast Guard documentation or state registration for the new vessel to
the NPS website along with this application. A vessel must be assigned to a permit prior to any fishing activity.
Note: An active HMS permit must be held by the designated vessel prior to fishing. Vessel assignment can only be changed once per
year, upon annual renewal, except in cases of force majeure. If designating a vessel, the permit holder is required to notify the permits
office in an email addressed to wcr-permits@noaa.gov, complete a Transfer Application online, and upload a copy of the vessel's current
Coast Guard documentation or state registration. NMFS may request additional information if necessary.
SECTION E- NEW PERMIT HOLDER: Please provide the new permit owner's name, date(s) of birth (if individual) or Tax Identification
Number (if business), address, phone number, and email address. For changes involving corporations, partnerships or other entities,
please update/complete an Ownership Interest Application online along with this request. For a request to change a permit's
ownership that is necessitated by the death of the permit owner(s), the individual(s) requesting conveyance of the permit to a new
owner must provide NMFS with a death certificate of the current permit owner(s) and appropriate legal documentation that either:
specifically registers the permit to a designated individual(s); or, provides legal authority to the transferor to convey the permit
ownership. This documentation can be emailed to wcr-permits@noaa.gov, or uploaded to the NPS website along with this application.
The Federal Limited Entry Deep-Set Buoy Gear permit owner cannot change or add additional individuals or entities as owners of the
permit, and a transfer may not occur if such a transfer will result in a person holding more than one Federal Limited Entry Deep-Set
Buoy Gear Permit. A person may only hold one Federal Limited Entry Deep-Set Buoy Gear permit, in whole or in part, including through
ownership interest in a corporation, partnership or other entity. For purposes of enforcing this limitation, partial ownership would
“count” as full ownership.
SECTION F- NEW VESSEL OWNER: If registering a new vessel to the permit, or if the vessel owner has changed, please submit the name
of the new vessel with Coast Guard documentation number or state registration number, as well as the name, date(s) of birth (if
individual) or Tax Identification Number (if business), address, phone number, and email address of the new vessel owner online.
Upload a copy of the updated Coast Guard Vessel documentation or State Vessel registration that identifies the new ownership.
SECTION G- SIGNATURE: Either the current permit applicant or an authorized representative of the permit applicant must sign and
date the form. By signing and dating the application, the applicant certifies that they are authorized to sign this form and that all
information set forth in the application is true, correct, and complete to the best of the applicant's knowledge
and belief. The application will not be considered without this signature.

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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- A Federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall
a person be subject to a penalty for failure to comply with an information collection subject to the requirements of the Paperwork
Reduction Act of 1995 unless the information collection has a currently valid OMB Control Number. The approved OMB Control
Number for this information collection is 0648-0204. Without this approval, we could not conduct this information collection. Public
reporting for this information collection is estimated to be approximately 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
information collection. Some of the information collection described above is confidential under section 402(b) of the MagnusonStevens Act. It is also confidential under NOAA Administrative Order 216-100, Protection of Confidential Fisheries Statistics. Phone
number, fax and email information and TIN are not released to the public. All responses to this information collection are mandatory/
required to obtain benefits pursuant to 50 CFR 660. Send comments regarding this burden estimate or any other aspect of this
information collection, including suggestions for reducing this burden to the National Marine Fisheries Service at: 501 W. Ocean
Blvd., Suite 4200, Long Beach, CA 90802, Attn: Permits Office, wcr-permits@noaa.gov

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.
Your date of birth and TIN are confidential and protected under the Privacy Act. Provision of your date of birth and TIN is mandatory
as part of this collection. The primary purpose for requiring the date of birth is to verify the identity of individuals/entities doing
business with the government to provide a unique identification for assistance to comply with the Debt Collection Improvement Act
of 1996 (Public Law 104-134) and for enforcement activities.
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 (S 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 XXXX (X FR
XXXX) and became effective on XXXX (X FR XXXX).

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