Form 05-15a - Commercial Fisheries Entry Commission Vessel License Change Of Information Form

Download a blank fillable Form 05-15a - Commercial Fisheries Entry Commission Vessel License Change Of Information Form in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form 05-15a - Commercial Fisheries Entry Commission Vessel License Change Of Information Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

Commercial Fisheries Entry Commission

8800 Glacier Hwy., #109

PO Box 110302, Juneau, AK 99811-0302

Vessel License Change of Information Form

phone 907-789-6150/fax 907-789-6170

INSTRUCTIONS:

This form may be used to add or change licensing information for a vessel which is already licensed for the current year. There is no fee

for changing this information, however, the vessel license receipt for the current year must be submitted along with this form. A copy of the completed form may be

used as a temporary vessel license ONLY if the bottom section of the form has been signed by an employee of the Entry Commission, the Department of Fish and

Game or the Division of Wildlife Troppers as authorized by the Entry Commission.

__________________

___________________________________________________

_______________________________

ADF&G Number

Vessel Name ___ check here if this is a new name for vessel

USCG Document number or

State registration number

(A) SALMON NET AREA REGISTRATION

Complete this section to register a vessel for salmon net ﬁ shing if the salmon net area was not designated at the time the vessel was licensed for the current year.

You may also change the designated area, as long as the vessel has not ﬁ shed in the original area of registration. If the vessel has already ﬁ shed in the

original area, the Commissioner of the Department of Fish and Game must authorize the request to re-register in a different area and a copy of the authorization

must be attached to this form. The current year’s vessel license receipt MUST be returned with this form.

____ The vessel has been licensed but has not yet been registered for a salmon net registration area for 20_____.

____ The vessel has been registered for a salmon net registration area in 20_____ but has NOT participated in salmon ﬁ shing in that area.

____ The vessel has participated in salmon net ﬁ shing in 20______ in the original registration area, but I have been authorized by the Commissioner of Fish

and Game to re-register the vessel as provided in 5AAC 39.120. A copy of the authorization must be attached.

Salmon Net Areas:

Current salmon net registration area, if applicable. _____________________________________

A - Southeast

E - Prince William Sound

H - Cook Inlet

K - Kodiak

L - Chignik

M - Peninsula/Aleutians

Area for which you wish to register the vessel. ________________________________________

T - Bristol Bay

CFEC permit number of salmon net permit(s) to be ﬁ shed on the vessel (example, S03T 99999):

1) S0______________________________ 2) S0______________________________ 3) S0______________________________

(B) SALMON TROLL REGISTRATION

Complete this section to add salmon hand troll or power troll registration, or to change the registration, ONLY if the form is being submitted prior to the start

of the troll season. The current year’s vessel license receipt MUST be returned with this form. Check hand or power troll below and indicate the date you wish the

registration to be effective. See regulation 5 AAC 29.115

____Hand troll

____Power troll

Effective troll registration date: ________________________________

Indicate which ﬁ shing activities or gear codes you want to add to your vessel license. The current year’s vessel license receipt MUST be returned with this form.

Fishing activities:

Gear Codes:

__ 92 Commercial Fishing

__ 01 Purse Seine

__ 02 Beach Seine

__ 03 Drift Gillnet

__ 04 Set Gillnet

__34 Herring Gillnet __ 05 Hand Troll

__ 87 Freezer/Canner

__ 15 Power Troll

__ 25 Dinglebar Troll __ 26 Mech Jig

__ 06/61 Long Line __ 09/91 Pot Gear

__ 10 Ring Nets

__ 88 Tender/Packer

__ 08 Fish Wheel

__ 11 Dive

__ 22 Dredge

__ 17 Beam Trawl

__ 07 Otter Trawl

__ 27 Dbl Otter Trawl

__ 89 Transporter

__ 37 Pair Trawl

__ 99 Other Gear

(D) VESSEL OWNERSHIP INFORMATION

Complete this section to change the name and address of the vessel owner if it has changed since the license was issued for the current year. The current year’s

vessel license receipt MUST be returned with this form. If you do not have the current vessel license you must submit a Request for Duplicate form and appropriate

fee. Has vessel ownership changed since it was licensed for the current year? ______YES ______NO

Date of ownership change: ________________

___________________________________________________________ ____________________________________

___________________

New owner’s name (please print)

Social security number

Date of Birth

___________________________________________________________ _______________________________________________________________

Permanent mailing address

City

State

Zip

___________________________________________________________ _______________________________________________________________

Temporary mailing address (if different)

City

State

Zip

___________________________________________________________

____________________________

Signature of vessel owner or authorized agent

Date

___________________________________________________________________________________________________________________________________________

Signature of CFEC, ADFG or FWP Employee

Name (Printed)

Title or Badge No.

Date

Under AS 16.05.815 and AS 16.05.480, social security numbers and other information required on this form may be used for ﬁ sheries research, management and licensing purposes and may be disclosed to: the Alaska Department of Fish and

Game, the National Marine ﬁ sheries service, Staff of the Paciﬁ c States Marine Fisheries Commission who are employed by the Alaska Fisheries Information Network project, the North Paciﬁ c Fisheries Management Council, Department of Public

Safety, Department of Revenue, child support enforcement agencies for child support purposes, and to other agencies or individuals as required by law or court order. Name, address, and licenses held are public information that may be released.

Form# 05-15A

Revised September 2009