Application for American Fisheries Act (AFA) Inshore Catcher Vessel Cooperative Permit

This form may be used to apply for an American Fisheries Act (AFA) Inshore Catcher Vessel Cooperative Permit.

A brief description of the form or Application to be filled out here.

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*
Cooperative Contact Information
Name of Cooperative
Name of Cooperative Representative
Is your business mailing address permanent or temporary?
- Permanent
- Temporary
Co-op Business Mailing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Business Telephone Number
Business Fax Number
E-mail Address
Designated Cooperative Processor Information
Name
Physical location of AFA Inshore Processor
Federal Processor Permit Number
Vessel Information
Vessel Name ADF&G Number Actions

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Application Fee
Price:
RENEWAL ADVANCED PAYMENT OPTION
- No Additional Years
- 2 year renewal +$75.00
- 3 year renewal +$150.00
- 4 year renewal +$225.00
- 5 year renewal +$300.00
Total
$450.00
Certification of Transferor
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
MM slash DD slash YYYY
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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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.

Vessel Name	ADF&G Number	Actions
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Contact Information

Cooperative Contact Information

Designated Cooperative Processor Information

Vessel Information

Certification of Transferor