VMS Certification Statement for Atlantic Highly Migrator

OMB #0648-0372
Expires 12/31/2023

Vessel Monitoring Systems Certification Statement
for Atlantic Highly Migratory Species Fisheries
INSTRUCTIONS: This form should be completed and signed by the owner and the qualified marine
electrician that installed the VMS unit on the vessel named below. The completed form should be sent to
NOAA Office of Law Enforcement, 263 13th Avenue South, Suite 109, St. Petersburg, Florida 33701. This
Vessel Monitoring Systems (VMS) Certification Statement for the Highly Migratory Species (HMS) Fisheries
is provided by the National Marine Fisheries Service (NOAA Fisheries) pursuant to the regulatory
requirements of 50 C.F.R. § 635.69. This certification statement is applicable for the VMS providers currently
approved for use in HMS fisheries.
A qualified marine electrician must follow the manufacturer’s installation procedures when installing or reinstalling a NOAA Fisheries-approved VMS unit. The vessel owner is responsible for all installation and
activation costs. After completion of the installation and activation, the owner should confirm that NOAA
Fisheries is receiving position reports by calling NOAA Office of Law Enforcement in St. Petersburg, Florida,
at, 800-758-4833 or by sending an e-mail to NMFS.OLE.SE@noaa.gov.

Vessel Name:___________________ U.S Coast Guard Documentation Number:_______________
Installing marine electrician or dealer (name, address, and telephone number):
_________________________________________________________________________________
_________________________________________________________________________________
Date of Installation (mm/dd/yyyy):__________________
VMS Enhanced Mobile Transceiver Unit (E-MTU):
Manufacturer name:_________________________________________________________________
Model:___________________________________________________________________________
Manufacturer serial number (S/N):_____________________________________________________
Communication network serial number (ISN):____________________________________________
VMS Mobile Communications Service Provider (MCSP)
Communications provider name:________________________________
Communications ID number assigned by service provider:____________________
Once the VMS E-MTU was installed, did the electrician/dealer, or the owner and/or operator of the
vessel verify with NOAA OLE VMS Program personnel that position data was being received?
Yes No
Certification:
In accordance with 50 C.F.R. § 635.69(d), as a qualified marine electrician, I hereby certify that the
VMS system on the vessel named above has been installed in compliance with applicable procedures.
Vessel Owner/Operator’s Name: ______________________________________________
Vessel Owner/Operator’s Signature___________________________ Date: ____________
Installer’s Name:___________________________________________________________
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OMB #0648-0372
Expires 1/31/2020

Installer’s Signature:________________________________________ Date:____________
Under the provisions of the Paperwork Reduction Act of 1995 (PL 104-13) and the Privacy Act of 1974 (PL 93-579), you are advised that disclosure of
the information requested in the Vessel Monitoring System (VMS) certification statement is mandatory for the purpose of managing the Atlantic HMS
fisheries. The certification statement is used to ensure proper operation of the VMS unit. Reporting burden for the collection of information is
estimated to average 4 hours per installation, including time for reviewing instructions, searching existing data sources, gathering and maintaining data
needed, and completing and reviewing the information. The burden for submission of this certification statement is estimated at 5 minutes per response.
Confidentiality of the information provided will be treated in accordance with NOAA Administrative Order 216-100. It is the policy of the National
Marine Fisheries Service not to release confidential data, other than in aggregate form, as the MSA protects the confidentiality of those submitting data.
Whenever data are requested, NMFS ensures the information identifying the pecuniary business activity of a particular individual is not identified. This
information collection has been issued a valid OMB control number, and is subject to the requirements of the Paperwork Reduction Act and penalties
associated with non-compliance. Send comments regarding this burden estimate or suggestions for reducing this burden to: NMFS, Office of Law
Enforcement, 8484 Georgia Avenue, Suite 415, Silver Spring, MD 20910.

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