NOAA Fisheries Service Federal Application for Catch Sha

OMB Control No. 0648-0551 Exp. Date: 7/31/20XX

U.S. DEPT OF COMMERCE, NOAA
NMFS Catch Share Program, F/SER29
263 13th Avenue South
St. Petersburg, FL 33701-5511
Toll Free 866-425-7627 (8 a.m. - 4:30 p.m. ET)
727-824-5305 (8 a.m. - 4:30 p.m. ET)
https://secatchshares.fisheries.noaa.gov/

NOAA FISHERIES SERVICE
FEDERAL APPLICATION
FOR CATCH SHARES
ONLINE ACCOUNT

FOR OFFICE USE ONLY
Reviewer's Initials and Date ___________________________
Sanction Case Number if Sanctioned and date held
__________________________________________________
Date Sanction Released and Initials _____________________

Application ID

APPLICATION INSTRUCTIONS
1. Current Catch Share participants need to complete this application to certify they are or are NOT a United States citizen or a permanent resident

alien.
2. This application is to establish a Catch Share account for new participants and update account information for existing participants. However, a
valid commercial permit for Gulf reef fish and allocation are required to possess (at and after the time of the advance notice of landing), land
or sell Gulf reef fish subject to this Catch Share program.
3. Follow the instructions at the top of each section. Make sure all the information is correct then sign and date the application below. The Catch
Share applicant signing the application must be an account holder listed in section 1 and a United States citizen or permanent resident alien.
4. Mail your completed application to: U.S. Department of Commerce, NOAA, National Marine Fisheries Service F/SER29, 263 13th Avenue
South, St. Petersburg, FL 33701-5505.
Public reporting burden for this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send
comments regarding this burden estimate or any other suggestions for reducing this burden to PRA Officer, National Marine Fisheries Service,
F/SER2, 263 13th Avenue South, St. Petersburg, FL 33701-5505.
The National Marine Fisheries Service requires this information for the conservation and management of marine fishery resources. The data reported
will be used to develop, implement, and monitor fishery management activities for a variety of uses. Responses to this collection are required to obtain
or retain a Catch Shares online account under the Magnuson-Stevens Act. Non-confidential information will be released via a NOAA Fisheries Service
website. Non-confidential information means: name, address, city, state, zip code, etc. All other data submitted will be handled as confidential material
in accordance with NOAA Administrative Order 216-100, Protection of Confidential Fishery Statistics. Notwithstanding any other provisions of the
law, no person is required to respond to, nor shall any person be subjected to a penalty for failure to comply with, a collection of information subject to
the requirements of the Paperwork Reduction Act, unless that collection of information displays a currently valid OMB Control Number.

SIGNATURE OF APPLICATION
The undersigned certifies under penalty of perjury that the foregoing information is true and correct (28 USC 1746; 18 USC 1621; 18 USC 1001, 16
USC 1857). Knowingly supplying false information for the purpose of obtaining a Catch Share Online Account is a violation of Federal law
punishable by a fine and/or imprisonment. Please note: The individual signing below MUST be either the Catch Share account holder OR must be one
of the officers or shareholders that is a United States citizen or permanent resident alien listed in section 2 of this application.

Applicant Signature ________________________________ Position in Company (if applicable) ___________________________
Print Name_______________________________________ Date ____________________ UserID ____________
(if applicable)
Last form revision 07/20/2021

1. CATCH SHARE ONLINE ACCOUNT HOLDER INFORMATION
1) Check the appropriate box below if the applicant is a new or existing Catch Share online account holder. Provide the USER ID for an existing
account holder.
2) Complete this page for all Catch Share online account holders. If the account holder is a business, enter the Federal ID number and date the business
filed with the state. If the account holder is an individual, enter their Social Security Number and date of birth.
3) Check the appropriate box below to certify that the applicant IS or IS NOT a United States citizen or permanent resident alien.

