Certificate of construction/reconstruction

OMB Control No. 0648-0090
Expiration Date: 10/31/2010

Case No. CCFCERTIFICATE OF CONSTRUCTION/RECONSTRUCTION

The undersigned hereby certifies that:
( ) Construction
of Schedule B, page

( ) Reconstruction*
,

, was completed
(Name of Vessel)

on

, by ( ) Contract ( ) Owner ( ) Both,
(Date)

for a TOTAL COST of $

.

.

If available, show breakdown below for above Total Cost:

Hull & House $
Machinery

$

Electronics

$

Fixed Gear

$

Other

$

(Signature)

(Print Name)

(Date)
*NOTE: All, or the major portion (ordinarily, not less than 80 percent), of the total cost must (for the purpose of meeting the
minimum cost requirement) be classifiable as a capital expenditure for IRS purposes. That portion of cost not classifiable as a
capital expenditure is not eligible for payment through the CCF.
--50 CFR, sec 259.31(b)(2)
Public reporting burden for this collection of information is estimated to average 1 hour 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 suggestions for reducing this burden to NOAA Fisheries, F/MB5,
1315 East West Hwy., Silver Spring, MD 20910.
The information collected is confidential under the Magnuson-Stevens Fishery Conservation and Management Act, as amended in 2006,
NOAA Administrative Order 216-100, which sets forth procedures to protect confidentiality of fishery statistics and 15CFR259.38(b).
Notwithstanding any other provisions of the law, no person is required to respond to, nor shall any person be subjected to a penalty for failure to comply
with, a collection of information subject to the requirements of the Paperwork Reduction Act, unless that collection of information displays a currently
valid OMB Control Number.