Reporting Form For Catch Documents Accompanying Fresh, Air-Shipped Shipments Of Toothfish - Us Department Of Commerce

OMB NO.:0648-0194

(Expires 03/31/2013)

UNITED STATES OF AMERICA

DEPARTMENT OF COMMERCE

NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION

ANTARCTIC MARINE LIVING RESOURCES

Reporting Form for Catch Documents Accompanying Fresh, Air-shipped Shipments of Toothfish

1. NAME OF IMPORTER (Contact Person): ___________________________________________________________________________

COMPANY NAME (Business):____________________________________________________________________________________

COMPANY ADDRESS: ______________________________CITY______________________ST______ZIP_____________________

PHONE NUMBER :_______________________________ FAX NUMBER:_______________________________________________

2. DATE OF ARRIVAL: _______________________________________________________________________________

3. PORT OF ARRIVAL (ALSO PORT OF UNLADING IF DIFFERENT THAN ARRIVAL): ____________________________________

4. CONSIGNEE(S) OF PRODUCT:___________________________________________________________________________________

5. AMOUNT TO BE IMPORTED (in kgs): _____________________________________________________________________________

6. U.S. CUSTOMS 7501 NUMBER : ........../........../........../........../........../........../.........../........../.........../........../.........

(MUST BE 11 DIGITS/CHARACTERS LONG)

7. AIRLINE AND FLIGHT NUMBER FOR THIS SHIPMENT:

_________________________________________________________________________________________________________________

THE FOLLOW ING ITEMS ARE FOUND ON THE DISSOSTICHUS CATCH DOCUMENT(s)

8. DOCUMENT NUMBER OF DCD(S): _______________________________________________________________________________

9. FLAG STATE CONFIRMATION NUMBER:________________________________________________________________________

10. EXPORT REFERENCE NUMBER: ________________________________________________________________________________

11. INDICATE W HETHER A RE-EXPORT DOCUMENT IS ALSO ACCOMPANYING THIS SHIPM ENT: Y or N

12. SIGNATURE: __________________________________TITLE:____________________________ DATE:_______________________

A fee for all shipments requiring pre-approval will be assessed at a rate of $200 per application which includes staff time plus overhead with this function

Return this form along with Catch Documents a minimum of 24 hours after importing resource(s) to the fax number below:

(228) 762-7144

Attention: CCAMLR Data Management

C om pletion of this application is required to obtain a permit to import A ntarctic marine living resources under provisions of the A ntarctic M arine Living R esources C onvention A ct

of 1984 (16 U SC 2431 et seq). N o authorization to import w ill be issued w ithout completion of this application. Pre-approval of toothfish imports enables N M FS to track all

imports and ensure that all A M LR are being imported in compliance with all applicable regulations

C ontinuing measures and U .S. regulations implementing them appear in

.

V olum e 50, Part 300, Subpart G of the C ode of Federal R egulations. A nnual measures are noticed in the Federal R egister and are also available at C C A M LR w ebsite located at

w .ccam

.

Public reporting burden for completing this form is estimated to average 15 minutes per response, including the time reviewing instructions, searching existing data sources, gathering

and maintaining the data needed, and completing and reviewing the collection of information. N otw ithstanding any other provision of the law, no person is required to respond nor

shall any person be subject to a penalty for failure to comply with, a collection of information subject to the requirements of the Paperw ork R eduction A ct, unless that collection of

information displays a currently valid O M B C ontrol N umber. Send Com ments regarding this burden estimate or any other aspect of this collection of information, including suggestions

for reducing this burden, to N ational M arine Fisheries Service, O ffice of International A ffairs, 1315 East W est Highw ay, A ttention: C C A M LR Permit O ffice, Silver Spring, M aryland,

20910.

To the extent permitted under the Trade Secrets A ct and the Freedom of Information A ct, N M FS w ill maintain the confidentiality of information determined to be a trade secret or

privileged and confidential commercial or financial information.