Form 01-824 - Vessel License Change Of Information Form
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1COMMERCIAL FISHERIES ENTRY COMMISSION
8800 Glacier Hwy., #109
PO Box 110302, Juneau, AK 99811-0302
(907) 789-6150
Vessel License Change of Information Form
INSTRUCTIONS: This form may be used to add or change licensing information for a vessel which is already licensed for the current
year. Information which may be changed includes: (A) salmon net registration area, (B) salmon troll registration, and (C) owner’s name
and address. There is no fee for changing this information, however, the vessel license receipt for the current year must be submitted
along with this form.
The carbon copy of the completed form may be used as a temporary vessel registration ONLY if the bottom section of the form has
been signed by an employee of the Entry Commission, or an employee of the Department of Fish and Game or Divsion of Fish and
Wildlife Protection as authorized by the CFEC.
ADF&G Number
Vessel Name (
check here if this 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 fishing 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 fished in the original area of
registration. (If the vessel has already fished in the original area, the Commissioner of the Department of Fish and Game must au-
thorize 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 fishing in that
area.
The vessel has participated in salmon net fishing 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 at-
tached).
SALMON NET AREAS
Write in the letter representing the registration area (listed at right):
A - Southeastern
E - Prince William Sound
_________ Current salmon net registration area, if applicable.
H - Cook Inlet
K - Kodiak
_________ Area for which you wish to register the vessel.
L - Chignik
M - Peninsula-Aleutians
CFEC permit number of salmon net permit(s) to be fished on the vessel (example, S03T 99999):
T - Bristol Bay
W - Kuskokwim
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 sub-
mitted 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 5 AAC 29.115)
_______ Hand troll
_______ Power troll
Effective troll registration date: ______________________
(C) 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 cur-
rent year. The current year’s vessel license receipt MUST be returned with this form, or a Request for Duplicate form (and appropriate
fee) must also be submitted.
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
Mailing address for change (if different):
(D) CERTIFICATION
I, ________________________________, certify under penalty of perjury that all information contained on this document is true and
complete to the best of my knowledge and that I am the owner of the vessel or the owner’s authorized agent.
Signature of Owner or Owner’s Agent
Date
IN ORDER FOR THE CARBON COPY OF THIS FORM TO BE USED AS A TEMPORARY VESSEL LICENSE, IT MUST BE SIGNED BELOW BY AN EMPLOYEE OF THE
COMMERCIAL FISHERIES ENTRY COMMISSION, DEPARTMENT OF FISH AND GAME OR DIVISON OF FISH AND WILDLIFE PROTECTION.
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 fisheries research, management and licensing
purposes and may be disclosed to: the Alaska Department of Fish and Game, the National Marine fisheries service, Staff of the Pacific States Marine Fisheries Commis-
sion who are employed by the Alaska Fisheries Information Network project, the North Pacific Fisheries Management Council, Department of Public Safety, Department of
Revenue, child support enforcement agencies for child support purposes, and to other agencies or indificuals as required by law or court order. Name, address, and licenses
held are public information that may be released.
01-824 (REV. 05/07)
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