Application for Eligibility to Receive QS / IFQ - Commercial Fishing Permits Center

FILLABLE_CLASS

Add name of CLASS under Advanced -> Default Value. Ex: Fillable_Alaska_1_999

Vessel Name

Vessel Use / Endorsement *

Pleasure
Commercial

Official Number *

Confirm Official Number *

Contact Information

Name

First Last

Email *

Enter Email Confirm Email

Phone *

Applicant Information

Vessel Owner Name

NMFS ID

Taxpayer ID or SSN

Is your business mailing address permanent or temporary?

Permanent
Temporary

Business Mailing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Business Telephone No.

Business Fax No.

Business Email Address

Are you a U.S. citizen?

Yes
No

If YES, enter Date of Birth

Are you a U.S. corporation, partnership, association or other non-individual business entity?

Yes
No

If YES, enter Date of Incorporation

Are you a resident of Adak, Alaska

Yes
No

If YES, enter date residency began

Freezer Shares

Is this TEC intended for an Entity that wishes to buy or lease Category A Quota Shares only?

Yes
No

Commercial Fishing Experience

Species

Gear

Location

Date From (MM/YY)

Date To (MM/YY)

Number of Actual Days Spent Harvesting Fish

Duties Performed While Directly Involved in the Harvesting of Fish (Be Specific)

Vessel Name

ADF&G or USCG Number

Vessel Owner

Vessel Operator

Reference Name

Reference's Relationship to You

Reference's Business Telephone Number

Reference's Business Mailing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Application Fee

Price:

RENEWAL ADVANCED PAYMENT OPTION

No Additional Years
2 year renewal
3 year renewal
4 year renewal
5 year renewal

Total

$0.00

Notary Certification

Consent *

I agree

I CERTIFY THAT THE RECITATIONS CONCERNING THE VESSEL: NAME, TONNAGE, DIMENSIONS, PROPULSION, OWNERSHIP, HAILING PORT, RESTRICTIONS, ENTITLEMENTS, REMARKS AND ENDORSEMENTS CONTAINED IN THE CERTIFICATE OF DOCUMENTATION REMAIN ABSOLUTELY THE SAME.

NAME: *

Type your full name to sign this secure webform

Signature *

CAPACITY OF PERSON SIGNING (E.G., OWNER, AGENT, TRUSTEE, GENERAL PARTNER, CORPORATE OFFICER, MEMBER)

Date

Authorization *

I agree

I agree to pay the above total amount according to the card issuer agreement and hereby authorize the charge for the total amount above for the processing of selected permits. I understand that my application will be processed in the order in which it is received by Commercial Fishing Permits Center, a private fee-for-service documentation company, not owned or operated by any governmental agency. I understand that application and processing fees are non-refundable as per Commercial Fishing Permits Center's no refund policy. I understand that submitting another application for a license or permit will supersede the current/pending application for that license or permit. I understand that Commercial Fishing Permits Center does not issue or sell any licenses or permits.

Credit Card

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My card information is not working

Check this box to move forward without your Credit Card.

BILLING ADDRESS

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

By clicking submit you agree to these Terms and Conditions and the above authorization of payment.