Application for Review by Special Master of

NOAA Notice of Violation and Assessment (NOVA)

All applications must be postmarked no later than Friday, May 6, 2011. All applications must be sent to the following address:

Special Master for NOAA Enforcement Cases

c/o JAMS

One Beacon Street

Suite 2300

Boston, Massachusetts

02108

NAME OF

APPLICANT:

ADDRESS:

TELEPHONE

NUMBER:

EMAIL:

NAME OF

COUNSEL

(IF ANY):

ADDRESS:

TELEPHONE

NUMBER:

EMAIL:

NAME OF NOAA

ENFORCEMENT

ATTORNEY:

NAME OF NOAA

SPECIAL AGENT:

DATE OF

VIOLATION:

Attach copy of Enforcement Action Report. (EAR)

VESSEL

NAME:

VESSEL AND/OR

OPERATOR

PERMIT#:

VESSEL

NAME/DOC#:

OTHER PARTIES

CHARGED WITH THIS

VIOLATION(S):

DATE OF NOTICE OF

VIOLATION

ASSESSEMNT:

Attach copy of NOVA

DATE OF

SETTLEMENT

OR OTHER

RESOLUTION:

Attach copy of settlement agreement or other resolution.

AMOUNT OF

PENALTY PAID:

Please Check Yes or No in response to the following questions:

Was the NOVA(s) listed above issued on or after March 17, 1994? ____ Yes ____ No

Was the NOVA(s) listed above settled or otherwise resolved before February 3, 2010?

____ Yes ____ No

Was a civil penalty imposed and paid with respect to NOVA(s) listed above?

____ Yes ____ No

Is an appeal of the NOVA(s) listed above currently pending before an Administrative Law Judge or the NOAA Administrator ? ____ Yes ____ No

Has a federal district court judge has issued any ruling in relation to the NOVA(s) listed above? ____ Yes ____ No

Provide specific details outlining the events leading up to and including the issuance of the NOVA(s) listed above. Attach additional pages if necessary.
Provide specific details outlining the events following the issuance of the NOVA(s) listed above, including any procedural steps that were taken following issuance and their result. Attach additional pages if necessary.
Describe how the NOVA(s) listed above involve circumstances that fall into one of the following categories:
(1) Case in which a General Counsel for Enforcement and Litigation attorney charged an excessive penalty in a manner that unfairly forced settlement; OR
(2) Case in which conduct of the kind specifically enumerated in the Inspector General’s September 2010 Report prejudiced the outcome of the case. Attach additional pages if necessary.
Provide any other relevant information that will assist the Special Master in determining whether to review your NOVA. Attach additional pages if necessary.

Please attach any documentation related to the NOVA(s) listed above that you feel supports your case, including the following (where available):

·  Pleadings filed in connection with an appeal to an Administrative Law Judge (ALJ), the NOAA Administrator and/or a United States District Court

·  Correspondence exchanged between you (or a third party on your behalf) and NOAA

·  Other documents (please describe each document in the box below)

Disclosure Note

This application is being made to the Special Master and the information contained herein may be made available to employees of the Department of Commerce. This application may also be publicly available as a result of requests made pursuant to the Freedom of Information Act, 5 U.S.C. § 552, et. seq. Any personally identifiable information will be redacted from any documents that are made publicly available pursuant to 5 U.S.C. § 552(b)(6).

Declaration

I declare under penalty of perjury pursuant to 28 U.S.C. 1746 that the information contained in this application is true and correct.

Executed on:

______

Signature Date

2