Mothership economic data survey

OMB Control No. 0648-0618 Expiration Date: 4/30/2015

Economic Data Collection (EDC) Form

WEST COAST GROUNDFISH

LIMITED ENTRY TRAWL

MOTHERSHIP VESSEL

2012

NOAA Fisheries – Northwest Fisheries Science Center

Who is responsible for submitting: All owners, lessees, and charterers of a mothership vessel registered to an MS permit at any time in 2012.

Complete all questions. If a question is not applicable, write "NA" in the answer box. The survey will not be considered complete unless there is an answer to every question.

Submit by September 1, 2013. Completed and signed EDC forms must be mailed and postmarked by or hand-delivered to NMFS no later than September 1, 2013. Mail or deliver to:

Economic Data Collection Program (FRAM Division),

Northwest Fisheries Science Center

2725 Montlake Boulevard East

Seattle, WA 98112

Retain a copy. Retain a copy of the completed form.

Fillable forms and more information: www.nwfsc.noaa.gov/edc.

Questions: Visit the website above or contact Erin Steiner at (866) 791-3726 or [email protected].

Public Reporting Burden Statement

Public reporting burden for this collection of information is estimated to take 8 hours per response, including time for reviewing the instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden to Erin Steiner, National Marine Fisheries Service, Northwest Fisheries Science Center, 2725 Montlake Blvd E, Seattle, WA 98112.

Additional Information

Before completing this form, please note the following: 1) Notwithstanding any other provision of the law, no person is required to respond to, nor shall any person be subject 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; 2) This information is mandatory and is required to manage commercial fishing efforts under 50 CFR part 660 and under section 402(a) of the Magnuson-Stevens Act (16 U.S.C. 1801, et seq.); 3) Responses to this information request are confidential under 402(b) of the Magnuson-Stevens Act (16 U.S.C. 1801, et seq.). They are also confidential under NOAA Administrative Order 216-100, which sets forth procedures to protect the confidentiality of fishery statistics.

I. Contact Information and Vessel Characteristics

1. Provide the following information about this vessel and its physical characteristics.

Item	Vessel Information
Vessel Name
USCG Vessel Number
Home Port
Length Overall (feet)
Fuel Capacity (gallons)
Horsepower of Main Engines

2. Provide the contact information for the owner of the mothership vessel.

Name of Company, Partnership, or Other Business Entity
Business Mailing Address Street / PO Box			Business Phone ( )
			Business Fax ( )
City	State	Zip Code	Business Email

3. If the vessel was leased or bareboat chartered during 2012, provide the contact information for the lessee or charterer of the mothership vessel. If necessary, use the last page for additional lessees or charterers.

Name of Company, Partnership, or Other Business Entity
Business Mailing Address Street / PO Box			Business Phone ( )
			Business Fax ( )
City	State	Zip Code	Business Email

4. List the mothership permit(s) used with this vessel during 2012 in the West Coast whiting fishery (West Coast includes Washington, Oregon, and California).

Mothership Permit Number	Permit Owned or Leased? Owned Leased
Mothership Permit Number (2)	Permit Owned or Leased? Owned Leased
Mothership Permit Number (3)	Permit Owned or Leased? Owned Leased

5. Provide the contact information for the individual completing this report. If your address, phone, and email are provided in the owner or lessee/charterer information, you do not need to repeat them here but please provide your name and title.

Mothership Vessel Owner (or Designated Representative) Mothership Vessel Lessee or Charterer (or Designated Representative)
Name			Title
Business Mailing Address Street / PO Box				Business Phone ( )
				Business Fax ( )
City	State	Zip Code		Business Email

6. Read the following statement and sign and date the box below.

I certify under penalty of perjury that I have reviewed all the information in this form and that it is true and complete to the best of my knowledge.
Signature	Date signed _____/_____/_________ mm dd yyyy

Please proceed to the next page

If a question is not applicable, write "NA" in the answer box.

7. Answer the following questions related to the most recent marine survey value of the vessel.

What was the year of this vessel's last value survey?	_________ yyyy
What was the market value of this vessel from the survey, rounded to the nearest 100 dollars?	$ ________________
What was the replacement value of this vessel from the survey, rounded to the nearest 100 dollars?	$ ________________
Did the survey values given above include the value of permits associated with this vessel at the time of the survey?	Yes No
Did the survey values given above include the value of quota associated with this vessel at the time of the survey?	Yes No
Did the survey values given above include the value of all processing equipment on this vessel at the time of the survey?	Yes No
Did the survey values given above include the value of all fishing gear on this vessel at the time of the survey?	Yes No

8. For the remainder of the survey, report values from your 2012 fiscal year. When did this vessel’s 2012 fiscal year begin?

_____/_____/__________

mm dd yyyy

Please report values from your 2012 fiscal year for the remainder of this survey.

