Federal Permit Application for Vessels Fishing for Wreckfish Off The South Atlantic States

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_12_10
Contact Information
Vessel Use / Endorsement*
- Pleasure
- Commercial
Name
First Last
Email*
Enter Email Confirm Email
Phone*
Section 1: Vessel Information
Official Number From USCG Certificate Of Documentation (If the vessel is documented)
Year Built
Length (ft)
Total Horsepower
State Registration Number
Vessel Name
Hull Identification Number (HIN)
Hailing Port City
Hailing Port County or Parish
Hailing Port State
USCG Documented Vessels Only*
Gross Tons
Net Tons
International Maritime Organization (IMO) Number
As applicable (see instructions)
Passenger Capacity Data For Charter Vessels/Headboats Only
- UNINSPECTED VESSEL - “6-PACK”
- USCG INSPECTED VESSEL
Specify Passenger Capacity as listed on the USCG Certificate of Inspection, not including Capt. and Crew.
Crew Size - Including the Captain, but not including passengers
HOLD or FISH BOX CAPACITY
How many pounds of product can you bring to the dock when full?
Hull Material
- Fiberglass
- Wood
- Steel
- Aluminum
- Other (Describe)
Describe
Fuel Data
- Diesel
- Gasoline
- Other (Describe)
Describe
Total Gallons
Product Storage
- ON ICE IN HOLD, FISH BOX, ICE CHEST, COOLER, ETC
- Freezer
- Live Well
Section 2: Wreckfish Shareholder Information
Is the Wreckfish Shareholder an Individual or Business?
- Individual
- Business
Shareholder's Certificate Number
Is this the mailing recipient?
All mail about this permit will go to this individual
- Yes
- No
Is this individual a United States Citizen or permanent resident alien?
- Yes
- No
What is this individual's Sex?
- Male
- Female
Is this Individual of Hispanic, Latino, or Spanish origin?
- Yes
- No
What is this individual’s race?
- White
- Black or African American
- American Indian or Alaska Native
- Asian American
- Native Hawaiian or Other Pacific Islander
- Other
Describe
Name
First Middle Last Suffix
If you are operating under a different name, what is your Doing Business As (DBA) name?
Tax ID Number (SSN)
Date of Birth (MM/DD/YYYY)
MM slash DD slash YYYY
Area Code
Phone Number
Mailing Address
Apt #
City
State
County/Parish
Zip Code
Country
Is the physical address the same as the mailing address?
- Yes
- No
Physical Address
Apt #
City
State
County/Parish
Zip Code
Country
Would you like to receive digital updates (texts & emails)?
- Yes
- No
Email
Cell Phone Number and provider
Type of business
- S Corporation
- C Corporation
- Cooperative
- Limited Liability Co.
- Partnership
- Other
Describe
Was this Business properly established by the laws of the United States or any state of the United States?
- Yes
- No
Is this the mailing recipient
All mail about this permit will go to this business
- Yes
- No
Registered Name of Business
Tax ID Number (FEIN)
Date Business Formed (MM/DD/YYYY)
MM slash DD slash YYYY
Area Code
Phone Number
Mailing Address
Apt #
City
State
County/Parish
Zip Code
Country
Is the Physical Address the same as the mailing address?
- Yes
- No
Physical Address (PO Box not acceptable)
Apt#
City
State
County/Parish
Zip Code
Country
Would you like to receive digital updates (texts & emails)?
- Yes
- No
Email
Cell Phone number and provider
Section 3: Individual Vessel Owner(s) Information
Section 3
- If the vessel's USCG documentation or state registration indicates the vessel is owned by one or more individuals, fill out Section 3.
Complete Section 3 for all owners listed. Complete Section 3a for an individual owner. Also fill out Section 3b if the vessel is jointly owned by another individual. Photocopy Section 3 as necessary to provide information for all individuals that own the vessel.
Section 3a: Primary or Sole Owner: Complete this section if there is one or more individual shown on the USCG documentation, State Registration or title as the registered owner of the vessel. Select only ONE mailing recipient.
Is this individual a United States Citizen or permanent resident alien?
- Yes
- No
What is this individual's Sex?
- Male
- Female
Is this Individual of Hispanic, Latino, or Spanish origin?
- Yes
- No
What is this individual’s race?
- White
- Black or African American
- American Indian or Alaska Native
- Asian American
- Native Hawaiian or Other Pacific Islander
- Other
Describe
Name
First Middle Last Suffix
If you are operating under a different name, what is your Doing Business As (DBA) name?
Tax ID Number (SSN)
Date of Birth (MM/DD/YYYY)
MM slash DD slash YYYY
Area Code
Phone Number
Mailing Address
Apt #
City
State
County/Parish
Zip Code
Country
Is the physical address the same as the mailing address?
- Yes
- No
Physical Address
Apt #
City
State
County/Parish
Zip Code
Country
Would you like to receive digital updates (texts & emails)?
- Yes
- No
Email
Cell Phone Number and provider
Complete this section if there is more than one individual shown on the USCG documentation, State Registration or title as the registered joint owner of the vessel.

