Groundfish Trawl Rationalization Ownership Interest - Commercial Fishing Permits Center

Contact Information

Name

First Last

Email *

Enter Email Confirm Email

Phone *

Section A - Applicant Information

Permit Number

or

Vessel Name

Vessel Use / Endorsement *

Pleasure
Commercial

USCG Doc or State Registration Number *

Confirm USCG Doc or State Registration Number *

Legal Name of Permit or Vessel Owner

First Middle Last

TIN (if business)

DOB (if person)

Stage Registered In (if business)

Address

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

Business Phone

Business Fax

Business Email

Section B - Identification of Shareholders and Partners

Part 1 - First Level

Name (Last, First, Middle Initial)	TIN or DOB	Business Mailing Address (Street or PO Box, City, State, Zip Code)	% Interest Held

Total Ownership (%)

NOTE: Owners of a business entity from Section B - Part 1 above must be listed down to the level of individual persons that make up that business. If more than one business is listed, be clear which individuals belong to which business.

Business Name 1 from Part 1

Name (Last, First, Middle Initial)	TIN or DOB	Business Mailing Address (Street or PO Box, City, State, Zip Code)	% Interest Held

Total Ownership of Business 1 (%)

Business Name 2 from Part 1

Name (Last, First, Middle Initial)	TIN or DOB	Business Mailing Address (Street or PO Box, City, State, Zip Code)	% Interest Held

Total Ownership of Business 2 (%)

Business Name 3 from Part 1

Name (Last, First, Middle Initial)	TIN or DOB	Business Mailing Address (Street or PO Box, City, State, Zip Code)	% Interest Held

Total Ownership of Business 3 (%)

Section C - Small Business Certification

Is your business or organization:

Independently owned and operated, and
not dominant in its field of operation (including and affiliates), and
considered small by the standards listed in the table above?

Have you answered yes to all of these questions?

Yes
No

Section D - Certification of Applicant

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

Applicant Signature

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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