6700-020 Fishers Workshop Pledges

11 - Fishers Workshop Pledges (Multiple languages)
OMB Control Number: 2030-0051
This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq.
(OMB Control No. 2030-0051). Responses to this collection of information are voluntary (40 CFR). An agency may
not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a
currently valid OMB control number. The public reporting and recordkeeping burden for this collection of
information is estimated to be 15-30 minutes per response. Send comments on the Agency’s need for this
information, the accuracy of the provided burden estimates and any suggested methods for minimizing respondent
burden to the Regulatory Support Division Director, U.S. Environmental Protection Agency (2821T), 1200
Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not
send the completed form to this address.

1. Which language would you prefer to complete your pledge?
?
¿en qué idioma prefiere completar su promesa?
Bạn muốn hoàn thành tờ đồng ý của mình bằng ngôn ngữ nào? Hãy chọn ngôn ngữ mình
muốn.
English
/ Khmer
Español / Spanish
Tiếng Việt / Vietnamese

Form Number: 6700-020

11 - Fishers Workshop Pledges (Multiple languages)
Fishing Club Pledge (English)
OMB Control Number: 2030-0051
* 2. Participant ID

* 3. Which team are you with?

GAL Team

Khmer Team

Vietnamese Team

LARC Team

4. Fisher's Pledges
I commit to fish for salmon only in the Duwamish River.
I commit to share information with other fishers about alternative fishing locations with safer seafood
options.

* 5. Date of commitment:

Today's date

Date

MM/DD/YYYY

Form Number: 6700-020

11 - Fishers Workshop Pledges (Multiple languages)
Fishing Club Pledge (Khmer)

OMB Control Number: 2030-0051
* 6.
Participant ID

* 7.

?

Which team are you with?

GAL Team

Khmer Team

Vietnamese Team

8.

Fishers' Pledge Card (Khmer)
I commit to fish only for salmon in the Duwamish River.

I commit to share information with other fishers about alternative fishing locations with safer seafood
options.

* 9.
Date

Date / Time

Date

MM/DD/YYYY

Form Number: 6700-020

11 - Fishers Workshop Pledges (Multiple languages)
Fishing Club Pledge (Spanish)
Compromiso
OMB Control Number: 2030-0051
* 10. #ID del participante:
Participant ID:

* 11. En que equipo estas?
Which team are you with?

GAL Team

Khmer Team

Vietnamese Team

12. Compromiso
Fisher's Club Pledge
Me comprometo a pescar solamente salmón en el Río Duwamish.
I commit to fish only for salmon in the Duwamish River.
Me comprometo a compartir información con otros pescadores sobre lugares de pesca alternativos con
opciones de mariscos más saludables.
I commit to share information with other fishers about alternative fishing locations with safer seafood
options.

* 13. Fecha
Date

Date / Time

Date

DD/MM/YYYY

Form Number: 6700-020

11 - Fishers Workshop Pledges (Multiple languages)
Fishing Club Pledge (Vietnamese)
OMB Control Number: 2030-0051
* 14. số ID của quý vị
PARTICIPANT ID #

* 15. Bạn đang ở với đội nào?
Which team are you with?

GAL Team

Khmer Team

Vietnamese Team

16. Fisher's Workshop Pledge
Tôi cam kết chỉ đánh cá cho cá hồi ở sông Duwamish.
I commit to fish only for salmon in the Duwamish River.
Tôi cam kết chia sẻ thông tin với những ngư dân khác về các địa điểm đánh bắt thay thế với các lựa chọn hải
sản an toàn hơn.
I commit to share information with other fishers about alternative fishing locations with safer seafood
options.

* 17. Ngày cam kết:
Date of commitment:

Today's date

Date

MM/DD/YYYY

Form Number: 6700-020