9. Was this vessel hauled out in 2012?

Yes No

10. Provide this vessel’s average fuel use per day (for propulsion or other uses) when engaged in each of the following activities in 2012.

• West Coast includes Washington, Oregon, and California.

• Fuel use should include all fuels used for propulsion or other uses.

Activity	Fuel Use
Processing and steaming in the West Coast whiting fishery	____________ gal/day
Steaming between the West Coast and Alaska	____________ gal/day

11. How many gallons of fuel did this vessel use (for propulsion or other uses) during 2012 in the West Coast whiting fishery?

• Exclude activities in Alaska and steaming between the West Coast and Alaska in these responses.

Type of Fuel	Gallons
Diesel	______________ gal
Bunker oil	______________ gal
Fish oil	______________ gal

12. Provide the number of days this vessel was at sea during 2012 in each of the following activities. Please note that there is a special category for days at sea steaming between the West Coast and Alaska. (This information will be used to allocate some of your expenses and expenditures between the West Coast and Alaska in order to avoid asking more detailed information about the vessel's activities in Alaska).

• Count partial days as full days

Activity	Days at Sea
Processing in the West Coast whiting fishery	____________ days
Steaming in the West Coast whiting fishery	____________ days
Off-loading in the West Coast whiting fishery	____________ days
Steaming between the West Coast and Alaska	____________ days
All Alaska fisheries	____________ days

13. Provide the number of one-way trips (count a round trip as 2 one-way trips) this vessel made steaming between the West Coast and Alaska during 2012.

______ one-way trips

14. Provide the average number of processing crew members and the average number of non-processing crew members (including the captain) when the vessel was operating in the West Coast whiting fishery during 2012.

• Processing crew includes line workers, fishmeal crew, quality control, technicians, cleanup, mechanics who work on processing equipment, factory manager, and combis.

• Non-processing crew includes wheelhouse, deckhands, engine room, and galley.

Fishery	Average Number of Processing Crew	Average Number of Non-Processing Crew (including captain)
West Coast whiting	____________	____________

II. Capitalized Investments

15. Provide the 2012 capitalized expenditures associated with each of the following categories for this vessel. Note that some capitalized expenditures are for All Fisheries the vessel participates in (West Coast, Alaska, and other) and others are for West Coast whiting fishery only. Round all answers to the nearest 100 dollars. (Capital investments shared across fisheries will be allocated to the West Coast based on days or tonnage.)

Capitalized Expenditure Category	Capitalized Expenditures in All Fisheries West Coast, Alaska, and Other	Capitalized Expenditures in West Coast Fisheries Only Washington, Oregon, and California
Vessel and On-board Equipment Include the purchase of a new or used vessel, electronics, safety equipment, and machinery not used to harvest or process fish Include any major upgrades, repairs, or maintenance to the vessel or equipment Exclude fishing gear and processing equipment
New or used vessel and on-board equipment (Regardless of where the vessel fished, enter all expenditures for vessel and on-board equipment under the All Fisheries column)	$______________
Fishing Gear Include nets, cables, doors, and fishing machinery used in the West Coast whiting fishery Exclude any fishing gear that is not used at least partially in the West Coast whiting fishery
Fishing gear used only in the West Coast whiting fishery		$______________
Fishing gear shared by the West Coast whiting and other fisheries	$______________
Processing Equipment Exclude all equipment, machines, and buildings based primarily on shore Exclude any processing equipment that is not used at least partially in the West Coast whiting fishery Include on-board freezers, storage equipment, packing equipment, conveyers, and on-board cargo handling equipment
Processing equipment used only in the West Coast whiting fishery		$______________
Processing equipment shared by the West Coast whiting and other fisheries	$______________

III. Quota and Permit Costs

16. Provide the total amount you paid for purchase or lease of co-op shares and mothership endorsed West Coast groundfish limited entry trawl permits during 2012 for use in the West Coast whiting fishery.

Purchase or Lease of Quota and Permits	Total Cost
Purchase of co-op shares	$_______________
Lease of co-op shares	$_______________
Purchase of mothership endorsed permit	$_______________
Lease of mothership endorsed permit	$_______________

IV. Annual Expenses

17. Provide the total amount expensed during 2012 in each of the categories below. Note that some expenses are for All Fisheries (West Coast, Alaska and other) and others are for the West Coast whiting fishery only. Round all answers to the nearest 100 dollars.

