NWPA-830 Appendix G NWPA-830

u.s. DEPARTMENT OF ENERGY

NWPA-830G

Germantown,

Appendix

G

-Standard

OMS ~o. 1901-0260

MD 20874-1290

Remittance

Advice for Payment of Fees

This information is being collected under mandatory authorrties vested in the U.S. Department of Energy under Public Law 97-425. Late filing, failure to file or otherwise comply with instructions provided
may resutt in interest penatties as provided by Article VIII C of the Standard Contract of Spent Nuclear Fuel and/or High Level Radioactive Waste. For information conceming confidentialrty of information
see Item 6 of the instructions. Public reporting burden for this collection of information is estimated to average 40 hours 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 the Statistics and Methods Group, EI-70, 1000 Independence Ave, S.W., Washington, D.C. 20585; and to the Office of
Information and Regulatory Affairs, Office of Management and Budget, Washington, D.C. 20503. According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection
of information unless tt displays a valid OMB control number.

IDENTIFICATION INFORMATION

1,0

1.3

1.1 Purchaser Information
(a) Name:
(b) Address:
(c) City, State & Zip Code:
1.3 Contact Person
(a) Name:
(b) Telephone (Include Area Code):

2.0

1.4 Period Covered by this Remittance Advice
(a) From
to
(Month/DayNear)
(Month/DayNear)
(b) Date of this Payment:
(Month/DayNear)

SPENT NUCLEAR FUEL (SNF) FEE
2.1
2.2

Number of Reactors Covered:
Total Purchaser Obligation as of April 7, 1983: $

2.6

Option Chosen:

2.3

Date ofF'C>tPayme""

2.7

Fee Data

2.4

1O-Year Treasury Note Rate as of the Date of
First Payment - - - - - - - - - - - >
Unpaid Balance Prior to this Payment: $

2.5
3.0

4.0

Standard Contract Identification Number:

FEE FOR ELECTRICITY

~

GENERATED

%

AND SOLD (MILLS PER KILOWATT

3.1

Number of Reactors Covered:

3.2

Total Electricity Generated and Sold (Megawatt hours)
(Sum of Line 4.2 from all Annex A's):

3.3

Current Fee Rate:

UNDERPAYMENT/LATE

3.4

HOUR, M/kWh)

Total Fee for Electricity Generated and Sold
(M/kWh) Transmitted with this Payment:
$

(M/kWh)
PAYMENT

Type of Payment
(a)
4.1

(a) Principal:
(b) Interest:
(c) Total Spent Nuclear Fuel Fee:
Transmitted with this Payment
$

(As notified by DOE)
Date of Notification
(Month/DayN ear)
(b)

DOE Invoice
Number
(c)

Date of Payment
Transmittal
(Month/DayNear)
(d)

Interest Paid Amount Transmitted
(e)
(f)

SNF Underoavment

4.2

Electricitv Generation Underoavment

4.3

TOTAL UNDERPAYMENT

4.4

SNF Late Pavment

4.5

Electricitv Generation Late Pavment

4.6

TOTAL

.

LATE PAYMENT

~ n OTHFR r.RFnlT~ r.1 AIMFn (Att~r.hp.ciF)(rl~n~tinn)
Enter the Total Amount Claimed for All Credits
60

i

TOTAL REMITTANCE
6.1 Total Spent Nuclear Fuel Fee Transmitted (from 2,7(c))

$

6.2 Total Fee for Electricity Generated and Sold (from 3.4)

$

6.3 Total Underpayment (from 4.3(f))

$

6.4 Total Late Payment (from 4.6(f))

$

6.5 Total Credits (from 5.0)

$

6.6 TOTAL REMITTANCE (Sum of 6.1 through 6.4 minus 6.5)
7.0 CERTIFICATION

$

I certifythat the Total Remittanceis true and accurateto the best of my knowledge.
Name
Date
Signature
Title 18 USC 1001makesit a crime for any personto knowin~lyandwillfully maketo anydepartmentor agencyof the UnitedStates any false,
fictitious,or fraudulentstatementsas to any matterwithin itsJurisdiction.
Copy Distribution: 1 White, DOE-Controller; 1 Canary,DOE-EIA; 2 Pink, DOE-OCRWM; 1 Goldenrod,Utility Copy