Form NOAA 34-82 NOAA 34-82 Capital Construction Fund Deposit and Withdrawal Report

NOAA FORM 34-82
OMB NO. 0648-0041
Expires 06/30/2009

U.S. DEPARTMENT OF COMMERCE
NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION
NOAA Fisheries

Mail report and tax return copy to:
NOAA Fisheries F/SF2
Capital Construction Fund Program
1315 East-West Highway
Silver Spring, MD 20910-3282
301/713-2393 ext. 194

Prepare a separate Form 38-42 report for each account you maintain.
DEPOSITORY BANK, OR INVESTMENT FIRM
Name:
_____________________________________________________________

Capital Construction Fund Program
DEPOSIT/WITHDRAWAL REPORT
Due 30 days after filing date of Federal Tax Return
(including extensions). This report must be filed annually,
whether or not agreement activity took place. Attach a
signed copy of the Federal Income Tax Return, as filed
with the IRS, to this report.

City and State: _____________________________________________________
Account Number: ________________________ Date Opened: _______________

AGREEMENT HOLDER:

CCF CASE NUMBER

Name:
_____________________________________

CCF-_____-_______________

Address:
___________________________________
__________________________________________
_

Type of Investment Account: Q Savings Q Money Marker Q Checking
Q Other: (describe) _________________________________________________

REPORT OF DEPOSITORY
ACTIVITY FOR TAX YEAR
ENDED:

__________________________________________
_

/

/

Telephone No.: _____________________________
Did you reduce taxable income for the current tax year due to CCF activity?
Q YES Q NO
Amount deferred $________________
Was a CCF deposit made during the current year for taxes deferred in the prior year? Q YES Q NO
Clearly identify this deposit in Account Activity section.

CLASSIFICATION OF DEPOSITS:
ORDINARY INCOME
(tax deferred)
DEPOSIT

Notes:

CAPITAL GAIN
(tax deferred)

WITHDRAWAL

DEPOSIT

SUMMARY
BALANCE

CAPITAL
(funds not tax deferred)

WITHDRAWAL

DEPOSIT

WITHDRAWAL

BALANCE FORWARD-FROM PRIOR YEAR’S REPORT
(Should be same as last year’s “Balance - End of Year” amount.
If different, attach a reconciling schedule.)
ACCOUNT ACTIVITY FOR THE TAX YEAR
Summarize interest and dividend deposits. For deposits of vessel income, provide name of
vessel and Schedule A page number. For all withdrawals, provide name of vessel and
Schedule B page number for project.
DATE
DESCRIBE

SCH.A
OR
SCH. B
PAGE #

1

1

2

2

3

3

4

4

5

5

6

6

7

7

8

8

9

9

10

10
TOTAL EACH COLUMN (include “Balance Forward” amount for each column)
WITHDRAWALS FOR THE YEAR (copy totals from adjacent column)

(
(

)

(

)

5

(

)

(

)

5

(

)

)

5

BALANCE - END OF TAX YEAR (net amounts and Summary Balance)
Public reporting burden for this collection of information is estimated to
average 20 minutes per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining
the data needed, and completing and reviewing the collection of
information. Send comments regarding this burden estimate or any other
aspect of this collection of information, including suggestions for reducing
this burden, to NOAA Fisheries F/SF2 1315 East-West Hwy., Silver Spring,
MD 20910.
NOAA FORM 34-82 CCF - DEPOSIT/WITHDRAWAL REPORT

I certify that for this tax year, there were no withdrawals or transfers other than those enumerated above for this Capital Construction Fund agreement. This report reflects true and complete statements in accordance
with all applicable rules and regulations issued or adopted by the Secretary of Commerce pertaining to Section 607 of the Merchant Marine Act of 1936, as amended. Information on this report is complete, true, and
correct to the best of my knowledge and belief. (Following information is required.)

SIGNATURE: ________________________________________________________________________________ DATE: ___________________________ Q Agreement holder or officer Q Authorized representative