Expenses Category	Expenses in All Fisheries West Coast, Alaska, and Other	Expenses in West Coast Fisheries Only Washington, Oregon, and California
Processing crew (include wages, bonuses, benefits, payroll taxes, and unemployment insurance)		$______________
Non-Processing crew (include wages, bonuses, benefits, payroll taxes, and unemployment insurance)		$______________
Crew travel not deducted from crew wages		$______________
Observer fees		$______________
Mothership co-op dues		$______________
Fuel and lubrication (do not include steaming between West Coast and Alaska)		$______________
Food		$______________
Non-fish ingredients (additives)		$______________
Packing materials		$______________
Freight to the vessel on supplies		$______________
Other supplies (linens, clothing, cleaning, etc.)		$______________
Communications		$______________
Offload expenses (cross-dock fees, port tariffs, etc.)		$______________
On-board cargo / product/ protection and indemnity insurance		$______________
Fishing gear purchases, upgrades, repairs, or maintenance used only in the West Coast whiting fishery (expensed during 2012)		$______________
Fishing gear purchases, upgrades, repairs, or maintenance shared by West Coast whiting fishery and Alaska (expensed during 2012)	$______________
Processing equipment purchases, upgrades, repairs, or maintenance (expensed in 2012)	$______________
Vessel and on-board equipment purchases, upgrades, repairs, or maintenance (expensed in 2012)	$______________

17. (Continued)

Expenses Category	Expenses in All Fisheries West Coast, Alaska, and Other	Expenses in West Coast Fisheries Only Washington, Oregon, and California
Insurance premium payments (hull and machinery, pollution insurance)	$______________
Moorage	$______________
Lease or bareboat charter of this mothership vessel	$______________
Depreciation (vessel, on-board equipment, and processing equipment) taken during 2012	$______________

18. Provide the weight and the cost of fish purchased from catcher vessels in the West Coast whiting fishery during 2012. Round weights to the nearest metric ton.

• Please include any post-season adjustments for purchases of fish that were harvested in 2012.

• Total cost should include taxes and vessel buyback program fees paid on behalf of catcher vessels.

Type of Fish	Total Weight of Fish Received but Not Paid For (for size or other reasons)	Total Weight of Fish Purchased	Total Cost of Fish Purchases
Whiting	________________mt	________________mt	$_______________
All other West Coast species	________________mt	________________mt	$_______________

19. Provide the total round weight of all fish harvested by this mothership vessel in All Fisheries (West Coast, Alaska, and other) during 2012. Round to the nearest metric ton. (This information will be used to allocate some of your expenditures between the West Coast and Alaska in order to avoid asking more detailed information about the vessel's activity in Alaska.)

Fishery	Total Round Weight Harvested
West Coast	________________mt
Alaska/Other	________________mt

V. Annual Earnings

20. Provide the total weight and value of production in the West Coast whiting fishery during 2012. Report weights to the nearest metric ton.

• Do not include any additional payment you received to cover any shipping, handling, or storage costs associated with the sale beyond the FOB port of discharge.

• Please include any post-season adjustments for products produced in 2012.

• For products produced in 2012 and held in inventory at the end of the year, estimate the value on the basis of the average price received for similar products sold during the year.

• Include products shipped to other establishments of your company.

• Do not include revenue associated with fish caught in any fishery except the West Coast whiting fishery.

Type of Fish	Total Weight of Production	Total Value of Production
Whiting
Surimi	________________mt	$_______________
Fillets	________________mt	$_______________
H&G	________________mt	$_______________
Round (unprocessed)	________________mt	$_______________
Fishmeal	________________mt	$_______________
Fish oil	________________mt	$_______________
Roe	________________mt	$_______________
Minced	________________mt	$_______________
Stomachs	________________mt	$_______________
Other (specify):___________	________________mt	$_______________
Other (specify):___________	________________mt	$_______________
Other Species
All other species on the West Coast	________________mt	$_______________

21. Provide the percentage, by value, of all products off-loaded from this mothership vessel in the West Coast whiting fishery at each of the following locations. The column should sum to 100%.

Location	Percentage of Total Off-load Value
Seattle	________%
Blaine / Bellingham	________%
Port Angeles	________%
Astoria	________%
Coos Bay	________%
Tacoma	________%
At sea (tramper)	________%
Other (specify):______________________	________%

22. Provide the revenue received during 2012 from the sale or lease of mothership endorsed West Coast groundfish limited entry trawl permits that were associated with this vessel.

Permits Purchased or Leased	Revenue Received
Sale of West Coast whiting mothership permits	$_______________
Lease of West Coast whiting mothership permits	$_______________

23. Provide the revenue received during 2012 from the sale or lease of West Coast co-op shares.

Sale / Lease of Quota	Revenue Received
Sale of co-op shares	$_______________
Lease of co-op shares	$_______________

24. Provide the revenue received during 2012 from the lease or bareboat charter of this mothership vessel.

$ ________________

Questionnaire Comments:

Revised: 11/23/11

Revised: 11/23/11

Revised: 11/23/11

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Revised: 11/23/1130/12: v6