SOUTH GEORGIA AND SOUTH SANDWICH ISLANDS

FISHING LICENCE APPLICATION FORM

To:Director of Fisheries

Government House

Stanley

Falkland Islands

Tel:+ 500 28214

Mackerel icefish fishery

Application Form for the2015/16 and 2016/17seasons

This application form plus the required documentation must be submitted to the Director of Fisheries by 1630hrs (Stanley time) on 13January2016. This application should be completed and submitted as the sole attachment to an e-mail sent to the Director of Fisheries. All other documentation should be submitted electronically in a separate e-mail.

Please consult the Icefish Licensing2015/16 and 2016/17Information for Applicantsdocument before completing this form.

1.APPLICATIONSUMARY

APPLICANT DETAILS
Name
Company
Address
Role of applicant (owner, charterer or operators)*
Telephone
E-mail address
Vessel
Flag state
Quota requested in 48.3 (2016)
Quota requested in 48.3 (2017)
Intended fishing periods

*Note the applicant should ordinarily be the operator of the vessel.

2. VESSEL INFORMATION (Please provide supporting documentation)

VESSEL DETAILS
Vessel name / Previous name of vessel
Call sign / Previous call sign
IMO Number / Flag state of vessel
Port of registry / Age of vessel
Ice classification / Yes
No / Previous seasons in the South Georgia fishery
Torremolinos compliance as assessed by GSGSSI or MCA?
If no Torremolinos inspection has been done, GSGSSI can arrange an inspection for successful applicants. / Yes
No / Date of Torremolinos Inspection by GSGSSI or MCA

RECENT HISTORY OF VESSEL

Please provide details of the vessel’s operations for the previous two years (Jan 2014to Dec 2015)

Start Date / End Date / Activity / Location / Target species

Validated (by the flag-state) VMS records must be provided with this application for the period 1stJanuaryto 31st December2015. Please also provide the records in Excel format. Further VMS records may be requested in advance of the fishing season.

FISHING MASTER AND CREW

Name (s) or details / Experience
Fishing master
Officers
Crew (number and experience)

3. OWNERS, CHARTERERS AND OPERATORS

(Please provide the full legal name and correspondence address)

Vessel owners and address
Parent company or companies of owners
Vessel charterers and address
Parent company or companies of charterers
Vessel operator and address
Parent company or companies of operators
Agent (in Stanley) and address
Relationship between applicant, owners, charterers and operators

4. ADDITIONAL INFORMATION

The following information is required with the application. If, for any reason, it cannot be supplied at the time of application, it must be provided at least two weeks in advance of fishing should the application be successful.

a) Details of seabird mitigation devices and procedures that will be employed
b) Manufacturer’s specification of the tamperproof VMS system that the vessel is equipped with
Have you appended a photograph of the VMS system in situ? / Yes
No

5. INFORMATION IN SUPPORT OF YOUR APPLICATION

In support of your application please provide information and evidence as to how the application addresses the criteria of the Icefish Licensing Policy. Please note these criteria are not exclusive.

a) Compliance [Maximum score 10].
Note GSGSSI will consult data recorded in South Georgia fisheries or recorded in, or ascertainable from, published CCAMLR tables, CCAMLR scientific observer reports, CCAMLR inspection reports, and other relevant documents, records and publications
b) Safety [Maximum score 10].
c) Catch efficiency [Maximum score 6].
Note GSGSSI will use records of previous catch rates in the fishery. Catch rates from other fisheries must be supported by validated documentation.
d) Experience [Maximum score 6].
e) Raising standards [Maximum score 6].
f) Additional Information in support of your application

6. Documentation

Please provide a list of documents that have been appended (electronically) to this application.

Document number / Content

7. DECLARATION

I, , hereby apply for a licence for the fishing vessel to fish for mackerel icefish in the Maritime Zone of South Georgia and the South Sandwich Islands during the 2015/16 and 2016/17seasons. In so doing, I declare that:

a)I have read and understood the information in the document entitled IcefishLicensing 2015/16 and 2016/17Information for Applicants;

b)The vessel will conform to all the mandatory requirements detailed in Annex A of the Icefish Licensing 2015/16 and 2016/17Information for Applicants;

c)I understand that GSGSSI will impose conditions on any offer of a licence to fish for icefish in the Maritime Zone, and that these conditions will include, but are not limited to, those set out in AnnexCof the document;

d)I will promptly inform the Director of Fisheries of the Government of SGSSI of any changes to the information contained in this application, which occur prior to and during either season;

e)I understand that all licensed vessels will be inspected at King Edward Point where their compliance with all relevant CCAMLR Conservation Measures and all relevant terms of their licence will be verified;

f)I understand that if a vessel fails inspection, the licence will be suspended until, in the opinion of the Government Officer, the grounds upon which she failed that inspection have been put right, or suitably redressed by alternative means. I understand that during the period of suspension the vessel will not be licensed to fish for icefish;

g)I understand that, as part of GSGSSI’s commitment to the safety of fishing activities, the vessel must be compliant with the provisions of the Torremolinos Protocol of 1993 relating to the Torremolinos International Convention for the Safety of Fishing Vessels 1977;

h)I understand that in submitting an application there is no guarantee of a licence.

In submitting this form electronically, I confirm that all the information included is accurate:

Signed:
Full name:
Dated: