Application for Amendment 80 Limited Access Fishery Perm

Revised: 02/15/2023

OMB Control No. 0648-0565 Expiration Date: 04/30/2023

Application for
AMENDMENT 80
LIMITED ACCESS
FISHERY PERMIT

U.S. Dept. of Commerce/NOAA
National Marine Fisheries Service (NMFS)
Restricted Access Management Program (RAM)
P.O. Box 21668
Juneau, AK 99802-1668
(800) 304-4846 toll free / (907) 586-7202 in Juneau
(907) 586-7354 fax / ram.alaska@noaa.gov

This application is used by an Amendment 80 quota share holder to annually request an Amendment 80 limited
access fishery permit. This application must be submitted annually and received by NMFS no later than 1700
hours Alaska local time (A.l.t.) on November 1 of the year prior to the year for which the applicant wishes to
participate in an Amendment 80 fishery. If sent by U.S. mail, the application must be postmarked by that time.
BLOCK A -- APPLICANT IDENTIFICATION
1. Applicant Name:

2. Tax ID Number:

3. NMFS Person ID:

4. Permanent Business Address:

5. Business Telephone Number:

6. Business Fax Number:

7. Business E-mail Address:

BLOCK B -- AMENDMENT 80 VESSEL IDENTIFICATION
1. Name of the Amendment 80 vessel owned by applicant:

2. ADF&G Number:
3. USCG Number:

1. Name of the Amendment 80 vessel owned by applicant:

2. ADF&G Number:
3. USCG Number:

BLOCK C – AMENDMENT 80 LLP IDENTIFICATION
List the Amendment 80 LLP license number(s) held by the applicant that will be used in Limited Access Fishery.

Application for A80 Limited Access Fishery Permit ― Page 1 of 5

BLOCK D – AMENDMENT 80 QS PERMIT INFORMATION
List the Amendment 80 QS permit number(s) held by the applicant that will be used in Limited Access Fishery.

BLOCK E -- AMENDMENT 80 QS OWNERSHIP DOCUMENTATION
Provide the names of all persons, to the individual level, holding an ownership interest in the Amendment 80 QS Permit(s)
held by the applicant and the percentage ownership each person and individual holds in the Amendment 80 QS Permit.
Percentage
Name(s)
Ownership

BLOCK F -- EDR SUBMISSION
Indicate whether the applicant has submitted a timely and complete the Annual Trawl Catcher/Processor
Economic Data Report for each Amendment 80 QS permit held by that person as required under § 679.94.
YES
NO

BLOCK G -- APPLICANT CERTIFICATION
The applicant must sign and date the application certifying that all information is true and correct to the best of their
knowledge and belief. If the application is completed by an authorized or designated representative, then explicit
authorization must accompany the application.
Pursuant to 28 U.S.C. § 1746, I declare under penalty of perjury that the foregoing is true and correct.
1. Signature of Applicant (or Authorized Representative):

2. Date:

3. Printed Name of Applicant (or Authorized Representative); if representative, attach authorization:

Application for A80 Limited Access Fishery Permit ― Page 2 of 5

Instructions for
APPLICATION FOR AMENDMENT 80 LIMITED ACCESS FISHERY PERMIT
An Amendment 80 limited access fishery permit is required for an Amendment 80 Quota Share (QS) holder to catch,
process, and receive Amendment 80 species assigned to the Amendment 80 limited access fishery, or use halibut and crab
prohibited species catch (PSC) assigned to the Amendment 80 limited access fishery.
An Amendment 80 limited access fishery permit is issued annually to an Amendment 80 QS holder who has submitted:
◆ A timely and complete application for the Amendment 80 limited access fishery as described at § 679.91 that is
approved by NMFS; and
◆ A timely and complete Annual Trawl Catcher/Processor Economic Data Report (EDR) for all Amendment 80
QS permits held by that person as described under § 679.94 that is subsequently approved by NMFS.
Pacific States Marine Fisheries Commission (PSMFC) has been designated by NMFS to be the Data Collection Agent for
the Amendment 80 EDR program. PSMFC mails EDR announcements and filing instructions to Amendment 80
QS permit holders by April 1. You may also use the web based EDR form or download the EDR form in fillable
PDF format. To request that a printed EDR be mailed to you, please call 1-877-741-8913, or email your request
to am80edr@psmfc.org.
An Amendment 80 limited access fishery permit is valid until whichever of the following occurs first:
◆ Until the end of the year for which the Amendment 80 limited access fishery permit is issued; or
◆ Until the permit is revoked, suspended, or modified pursuant to § 679.43 or under 15 CFR part 904.
Deadline: A completed EDR must be received by NMFS no later than 1700 hours A.l.t. on June 1 of the year following
the calendar year during which the Amendment 80 CQ permit was held, or if sent by U.S. mail, postmarked by that date.
Deadline: This completed application must be received by NMFS no later than 1700 hours A.l.t. on November 1 of the
year prior to the year for which the applicant wishes to participate in an Amendment 80 fishery, or if sent by U.S. mail,
the application must be postmarked by that time.
A legible copy of the Amendment 80 limited access fishery permit must be carried onboard an Amendment 80 vessel
assigned to the Amendment 80 limited access fishery when fishing in the BSAI or adjacent waters open by the State of
Alaska for which it adopts a Federal fishing season.
GENERAL INFORMATION
Please allow at least 10 working days for this application to be processed. It is important that all blocks are completed and
any required attachments are provided. Failure to answer any of the questions, provide any of the required documents, or to
have signatures could result in delays in the processing of your application.
Forms are available on the NMFS Alaska Region website at https://www.fisheries.noaa.gov/region/alaska.
Print information in the application legibly in ink or type information.
Retain a copy of completed application for your records.
When completed, submit the application —
By mail to:

