Crab CDQ and Community Allocation Permit Application

P.O. Box 110302
2015 Crab CDQ and Community Allocation
Juneau, Alaska 99811-0302
Phone: 907-789-6150/Toll Free within Alaska 1-855-789-6150
Permit Application
Fax 907-789-6170
www.cfec.state.ak.us
Use this form to apply for a CDQ and Community Allocation permit. Applicant information, fishery information, and certification sections
MUST be completed.
FOR PAYMENT SUBMIT A CHECK OR MONEY ORDER MADE PAYABLE TO THE STATE OF ALASKA OR IF PAYING WITH A CREDIT
CARD COMPLETE THE ATTACHED CREDIT CARD AUTHORIZATION.
The Alaska Department of Fish and Game manages the Crab CDQ and Community Allocation (CDQ/CA) fisheries occurring in the Bering Sea, Bristol Bay,
Aleutian Islands, Norton Sound and Adak areas. CDQ/CA groups must register with ADF&G and provide the Entry Commission with the names of the captains
and vessels harvesting their allocations. Individual captains authorized by each CDQ/CA group to operate fishing vessels must apply for a 2015 crab CDQ/CA
interim-use permit by completing this application. Captains must complete separate applications for each CDQ/CA group they fish.
Applicant Information:
Yrs.
Mos.
(
)
_____________________________________________________ ________________________________________________________
Applicant name - print clearly
How long at physical address? Telephone (Check if unlisted: ___ )
_____________________________________________________ ________________________________________________________
Permanent mailing address
Physical location of residence (where you live)
_____________________________________________________ ________________________________________________________
City
State
Zip
City
State
Zip
_____________________________________________________ ________________________________________________________
Email address
Temporary mailing address for these permits
_____________________________________________________ ________________________________________________________
Social security number
Birth date
City
State
Zip
Fishery Information: Provide the name and ID number of the CDQ/CA group for which you will be fishing. If you fish for more than one
group in a particular fishery, please complete a separate application form for each CDQ/CA group. Be sure to provide the ADF&G number
of the vessel you will fish in 2015. The vessel must be licensed for 2015 in order for the permit card to be issued. Fees for each fishery are
shown on the next page of this form.
Fishery
Name of CDQ/CA Group
GROUP ID#
Fishery Code and Permit #
Vessel ADF&G #
King crab, Aleutians
_______________________________
___________
____________________________ ________________
King crab, Bering Sea _______________________________
___________
____________________________ ________________
King crab, Bristol Bay _______________________________
___________
____________________________ ________________
King crab, Norton Sound _______________________________
___________
____________________________ ________________
Tanner crab, Bering Sea _______________________________
___________
____________________________ ________________
Golden King crab, Adak _______________________________
___________
____________________________ ________________
Nonresidents are required to pay an annual nonresident differential of $190 with issuance of their first 2015 permit:
Total permit fees due:
$ ________
$ ________
20 AAC 05.425(c) FEES SUBMITTED FOR AN INTERIM-USE PERMIT FOR A SPECIFIC FISHERY WILL BE REFUNDED ONLY IN THE EVENT OF A SEASON-LONG CLOSURE OF THE FISHERY OR IF
THE COMMISSION FINDS THAT A CIRCUMSTANCE APPLICABLE TO ALL PERMITTEES IN THAT FISHERY HAS PREVENTED A SUBSTANTIAL NUMBER OF PERMITTEES FROM PARTICIPATING.
Certification: You must complete this portion or there will be delays in processing
20 AAC 05.290. Residency Definition
For the purpose of assessing fees for the application for, annual issuance of, or renewal of entry and interim-use permits, an
individual is a resident of this state if, on the date of permit application, issuance, or renewal, and throughout the 12-month
period before that date, that individual maintained their domicile in this state and neither claimed residency in another state,
territory, or country nor obtained benefits under a claim of residency in another state, territory, or country.
Residency:
Alaska Resident
Nonresident
Citizenship:
U.S. Citizen
Alien* (Registration no. _________________ )
*Aliens must enclose a copy of their green card
I certify under penalty of perjury that the information contained herein is true and complete.
___________________________________________________
_________________________
Signature of Permit Holder (Authorization must be attached if signed or picked-up by someone else)
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 Commission 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 individuals as required by law or court order. Name, address, and licenses held are public information that may be released.
