Pacific Salmon Treaty Voluntary Salmon Troll Licence Retirement Application

Part 1 – Applicant & Optional Representation

(Please PRINT clearly)

DFO USE ONLY
APP#
FIN
FIN

First Name

Initial

Surname

Company Name

I/We appoint(insert name) as the person to communicate with in regard to this application (optional).

Street Address

City

Province

Postal Code

Telephone Number

Fax Number (optional)

E-mail Address (recommended)

Part 2 – Information and Help

  1. For help on how to complete this application and general information, please read the companion documents.
  2. To speak with someone about your application, please contact Andria Charette at (604) 666-1640.
  3. Mail or fax the application to: Fisheries and Oceans Canada,
    Pacific Fishery Licence Unit,
    200 - 401 Burrard Street, Vancouver, BC, V6C 3S4,
    Fax: (604) 666-5855

Part 3 – Declaration and Signatures (each applicant only signs once)

I/We declare that the information given on this application is complete, true and correct.

I/We consent to any inquiries, audits and inspections necessary to verify the information given.

I/We hereby submit our offer as presented in Part 4 of this application.

I/We authorize the person, if any, designated in Part 1 to engage in all communication in regard to this application.

DFO USE ONLY
SA on file ( )
APP#
FIN
FIN
FIN

Applicant (Print clearly)

Signature

Date

Applicant (Print clearly)

Signature

Date

Applicant (Print clearly)

Signature

Date

If the vessel owner(s) is a company, only authorized signatories may sign the application on behalf of the company in accordance with the Fisheries (General) Regulations. Under the Regulations, only officers of the company may sign the application on behalf of the company. The Pacific Fishery Licence Unit (PFLU) must have on record a copy of the BC Company Summary identifying the signing authorities associated with the company. You should consult with a lawyer if you have any questions regarding the authorized signatories of the company in relation to the application.

DFO USE ONLY

Date Received:

Verified by:

Date:

Comments:

Part 4 – Offer

4a. Individual Salmon Troll Licence Eligibilities (including any associated Schedule II privileges)

Complete this section to offer one or more individual salmon troll licence eligibilities, one payment per eligibility. If you wish to retire less than all the salmon troll licence eligibilities held on vessel, only the shorter length licence may be retired.

VRN Vessel Name Homeport Licence Eligibility # Area Species Payment Requested
AT Salmon Troll $
$
$
$
$
Should you wish to retire less than all salmon troll licenses held on the above mentioned vessel, please indicate the Area you wish to retain.
AREA ____________

DFO USE ONLY

4b. Combination of Salmon Troll Licence Eligibilities Offered as a Package

Package: Retirement of all salmon troll licence eligibilities held on the vessel.

VRN Vessel Name Homeport Licence Eligibility # Area Species
AT Salmon Troll
AT Salmon Troll
           
           
           

DFO USE ONLY

Payment Requested: $