4) If the Catch Share account is held by a business, please also complete Section 2 on page 4.
Check the appropriate box below:
NEW Catch Share online account holder
EXISTING Catch Share online account holder and provide the Catch Share Online account holder’s UserID: ________________
E-mail address: _________________________________________________________________________________________________

CATCH SHARE ONLINE ACCOUNT HOLDER INFORMATION
Check one: Individual/Sole Proprietorship
Joint Ownership
Partnership
______________
Certify Citizenship Status:
The applicant IS a United States citizen or permanent resident alien.
The applicant IS NOT a United States citizen or permanent resident alien.
Prefix

Last Name or Business Name

Corporation

First Name

If you are operating under a different name,
what is your Doing Business As (DBA) name?
Mailing Address
Apt/Suite

Other

Middle Name

Suffix

City

State

County/Parish

Zip Code

Country

City

State

County/Parish

Zip Code

Country

Physical Address
Apt/Suite

Check if same as mailing address

Tax ID number (FED ID or SSN)

Date of Birth or Date Business Filed (mm/dd/yyyy)

Area Code

Select one:

Primary Phone Number

Home

Work

Cell

ADDITIONAL CATCH SHARE ONLINE ACCOUNT HOLDER INFORMATION
Check one: Individual/Sole Proprietorship
Joint Ownership
Partnership
______________
Certify Citizenship Status:
The applicant IS a United States citizen or permanent resident alien.
The applicant IS NOT a United States citizen or permanent resident alien.
Prefix

Last Name or Business Name

Corporation

First Name

If you are operating under a different name,
what is your Doing Business As (DBA) name?
Mailing Address
Apt/Suite City

Other

Middle Name

Suffix

State

County/Parish

Zip Code

Country

State

County/Parish

Zip Code

Country

Physical Address
Check if same as mailing address

Tax ID number (FED ID or SSN)

Apt/Suite City

Date of Birth or Date Business Filed (mm/dd/yyyy)

Area Code

Primary Phone Number

Select one: Home

2

Work

Cell

ADDITIONAL CATCH SHARE ONLINE ACCOUNT HOLDER INFORMATION
1) Only complete this page for all additional Catch Share online account holders. If the account holder is a business, enter the Federal ID number and
date the business filed with the state. If the account holder is an individual, enter their Social Security Number and date of birth.
2) Check the appropriate box below to certify that the applicant IS or IS NOT a United States citizen or permanent resident alien.

Catch Share online account holder’s UserID (if applicable):

ADDITIONAL CATCH SHARE ONLINE ACCOUNT HOLDER INFORMATION
Check one: Individual/Sole Proprietorship
Joint Ownership
Partnership
______________
Certify Citizenship Status:
The applicant IS a United States citizen or permanent resident alien.
The applicant IS NOT a United States citizen or permanent resident alien.
Prefix

Last Name or Business Name

Corporation

First Name

If you are operating under a different name,
what is your Doing Business As (DBA) name?
Mailing Address
Apt/Suite

Other

Middle Name

Suffix

City

State

County/Parish

Zip Code

Country

City

State

County/Parish

Zip Code

Country

Physical Address
Check if same as mailing address

Tax ID number (FED ID or SSN)

Apt/Suite

Date of Birth or Date Business Filed (mm/dd/yyyy)

Area Code

Select one:

Primary Phone Number

Home

Work

Cell

ADDITIONAL CATCH SHARE ONLINE ACCOUNT HOLDER INFORMATION
Check one: Individual/Sole Proprietorship
Joint Ownership
Partnership
______________
Certify Citizenship Status:
The applicant IS a United States citizen or permanent resident alien.
The applicant IS NOT a United States citizen or permanent resident alien.
Prefix

Last Name or Business Name

Corporation

First Name

If you are operating under a different name,
what is your Doing Business As (DBA) name?
Mailing Address
Apt/Suite

Other

Middle Name

Suffix

City

State

County/Parish

Zip Code

Country

City

State

County/Parish

Zip Code

Country

Physical Address
Check if same as mailing address

Tax ID number (FED ID or SSN)

Apt/Suite

Date of Birth or Date Business Filed (mm/dd/yyyy)

Area Code

Select one:

3

Primary Phone Number

Home

Work

Cell

2. OFFICER/SHAREHOLDER INFORMATION FOR
CORPORATION/BUSINESS/LLC THAT HOLD THE CATCH SHARE ONLINE ACCOUNT
1) If this Catch Share online account is held by a business, then complete this section for EACH officer or partner associated with the business.
Provide the information for all officers or partners that are shown on your most recent annual report. If your business is structured as a corporation,
identify all shareholders in the corporation that own at least 1% or more of the shares, as well as the percentage of all shares in the corporation held
by each shareholder. Individuals holding less than 1% of the shares (minor shareholders) should not be individually listed. Total shareholders must
equal 100%. For all provide position held in business, name, address, social security number, date of birth, and telephone number.
2) Check the appropriate box below to certify that the applicant is or is NOT a United States citizen or permanent resident alien.

