Federal Permit / Certificate Application to Fish in Colombian Treaty Waters A brief description of the form or Application to be filled out here. Contact InformationName First Last Email* Enter Email Confirm Email Phone*Vessel InformationUSCG DOC. OR STATE REG. NO. VESSEL* Confirm USCG DOC. OR STATE REG. NO. VESSEL* Vessel Name Vessel Use / Endorsement* Pleasure Commercial Home Port and State USCG Documented Hail Port and State Radio Call Sign Does this vessel have an operational vms? Yes No Registered Length (FT.) Registered Breadth (FT.) Registered Depth (FT.) Gross Tons Net Tons Hold Capacity (Short Tons, 1 ST = 2,000 LBs) Refrigeration Type Ice Brine Spray Brine Blower/Blast Other Propulsion Type Gas Diesel Other Horsepower Hull Material Year Built Location Built Crew Size (Including Officers) Previous Vessel Names Vessel Flag Effective Dates Select the type of gear to be authorized by the HMS permitCommercial Harpoon Purse Seine Troll/Jig Longline Drift Gillnet Baitboat Recreational Charter Vessel Yes No Passenger Capacity Vessel Ownership InformationIS EACH HOLDER OF THIS PERMIT A U.S. CITIZEN (INCLUDING ALL MEMBERS OF AN ASSOCIATION OR JOINT VENTURE)? IF THE VESSEL IS OWNED BY A TRUST, PARTNERSHIP, CORPORATION, THE PERMIT HOLDER IS AN "ELIGIBLE OWNER" AS DESCRIBED ON PAGE TWO OF THIS FORM. Yes No Permit Holder and/or Company Name Date Corporation Filed EIN/SSN Business Address City State ZIP Business Telephone Business Fax Business Cell Phone Business Email Manging Owner Name First Middle Last Suffix Managing Owner Date of Birth MM slash DD slash YYYY Second Owner Name First Middle Last Suffix Second Owner Date of Birth MM slash DD slash YYYY Third Owner Name First Middle Last Suffix Third Owner Date of Birth MM slash DD slash YYYY 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 SignatureConsent* I agreeI 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.Owner's Signature*NAME:* Type your full name to sign this secure webformCAPACITY OF PERSON SIGNING (E.G., OWNER, AGENT, TRUSTEE, GENERAL PARTNER, CORPORATE OFFICER, MEMBER) Date MM slash DD slash YYYY Authorization* I agreeI 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 CardPlease check if you have activated a Stripe feed for your form. Having Trouble with your card? My card information is not workingCheck this box to move forward without your Credit Card.By clicking submit you agree to these Terms and Conditions and the above authorization of payment.