Revised August 2014
Form # 05-02A
PAGE 1
2015 CDQ/CA FISHERY CODE AND PERMIT FEE TABLE
King
g Crab
Tanner Crab
T
APICDA
Bering Sea
Pot gear VL under 60’ K09QA
Pot gear VL 60’ or over K91QA
Bristol Bay
Pot gear VL under 60’ K09TA
Pot gear VL 60’ or over K91TA
Aleutian Islands
Pot gear VL under 60’ K09OA
Pot gear VL 60’ or over K91OA
APICDA
Bering Sea
Pot gear VL under 60’ T09QA
Pot gear VL 60’ or over T91QA
$75
$2,625
BBEDC
Bering Sea
Pot gear VL under 60’ T09QB
Pot gear VL 60’ or over T91QB
$75
$3,000
CBSFA
Bering Sea
Pot gear VL under 60’ T09QC
Pot gear VL 60’ or over T91QC
$75
$3,000
CVRF
Bering Sea
Pot gear VL under 60’ T09QD
Pot gear VL 60’ or over T91QD
$75
$3,000
NSEDC
Bering Sea
Pot gear VL under 60’ T09QE
Pot gear VL 60’ or over T91QE
$75
$3,000
YDFDA
Bering Sea
Pot gear VL under 60’ T09QF
Pot gear VL 60’ or over T91QF
$75
$3,000
BBEDC
Bering Sea
Pot gear VL under 60’ K09QB
Pot gear VL 60’ or over K91QB
Bristol Bay
Pot gear VL under 60’ K09TB
Pot gear VL 60’ or over K91TB
Aleutian Islands
Pot gear VL under 60’ K09OB
Pot gear VL 60’ or over K91OB
CBSFA
Bering Sea
Pot gear VL under 60’ K09QC
Pot gear VL 60’ or over K91QC
Bristol Bay
Pot gear VL under 60’ K09TC
Pot gear VL 60’ or over K91TC
Aleutian Islands
Pot gear VL under 60’ K09OC
Pot gear VL 60’ or over K91OC
CVRF
Bering Sea
Pot gear VL under 60’ K09QD
Pot gear VL 60’ or over K91QD
Bristol Bay
Pot gear VL under 60’ K09TD
Pot gear VL 60’ or over K91TD
Aleutian Islands
Pot gear VL under 60’ K09OD
Pot gear VL 60’ or over K91OD
NSEDC
Norton Sound
Pot gear VL under 60’ K09ZE
Bering Sea
Pot gear VL under 60’ K09QE
Pot gear VL 60’ or over K91QE
Bristol Bay
Pot gear VL under 60’ K09TE
Pot gear VL 60’ or over K91TE
Aleutian Islands
Pot gear VL under 60’ K09OE
Pot gear VL 60’ or over K91OE
YDFDA
Norton Sound
Pot gear VL under 60’ K09ZF
Bering Sea
Pot gear VL under 60’ K09QF
Pot gear VL 60’ or over K91QF
Bristol Bay
Pot gear VL under 60’ K09TF
Pot gear VL 60’ or over K91TF
Aleutian Islands
Pot gear VL under 60’ K09OF
Pot gear VL 60’ or over K91OF
$75
$825
$75
$2,325
$75
$375
$75
$300
$75
$2,175
$75
$900
$75
$375
$75
$2,700
$75
$1,275
2014 Community Allocation
$75
$1,050
$75
$3,000
$75
$1,650
Golden (Brown)
(
) King
g
Adak
Pot gear VL under 60’ K09OG
Pot gear VL 60’ or over K91OG
$75
$3,000
$75
$75
$75
$75
$3,000
$75
$3,000
$75
$75
$75
$75
$2,400
$75
$1,050
Reduced fee: To apply for a reduced permit fee (half of the fee shown), submit a 2015 Reduced Fee Application and a complete copy of your 2013 or
2014 federal income tax return, or a copy of your QUEST card or other supporting documents showing you are currently receiving Public Assistance.
The Reduced Fee Application may be obtained from CFEC, our website, or your local ADF&G office. The reduced fee criteria for 2015 are based upon
Federal Food Stamp Guidelines.
PAGE 2
Credit Card Authorization
P.O. Box 110302
Juneau, Alaska 99811-0302
Phone: 907-789-6150/Toll Free within Alaska 1-855-789-6150
Fax 907-789-6170
www.cfec.state.ak.us
I authorize the Commercial Fisheries Entry Commission to charge the card indicated on this authorization.
This payment is for the items listed below, for the amount indicated below and is valid for a one time use. I
certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit
card company as long as the transaction corresponds to the information indicated on this form.
PLEASE NOTE: 20 AAC 05.425(c) FEES SUBMITTED FOR AN INTERIM-USE PERMIT FOR A SPECIFIC FISHERY
WILL BE REFUNDED ONLY IN THE EVENT OF A SEASON-LONG CLOSURE OF THE FISHERY OR IF THE COMMISSION FINDS THAT A CIRCUMSTANCE APPLICABLE TO ALL PERMITTEES IN THAT FISHERY HAS PREVENTED A SUBSTANTIAL NUMBER OF PERMITTEES FROM PARTICIPATING.
List the items below that you want to pay for:
Permit fees: $______________
List all the permit number(s) you are paying for: _________________________
Vessel fees: $______________
List all the vessel ADF&G number(s) you are paying for: __________________
Transfer fees: $_____________ (each transfer requires a $50.00 fee)
List all the permit number(s) you are paying for: _________________________
(Transfer fees are for permit or vessel permit transfers only)
If you want your licenses express mailed you must mark the space below:
__ Please express mail my licenses. I have checked the USPS website for the
current rate of express mail postage and I agree to pay the postage fee as well
as the additional service fee of $15.00.
Total fees to be charged on my credit card $ ________________________
Card holder name: _________________________________________________
Card holder phone number: _________________________________________________
Signature of card holder: ____________________________________________
Date: ________________
Account type: ____ VISA ______ MASTERCARD ______ DISCOVER
Expiration date: _________
Credit card #: _____________ - _____________ - _____________ - ____________
Note: The Entry Commission does not retain credit card information.
PAGE 3

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