Business name _____________________________________ Federal Tax ID number ____________________

Officer or Shareholder Information
Check all that apply: President/CEO
Shareholder

Vice President

Secretary

Treasurer

Director/Manager

Other __________________

Percent (%) of corporation held: _______________________

Certify Citizenship Status:
The applicant IS a United States citizen or permanent resident alien.
The applicant IS NOT a United States citizen or permanent resident alien.
Prefix

Last Name

First Name

Mailing Address

Middle Name

Suffix

Apt/Suite

City

State

County/Parish

Zip Code

Country

Apt/Suite

City

State

County/Parish

Zip Code

Country

Physical Address
Check if same as mailing address

SSN

Date of Birth (mm/dd/yyyy)

Area Code

Select one:

Primary Phone Number

Home

Work

Cell

Additional Officer or Shareholder Information
Check all that apply: President/CEO

Vice President

________________

Secretary

Treasurer

Shareholder

Director/Manager

Other

Percent (%) of corporation held: _______________________

Certify Citizenship Status:
The applicant IS a United States citizen or permanent resident alien.
The applicant IS NOT a United States citizen or permanent resident alien.
Prefix

Last Name

Mailing Address

First Name

Middle Name

Suffix

Apt/Suite

City

State

County/Parish

Zip Code

Country

Apt/Suite

City

State

County/Parish

Zip Code

Country

Physical Address
Check if same as mailing address

SSN

Date of Birth (mm/dd/yyyy)

Area Code

Select one:

Primary Phone Number

Home

Work

Cell

_________ MINOR SHAREHOLDERS - Check here if one or more of your shareholders each individually hold shares that total less than 1% of the total shares of the
corporation/business/LLC. For example, there might be three shareholders whose total shares added together is 2% of the total shares but each shareholder
individually only holds 0.66% of the shares.
________ TOTAL PERCENTAGE (%) of corporation/business/LLC held by minor shareholder(s) that individually holds less than 1% of the total shares of the
corporation/business/LLC.

4

ADDITIONAL OFFICER/SHAREHOLDER INFORMATION FOR
CORPORATION/BUSINESS/LLC THAT HOLD THE CATCH SHARE ONLINE ACCOUNT
1) If this Catch Share online account is held by a business, then complete this section for EACH officer or partner associated with the business.
Provide the information for all officers or partners that are shown on your most recent annual report. If your business is structured as a corporation,
identify all shareholders in the corporation that own at least 1% or more of the shares, as well as the percentage of all shares in the corporation held
by each shareholder. Individuals holding less than 1% of the shares (minor shareholders) should not be individually listed. Total shareholders must
equal 100%. For all provide position held in business, name, address, social security number, date of birth, and telephone number.
2) Check the appropriate box below to certify that the applicant is or is NOT a United States citizen or permanent resident alien.

Additional Officer or Shareholder Information
Check all that apply: President/CEO

Vice President

________________

Secretary

Treasurer

Shareholder

Director/Manager

Other

Percent (%) of corporation held: _______________________

Certify Citizenship Status:
The applicant IS a United States citizen or permanent resident alien.
The applicant IS NOT a United States citizen or permanent resident alien.
Prefix

Last Name

First Name

Mailing Address

Middle Name

Suffix

Apt/Suite

City

State

County/Parish

Zip Code

Country

Apt/Suite

City

State

County/Parish

Zip Code

Country

Physical Address
Check if same as mailing address

SSN

Date of Birth (mm/dd/yyyy)

Area Code

Select one:

Primary Phone Number

Home

Work

Cell

Additional Officer or Shareholder Information
Check all that apply: President/CEO

Vice President

________________

Secretary

Treasurer

Shareholder

Director/Manager

Other

Percent (%) of corporation held: _______________________

Certify Citizenship Status:
The applicant IS a United States citizen or permanent resident alien.
The applicant IS NOT a United States citizen or permanent resident alien.
Prefix

Last Name

Mailing Address

First Name

Middle Name

Suffix

Apt/Suite

City

State

County/Parish

Zip Code

Country

Apt/Suite

City

State

County/Parish

Zip Code

Country

Physical Address
Check if same as mailing address

SSN

Date of Birth (mm/dd/yyyy)

Area Code

Select one:

Primary Phone Number

Home

Work

Cell

_________ MINOR SHAREHOLDERS - Check here if one or more of your shareholders each individually hold shares that total less than 1% of the total shares of the
corporation/business/LLC. For example, there might be three shareholders whose total shares added together is 2% of the total shares but each shareholder
individually only holds 0.66% of the shares.
________ TOTAL PERCENTAGE (%) of corporation/business/LLC held by minor shareholder(s) that individually holds less than 1% of the total shares of the
corporation/business/LLC.

5