Section 3b: Joint Owner

Name	Tax ID Number (SSN)	Date of Birth (MM/DD/YYYY)	Phone Number	Apt #	Actions

There are no Entries.

Section 4: Business Vessel Owner(s) Information
Section 4
- If the vessel's USCG documentation or state registration indicates the vessel is owned by one or more businesses, fill out Section 4.
Complete section 4 for all the business owners listed. Please complete section 4b, if the vessel is jointly owned by another business.
Type of business
- S Corporation
- C Corporation
- Cooperative
- Limited Liability Co.
- Partnership
- Other
Describe
Was this Business properly established by the laws of the United States or any state of the United States?
- Yes
- No
Is this the mailing recipient
All mail about this permit will go to this business
- Yes
- No
Registered Name of Business
Tax ID Number (FEIN)
Date Business Formed (MM/DD/YYYY)
MM slash DD slash YYYY
Area Code
Phone Number
Mailing Address
Apt #
City
State
County/Parish
Zip Code
Country
Is the Physical Address the same as the mailing address?
- Yes
- No
Physical Address (PO Box not acceptable)
Apt#
City
State
County/Parish
Zip Code
Country
Would you like to receive digital updates (texts & emails)?
- Yes
- No
Email
Cell Phone number and provider
Section 4b: Joint Owner: Complete this section if there is another business shown on the USCG Documentation, State Registration or Title as the registered joint owner of the vessel.

Section 4b Joint Owners

Registered Name of Business	Tax ID Number (FEIN)	Date Business Formed (MM/DD/YYYY)	Phone Number	Actions

There are no Entries.

Section 5: Lease Information
Lease Type
- Leased by one or more individuals
- Leased by one or more businesses
Lease start date
MM slash DD slash YYYY
Lease end date
MM slash DD slash YYYY

Section 5a: Individual or Joint Lessee:

Name	Tax ID Number (SSN)	Area Code	Phone Number	Actions

There are no Entries.

Section 5b: Business Lessee: Complete this section if a business is leasing the vessel from the vessel owner. If a business is leasing the vessel, officer and owner information for the business must be provided in section 6.

Section 5b: Business Lessee:

Registered Name of Business	Tax ID Number (FEIN)	Phone Number	Actions

There are no Entries.

Section 6: Businesses that own businesses
Section 6
- If the vessel is Owned or Leased by a business which is owned by another business, complete Section 6.
Complete this section for any business that owns more than 1% of any business within the ownership hierarchy of vessel owners or lessees listed in section 5a, 5b, or 6b. For every business, the sum of ownership, by either individuals or other businesses, must total 100%.

