Application to register a vessel on the New Zealand Western Central Pacific Fisheries Convention Vessel Register
section a: Operator DetaIls, Owner dETAILS AND cONTACT PERSON
Operator Details
/Operator’s full legal name
/ Click here to enter text.Operator’s FishServe client number
/ Click here to enter text.Operator’s business postal address
/ Click here to enter text.Operator’s phone number(s)
/Phone Click here to enter text.
/Mobile Click here to enter text.
/Fax Click here to enter text.
Operator’s email address
/ Click here to enter text.Is the Operator of this vessel also the Owner of this vessel?
/NO
/ If NO, please give Owner details below.YES
/ If YES, please go to Contact Person details.Owner Details
/*Owner’s full legal name
/ Click here to enter text.*Operator’s FishServe client number
/ Click here to enter text.*Operator’s business postal address
/ Click here to enter text.Operator’s phone number(s)
/Phone Click here to enter text.
/Mobile Click here to enter text.
/Fax Click here to enter text.
Operator’s email address
/ Click here to enter text.* The provision of this information is mandatory under the Fisheries (Western and Central Pacific Ocean Highly Migratory Fish Stocks) Regulations 2003.
Contact Person
/Contact person
/ Click here to enter text.Contact person’s business postal address
/ Click here to enter text.Contact person’s phone number(s)
/Phone Click here to enter text.
/Mobile Click here to enter text.
/Fax Click here to enter text.
Contact person’s email address
/ Click here to enter text.Section B: vessel details (to be completed by all applicants)
*Current name of vessel
/ Click here to enter text.*New Zealand High Seas fishing permit number (issued under the Fisheries Act 1996)
/ Click here to enter text.What is the type, capacity and number of freezers?
/ Type Click here to enter text. / Cubicmetres Click here to enter text. / Number Click here to enter text.
Is this vessel on the New Zealand Fishing Vessel Register?
/NO
/ If NO, please complete Sections C, D, E and F.YES
/ If YES, please go to next question.Vessel Registration number on the New Zealand Fishing Vessel register (issued under the Fisheries Act 1996)
/ Click here to enter text.Is this vessel registered on the New Zealand Fishing Vessel Register as a vessel over 28 metres?
/NO
/ If NO, please complete Sections D, E and F.YES
/ If YES, please go to next question.* The provision of this information is mandatory under the Fisheries (Western and Central Pacific Ocean Highly Migratory Fish Stocks) Regulations 2003.
section c: vessel details (to be completed for vessels that ARE NOT on the New Zealand Fishing Vessel Register)
*Previous names (if any)
/ Click here to enter text.*Official number or registration number (issued by Maritime New Zealand under the Ship Registration Act 1992)
/ Click here to enter text.*International Radio call sign
/ Click here to enter text*Where built?
/ City Click here to enter text. / Country Click here to enter text.*Year built
/ Click here to enter text.Base port
/ Click here to enter text.*Overall length
/ Click here to enter text. metres*Beam
/ Click here to enter text. metres*Moulded depth
/ Click here to enter text. metres*Gross registered tonnage
/ Click here to enter text. tonnes*Type of fishing method(s)
Tick all proposed fishing methods / O / LongliningO / Pole and line
O / Trolling
O / Purse seining
O / Handlining
O / Other – please specify:
* Type(s) of vessel
e.g. Purse Seiner, Surface Longliner, Troller
/Click here to enter text.
*Power output of vessel’s main engine(s)
Tick either Kw or Hp / Click here to enter text. / O / Kw / O / Hp*Total capacity of fish holds
/ Click here to enter text. cubic metres*Full name of Master
/ Click here to enter text.Master’s nationality
/ Click here to enter text.*Total crew (what is the total number of crew that will be on the vessel at any one time including Master and officers?)
