Fillable Annual Reporttemplate Feb 2015

Fill Online, Printable, Fillable, Blank Annual Reporttemplate Feb 2015 Form

Use Fill to complete blank online NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION (MD) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Annual Reporttemplate Feb 2015

On average this form takes 50 minutes to complete

The Annual Reporttemplate Feb 2015 form is 6 pages long and contains:

  • 0 signatures
  • 0 check-boxes
  • 200 other fields

Country of origin: US
File type: PDF

U.S.A. forms for National Oceanic and Atmospheric Administration

BROWSE NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION (MD) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
ANNUAL PERMITTEE REPORT
Due Annually by December 31
st
NOTE: This report is a comprehensive annual summary of all activities undertaken within
Papahānaumokuākea Marine National Monument (Monument or PMNM ), including but not
limited to: dates of all arrivals and departures from islands and atolls within the Monument,
names of all persons involved in permitted activities, details of all specimens collected,
handled, etc., any other pertinent information, GPS locations of all samples collected,
transects, etc., results of work to date, copy of all data collected, and a proposed schedule of
publication or production of final work. The report shall include a concise summary or
abstract for use in Monument reports. The annual report is due by December 31
st
each
calendar year that the permit was in effect and activities were conducted or before a new
permit is issued, whichever comes first (Monument permit General Condition #22).
TODAY’S DATE ___________
PERMITTED ACTIVITY DATES __________________
FOR CALENDAR YEAR _______
PERMIT SUMMARY INFORMATION
Monument Permit #: ___________
NOTE: If your permit has ended and you have completed the “30-Day Summary Report
Template,” please skip to Question #9.
1. Permit Category:
(Research, Conservation and Management, Education, Native Hawaiian Practices, Recreation, or
Special Ocean Use): __________
2. Principal Investigator Information:
PI Name:
PI Address:
PI Email Address:
PI Phone:
3. Field PI Name:
Rev. 2/2015 1
4. List all participants who entered the Monument under this permit (append an
additional sheet if necessary):
First Name
Last Name
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
5. Complete the following table for each person listed who visited land for >1/2 day while
in the Monument (NOTE: Use additional rows if the same person visited more than one
island or atoll, and append an additional sheet if necessary):
Last Name
Island or Atoll Visited*
Start Date
End Date
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
*Your 30-Day Permit Summary Report (Due 30 days after permit expiration date) will require
more detailed listing of participant locations.
Rev. 2/2015 2
DESCRIPTIVE INFORMATION FOR MONUMENT MANGEMENT REPORTS
6. Provide project abstract/description of conducted activities for calendar year:
7. List ALL physical and biological samples or specimens (include amounts of each) that
were removed from PMNM (append list sheet if necessary):
Collection Type-
General (e.g., seawater,
coral, algae)
Scientific Name
Common Name
Specimen Amount /
Sample Size
Notes
8. List ALL observation activities conducted (append list sheet if necessary):
Observation Type
(e.g. survey,
mapping, tagging
event, etc.)
Type of
Observation
If Other (please
specify here)
Number of
Observations (e.g.
number of
photographs taken,
length of video, tags
deployed, etc.)
Number of Individuals
Studied (e.g. number of
sharks on which acoustic
tags deployed, number of
bird nests monitored)
Notes
Rev. 2/2015 3
9. Of all items collected and removed from PMNM, list the current location(s), and any
intended future disposition, of all samples, artifacts, etc. that were removed from
PMNM:
10.
11.
10. Describe any instrumentation (including animal monitoring tags) left or temporarily
installed in the Monument:
11. Describe current stage of project (e.g. lab work being conducted, data analyses being
carried out, film being edited, classroom curriculum being prepared, etc.):
Rev. 2/2015 4
12. Describe plans for additional future work within PMNM that would add to the
results/conclusions/products from this year’s permitted activity:
13. Please describe briefly any interesting preliminary findings based on your permitted
activity so far.
14. Provide additional or new information on ways in which results/conclusions/products
will aid in PMNM management decisions:
14. Provide additional or new information on ways in which results/conclusions/products
will aid in PMNM management decisions:
Rev. 2/2015 5
15. List publications/reports/products currently in prep, in press, or published based on
this project (please send listed documents as attachments with this permit report, if
possible):
16. Required for Special Ocean Use Permits: In accordance with 50 CFR Part 404.11(f),
“Each person issued a permit for a special ocean use under this section shall submit an
annual report to the Secretaries not later than December 31 of each year which describes
activities conducted under that permit and revenues derived from such activities during
that year.”
“Revenues derived” are defined as (1) gross revenue (before any costs or expenses are
deducted) and (2) net revenue (profits or income gained). Please provide dollar
amounts of both types of revenue below:
17. Required for Special Ocean Use Permits: Do you anticipate future generation of
revenues derived from projects involving this permitted activity? If yes, please provide
projected revenues for the foreseeable future.
Rev. 2/2015 6
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Annual Reporttemplate Feb 2015

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 4 November 2019

Message

View Audit Log
Print With Audit Log
Duplicate Document