Application for Registered Salmon Receiver (RSR) Permit

Created: xx/xx/xxxx

OMB Control No. 0648-XXXX Expiration Date: xx/xx/xxxx

APPLICATION FOR
REGISTERED SALMON
RECEIVER (RSR) PERMIT

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

This application is used to obtain a Registered Salmon Receiver Permit (RSR).
NOTE: A Salmon Federal Processor Permit must be obtained for any processing activity. The Registered Salmon
Receiver Permit is used solely for transporting fish from the initial point of offload to the point of processing or sale.
BLOCK A – NATURE OF THE RSRP FOR WHICH YOU ARE APPLYING
To be completed by all applicants.

New Application
Renewal of existing RSR Permit
Amendment to existing RSR Permit
Surrender Permit
If application is a renewal, surrender, or an amended application, provide current RSR permit number:
BLOCK B – APPLICANT
IDENTIFICATION

To be completed by all applicants

1. Name of Applicant:

2. NMFS Person ID Number::

3. Name of Contact Person (if Applicant is company, partnership, or other business entity):
4. Permanent Business Mailing Address:

5. Business Telephone Number:

6. Business Fax Number:

7. Business E-mail Address:

BLOCK C – TYPE OF ACTIVITY
(Facility/Vessel Identification)

1. Identify Salmon Receiver Operation (check appropriate box and enter information)
Vehicle
:
ADF&G Vessel Registration Number:

Vessel
Name of Vessel:

Vessel’s USCG Number:
Physical Location of Facility:

Facility
Name of Facility:

BLOCK D – SIGNATURE
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: (Note: If completed by representative, attach authorization.)

PERMIT
An RSR permit must be issued to, and displayed by, any processor that receives salmon. A separate permit is required
(and a separate application must be submitted) for each Registered Salmon Receiver. Only one permit (and one
application) is needed for any number of the permit holder’s salmon receivers. RSR permits are issued annually, for
salmon fishing years (July 1 through June 30).
Application forms and instructions are available on the NMFS Alaska Region web site at
https://www.fisheries.noaa.gov/region/alaska.
Additionally:
♦

Type or print legibly in ink.

♦

Retain a copy of the completed application for your records.

♦

Applications may be faxed to RAM at (907) 586-7354; however, permits will not be returned by fax. Do not
wait until right before an opening to apply for your permit, as you may not receive it on time.

When complete, mail the application to:
National Marine Fisheries
Service (NMFS), Alaska
Region Restricted Access
Management (RAM)
P.O. Box 21668
Juneau, Alaska 99802-1668
Or deliver to:

National Marine Fisheries
Service (NMFS), Alaska
Region Restricted Access
Management (RAM)
Room 713
Juneau, Alaska 99801

Or by fax to:

907-586-7354

Or email:

ram.alaska@noaa.gov

COMPLETING THE APPLICATION
BLOCK A – NATURE OF THE RSR FOR WHICH YOU ARE APPLYING
Indicate if the application is for a new permit, a renewal, an amendment to an existing permit. If
the application is a renewal or amendment, provide the current RSR permit number.

BLOCK B – APPLICANT IDENTIFICATION
1. Provide the name of the person applying to become an RSR.
2. Provide NMFS ID: If you do not have a NMFS ID, leave the field blank and NMFS will assign one.
3. Provide the name of an authorized representative for the applicant, if the applicant is a corporation,
partnership, association, or other non-individual business entity.
4. Provide the permanent business mailing address of the applicant. This is the address to which the RSR permit
will be sent.
5 – 7. Provide the business telephone number and business fax number, including area code, and business e-mail
address.
BLOCK C – TYPE OF ACTIVITY (Facility/Vessel Identification)
Identity of Salmon Receiver Operation.
If a vehicle, check “vehicle”
If a vessel, enter the name, Alaska Department of Fish & Game (ADF&G) vessel registration number, or the USCG
documentation number of the vessel.
If a facility, enter the name and physical location.
BLOCK D – SIGNATURE
Applicant must sign, print name, and enter date signed. Representatives acting on behalf of an applicant must attach
proof of authorization

Public Reporting Burden
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-XXXX. Without this approval, we could not conduct this information collection. Public reporting for this
information collection is estimated to be approximately 20 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.
All responses to this information collection are required to obtain benefits. Send comments regarding this burden estimate or any other
aspect of this information collection, including suggestions for reducing this burden to the Assistant Regional Administrator,
Sustainable Fisheries Division, NMFS Alaska Region, 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 is collecting this information to manage the Cook Inlet EEZ commercial salmon fishery.
Routine Uses: The Department will use this information to determine permit eligibility and to identify fishery participants.
Information collections by NMFS Alaska Region are protected under confidentiality provisions of section 402(b) of the
Magnuson-Stevens Act as amended in 2006 (16 U.S.C. 1801, et seq.) and under NOAA Administrative Order 216-100, which sets forth
procedures to protect confidentiality of fishery statistics. Disclosure of this information is permitted under the Privacy Act of 1974 (5
U.S.C. Section 552a) to be shared among authorized staff for work-related purposes. Personal information is confidential and protected
under the Privacy Act (5 U.S.C. 552a). Disclosure of this information is also subject to 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 mandatory. Failure to provide complete and accurate information may delay or prevent the
issuance of a Registered SalmonReceiver Permit