NMFS Alaska Region
Restricted Access Management (RAM)
P.O. Box 21668
Juneau, AK 99802-1668
Application for A80 Limited Access Fishery Permit ― Page 3 of 5

By delivery to: Room 713, Federal Building
709 West 9th Street
Juneau, AK 99801
Or, by fax to:

907-586-7354

If you need additional information:
Contact RAM at: (800) 304-4846 (Option #2) or (907) 586-7202 (Option #2)
E-mail address: ram.alaska@noaa.gov
Website: https://www.fisheries.noaa.gov/region/alaska
COMPLETING THE APPLICATION
BLOCK A -- APPLICANT IDENTIFICATION
1.
Applicant name
2.
Tax ID number
3.
NMFS person ID
4.
Permanent business mailing address
5.
Business telephone number
6.
Business fax number
7.
Business e-mail address
BLOCK B -- AMENDMENT 80 VESSEL IDENTIFICATION
1. Name of Amendment 80 vessel(s) owned by applicant to be used in the limited access fishery.
2. ADF&G vessel registration number
3. USCG documentation number
BLOCK C – AMENDMENT 80 LLP IDENTIFICATION
List the Amendment 80 LLP license number(s) held by the applicant that will be used in the limited access fishery.
BLOCK D – AMENDMENT 80 QS PERMIT INFORMATION
List the Amendment 80 QS permit number(s) held by the applicant that will be used in the limited access fishery.
BLOCK E – AMENDMENT 80 OWNERSHIP DOCUMENTATION
Names of all persons, to the individual level, holding an ownership interest in the Amendment 80 QS Permit(s)
held by the applicant; and
Percentage ownership each person and individual holds in the Amendment 80 QS Permit.
Name of Owner
% Interest
Joe Potpuller

25%

Alice Potpuller

25%

LLP Family Holdings, Inc.

50%

C. A80QSholder

25% (of 50%)

R. A80QSholder

25% (of 50%)

A. A80QSholder

25% (of 50%)

B. A80QSholder

25% (of 50%)

BLOCK F – EDR SUBMISSION
Indicate (YES or NO) whether the applicant has submitted a timely and complete EDR for each Amendment 80 QS
permit held by that person as required under § 679.94.
Application for A80 Limited Access Fishery Permit ― Page 4 of 5

BLOCK G -- APPLICANT CERTIFICATION
Enter applicant or authorized representative printed name, signature, and date signed.
If the application is completed by an authorized or designated representative, then explicit authorization must accompany
the application.

PUBLIC REPORTING BURDEN STATEMENT

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 0648-0565. Without this approval, we could not conduct this information collection. All responses to this information
collection are required to obtain or retain benefits and are required to manage commercial fishing efforts under 50 CFR part 679 and
under section 402(a) of the Magnuson-Stevens Act (16 U.S.C. 1801, et seq.) as amended by Public Law 109-479. Public reporting
burden for this information collection is estimated to average 2 hours per response, including the time for reviewing the instructions,
searching the existing data sources, gathering and maintaining the data needed, and completing and reviewing the information
collection. Send comments regarding the burden estimate or any other aspect of this information collection, including suggestions for
reducing the burden, to Assistant Regional Administrator, Sustainable Fisheries Division, NOAA National Marine Fisheries Service,
P.O. Box 21668, Juneau, AK 99802-1668.
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.
Purpose: NMFS uses information provided in this application to determine eligibility for the applicant to receive an Amendment 80
(A80) limited access fishery permit and to assign the permit. This permit authorizes the QS holder to catch, process, and receive
A80 species assigned to the A80 limited access fishery, or use halibut and crab prohibited species catch assigned to the A80 limited
access fishery, for the specified fishing year. The primary purpose for requesting the TIN is for the collection and reporting on any
delinquent amounts arising out of such person’s relationship with the government pursuant to the Debt Collection Improvement Act
of 1996 (Public Law 104-134). Personal information is confidential and protected under the Privacy Act (5 U.S.C. 552a). Business
information may be disclosed to the public.
Routing Uses: Disclosure of this information is subject to the published routine uses identified in the Privacy Act System of Records
Notice COMMERCE/NOAA-19, Permits and Registrations for the United States Federally Regulated Fisheries. NMFS posts some
information from this form on its public website (https://alaskafisheries.noaa.gov/). In addition, NMFS may share information
submitted on this application with other State and Federal agencies or fishery management commissions, including staff of the North
Pacific Fishery Management Council and Pacific States Marine Fisheries Commission. Other information is confidential under
section 402(b) of the Magnuson-Stevens Act and NOAA Administrative Order 216-100, which sets forth procedures to protect
confidentiality of fishery statistics.
Disclosure: Furnishing this information is voluntary; however, failure to provide complete and accurate information will prevent
determination of eligibility for an A80 limited access fishery permit.

Application for A80 Limited Access Fishery Permit ― Page 5 of 5