/ Click here to enter text.* The provision of this information is mandatory under the Fisheries (Western and Central Pacific Ocean Highly Migratory Fish Stocks) Regulations 2003.
section D: vessel details (to be completed for vessels that:1 ARE NOT on the New Zealand Fishing Vessel Register; or
2 ARE on the New Zealand Fishing Vessel Register AND are 28 metres and under)
*Port of registry
/ Click here to enter text.*Previous flags (if any)
/ Click here to enter text.*Vessel cellphone number
/ Click here to enter text.*Vessel fax number
/ Click here to enter text.Does the vessel have satellite communications equipment
/NO
YES
*If YES, please specify the type and contact numbers for all equipment held on board / Contact numberImmarsat – specify types Click here to enter text.
/ Click here to enter text.Satellite telephone Click here to enter text.
/ Click here to enter text.Other – specify Click here to enter text.
/ Click here to enter text.*Radio communications
/Radio type
/Main working frequency or channel
/Please select ONE
Click here to enter text. / Click here to enter text. / Channel / MHz / kHzClick here to enter text. / Click here to enter text. / Channel / MHz / kHz
Click here to enter text. / Click here to enter text. / Channel / MHz / kHz
* The provision of this information is mandatory under the Fisheries (Western and Central Pacific Ocean Highly Migratory Fish Stocks) Regulations 2003.
Section E: Attachments (to be completed by all applicants)
All applicants are required to:
• *Attach a colour photo of the vessel (if electronic, please email to )
• *Attach a copy of each authorisation issued to the vessel to fish for species managed under the Western Central Pacific Fisheries Convention in areas under the national jurisdiction of other States within the Convention area.
* The provision of this information is mandatory under the Fisheries (Western and Central Pacific Ocean Highly Migratory Fish Stocks) Regulations 2003.
Section f: Declaration (to be completed by all applicants)
I declare that:
• The information I have given on this application is true and correct.
• I am authorised to provide this information and make this declaration.
• I am aware that it is an offence to provide false or misleading information or omit any material information.
• I understand the applicant is required to notify the Ministry for Primary Industries if there are any changes in the particulars I have provided on this application.
• I have read and understood the Notes and the Collection of Personal Information details supplied with this application (below).
Full Legal Name (please print)
/Position
/Signature
/Date
Click here to enter text. / Click here to enter text. / Click here to enter text. / Click here to enter text.Click here to enter text. / Click here to enter text. / Click here to enter text. / Click here to enter text.
Notes
If the vessel ceases to be a New Zealand flagged vessel, the master, operator or owner must immediately notify the Director-General of the Ministry for Primary Industries in writing and the registration of the vessel on the New Zealand Western Central Pacific Fisheries Convention Vessel Register will be cancelled immediately.
If any of the details relating to the registration of this vessel change, the master or operator must immediately notify the Director-General of the Ministry for Primary Industries in writing.
The provision of optional information will assist New Zealand in meeting its obligations. Failure to provide optional information may result in a delay with the processing of your registration.
The master or operator of a vessel authorised to fish for highly migratory fish stocks in the Convention area should be aware of their obligations under the Fisheries (Western and Central Pacific Ocean Highly Migratory Fish Stocks) Regulations 2003.
Collection of Personal Information
In regard to any information being collected on this application that is personal information, notification is hereby provided, in accordance with Principle 3 of the Privacy Act 1993 of the following matters:
• This information is being collected for purposes relating to New Zealand’s obligations with respect to the management of highly migratory fish stocks under the Western Central Pacific Fisheries Convention and the management of fisheries resources in accordance with the Fisheries Act 1996.
• The agency that will collect and hold the information is the Ministry for Primary Industries, PO Box 2526, Wellington, New Zealand. Personal information will be recorded on publicly available registers.
• You are reminded that under Principles 6 and 7 of the Privacy Act 1993, you have the right of access to, and correction of, any personal information which has been provided.
• You may apply to the Ministry for Primary Industries to prevent the display of your personal information on registers kept under the Fisheries (Western and Central Pacific Ocean Highly Migratory Fish Stocks) Regulations 2003 where you consider that disclosure would be prejudicial to your personal safety or to the safety of your family.
Once completed, return this form to:
FishServe, PO Box 297
Wellington 6140, New Zealandor email to
Ministry for Primary Industries March 2013 Page 4 of 4