Section 6: Business Owner

Registered Name of Business	Tax ID Number (FEIN)	Phone Number	Actions

There are no Entries.

Section 7: Business Officers and Individual Owners
Section 8
- If the vessel is Owned or Leased by a business, complete Section 7.
Complete this section for any individual that owns more than 1% of any business within the ownership hierarchy of vessel owners or lessees, as listed in sections 2b, 4, 5b, and 6. For every business, the sum of ownership, by either individuals or other businesses, must total 100%.

Example: If a vessel’s USCG documentation indicates that the vessel is owned by Company A,provide information about all owners and officers of Company A. If Company A is also owned in whole or part by Company B, complete section 8 to provide information about all individual owners and officers of Company A and Company B.

Section 7: Individual Officer/Owner:

Tax ID Number (SSN)	Date of Birth (MM/DD/YYYY)	Phone Number	Actions

There are no Entries.

Section 8: Small Business or Organization Certification
All applicants must complete this section.

● For vessels that are leased, complete this section for business(es), including sole proprietorship(s),or organization(s) that lease the vessel.

● For vessels that are not leased, complete this section for business(es), including sole proprietorship(s), or organization(s) that own the vessel (i.e., the business(es), including sole proprietorship(s), or organization(s) that appear on the vessel’s USCG documentation or state registration)
Is the business primarily involved in harvesting seafood (commercial fishing)?
- Yes
- No
1A) Was the business active prior to this year?
- Yes
- No
1B) What was the most recent year the business was active prior to this year?
1B) Did the business have more than $11 million in gross receipts in that year?
- Yes
- No
Is the business primarily involved in for-hire fishing services (charter, party/ headboat)?
- Yes
- No
2A) Was the business active prior to this year?
- Yes
- No
2B) What was the most recent year the business was active prior to this year?
2B) Did the business have more than $7.5 million in gross receipts in that year?
- Yes
- No
Is the business primarily involved in buying and selling seafood (seafood dealer/wholesaler)?
- Yes
- No
3A) Was the business active prior to this year?
- Yes
- No
3B) What was the most recent year the business was active prior to this year?
3B) Did the business have more than 100 employees?
- Yes
- No
Is the business primarily involved in processing seafood (seafood processor)?
- Yes
- No
4A) Was the business active prior to this year?
- Yes
- No
4B) What was the most recent year the business was active prior to this year?
- Yes
- No
4B Did the business have more than 750 employees?
- Yes
- No
Is the organization an Environmental, Conservation and Wildlife, or Professional Non-Profit Organization?
- Yes
- No
5A) Was the organization active prior to this year?
- Yes
- No
5B) What was the most recent year the organization was active prior to this year?
5B) Did the organization have more than $15 Million in gross receipts?
- Yes
- No
Is the organization some other Non-Profit Organization (e.g., business association)?
- Yes
- No
6A) Was the organization active prior to this year?
- Yes
- No
6B) What was the most recent year the business was active prior to this year?
6B) Did the organization have more than $7.5 Million in gross receipts?
- Yes
- No
The business or organization must be primarily involved in another industry not related to fishing or seafood. Refer to SBA’s list of NAICS codes (see https://go.usa.gov/xRGvQ) and enter the NAICS code for your primary activity here:
Based on the applicable SBA size standard, check the appropriate box to indicate if the business or organization is Large or Small and report the year on which that conclusion was based.
- Large
- Small
Year
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
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.
Applicant Signature*
Position in Business
Date
MM slash DD slash YYYY
NAME:*

Type your full name to sign this secure webform
Designated Operator Signature*
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
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Contact Information

Section 1: Vessel Information

Section 2: Wreckfish Shareholder Information

Section 3: Individual Vessel Owner(s) Information

Section 4: Business Vessel Owner(s) Information

Section 5: Lease Information

Section 6: Businesses that own businesses

Section 7: Business Officers and Individual Owners

Section 8: Small Business or Organization Certification

Certification of Transferor