Application NMFS Authorized Distributor Prohibited Species Donation Program

Vessel Name

Vessel Use / Endorsement *

Pleasure
Commercial

Official Number *

Confirm Official Number *

Vessel Owner Contact Information

Name

First Last

Email *

Enter Email Confirm Email

Phone *

Fax

Address

Street Address Address Line 2 City State ZIP Code

Processor Owner / Plant Manager Contact Information

Name

First Last

Processor's Federal Fisheries Permit Number *

Email *

Enter Email Confirm Email

Phone *

Fax

Address

Street Address Address Line 2 City State ZIP Code

Description of arrangements for processing, shipping, storing, and transporting donated fish and an estimate of the associated costs:

Description Expertise in providing for the distribution of food product from remote Alaskan locations to hunger relief agencies, food bank networks, or food bank distributors, including arrangements for transportation, distribution costs, and product quality control:

Description of operating budget that is adequate to ensure that PSD fish are distributed to hunger relief agencies, food bank networks, or food bank distributors and that the fish will be maintained in a manner fit for human consumption:

Description quality control criteria for vessels, processors, hunger relief agencies, food bank networks, and food bank distributors:

Number of vessels that the applicant is capable of administering effectively:

Number of processors that the applicant is capable of administering effectively:

Locations where fish must be delivered by participating vessels and processors:

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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

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.

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BILLING ADDRESS

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

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