Form 10-356A CONCESSIONER ANNUAL FINANCIAL REPORT (For Concessioners

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Overview

Concessioner Info
A
B
C
M1
- SUBMIT -

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Sheet 1: Concessioner Info

NPS Form 10-356A

UNITED STATES DEPARTMENT OF THE INTERIOR

FORM APPROVED

OMB No. 1024-0029

NATIONAL PARK SERVICE

Expires: xx/xx/2016

CONCESSIONER ANNUAL FINANCIAL REPORT

(For Concessioners with Gross Receipts of Less Than $500,000)

For the Period from

to

Error: The Period End date must

be after the Begin date!

Concessioner ID

Concessioner

Park Unit

(Contract or Permit No.)

(Effective Date)

(Expiration Date)

Relationship:

ANNUAL FINANCIAL STATEMENT CERTIFICATION

(Either one or both of the certifications below may be completed)

COMPLETE THIS CERTICATION IF YOU ARE THE CONCESSIONER AND RESPONSIBLE FOR THE ANNUAL FINANCIAL REPORT

By typing my name below, I certify that I am authorized to complete and submit this report. This report has been examined by me and to the best of my knowledge and belief is true, correct, and complete report.

(Name of Person Responsible for Report Information)

(Title)

(Date)

COMPLETE THIS CERTIFICATION IF YOU ARE A CPA WHO HAS EITHER COMPILED, REVIEWED OR AUDITED THE CONCESSIONER'S FINANCIAL STATEMENTS AND HAVE COMPLETED THE ANNUAL FINANCIAL REPORT.

By typing my name in the box below, I certify that I have been authorized to complete and submit this report on behalf of the concessioner. This report has been completed/prepared under my supervision using data/information from the company's compiled/reviewed/audited financial statements and/or other financial records and to the best of my knowledge and belief is a true, correct, and complete report.

(Name of Person Responsible for Report Information)

(Title)

(Date)

Concessioner Information:

(

-

ext.

(Mailing Address)

(Telephone)

1

EMail Address:

PRORATION OF REVENUES AND/OR EXPENSES

If expenses and/or revenues are prorated as a portion of the entire operation, check this box.

Select One:

%

were prorated based on time spent in the park.

0.0%

Proration %

Days spent in park

Total days of operation

were prorated based on miles travelled in the park.

0.0%

Proration %

Miles traveled in the park

Total miles traveled

If you prorated revenues/expenses based on another method, please explain below:

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Sheet 2: A

		SCHEDULE A - DETAIL OF GROSS RECEIPTS
		CONCESSIONER:								YEAR ENDING: 12/30/99
		DETAIL OF GROSS RECEIPTS
		LODGING							TRANSPORTATION OF VISITORS
	1	Hotel and Motel						36	Water
	2	Cabins and Cottages						37	Air
	3	Hostels						38	Ground
	4	Tent Cabins						39	Other:
	5	LODGING DEPARTMENT TOTALS			-			40	TRANSPORTATION OF VISITORS			-
									DEPARTMENT TOTALS
		FOOD AND BEVERAGE
	6	Restaurant							HORSE AND MULE
	7	Cafeteria						41	Horse and Mule Services
	8	Snack Bar and Fast Food
	9	FOOD DEPARTMENT TOTALS			-				GUIDED TOURS
	10	Alcoholic Beverages						42	Float Trips and River Runners
								43	Water
		SOUVENIRS						44	Ground (Vehicle/Tram/Bus)
	11	Gifts, Curios						45	Ground (Snowmobiles)
	12	Genuine Authorized Native						46	Air
		Handicrafts						47	Backcountry Horse
	13	SOUVENIR DEPARTMENT TOTALS			-			48	Backcountry Hiking
								49	Other:
		GENERAL MERCHANDISE						50	GUIDED DEPARTMENT TOTALS			-
	14	Grocery
	15	Package Liquor							CRUISE SHIPS
	16	Camera and Photographic Supplies						51	Cruise Ships
	17	Other:
	18	MERCHANDISE DEPARTMENT			-
		TOTALS							OTHER
								52	Parking Lot
		RECREATION VEHICLE PARKS AND CAMPSITES						53	Vending Machine
	19	Tents						54	Bathhouse/Health Spa Services
	20	RV Camping (without hook-ups)						55	Rentals (Equipment, Video,
	21	RV Camping (with hook-ups)							Bicycles & Other)
	22	RV Park						56	Hunting Guides
	23	RV DEPARTMENT TOTALS			-			57	Instructional Service (mountain
									climbing school; environmental
		AUTO SERVICE							school etc)
	24	Fuel and Oil						58	Medical Care
	25	Parts, Service and Other						59	Golf Course and Driving Range
	26	AUTO SERVICE DEPARTMENT			-			60	Sports Facilities
		TOTALS						61	Other:
								62	Other:
		MARINA
	27	Slips and Mooring							EMPLOYEE CHARGES
	28	Houseboat Rental						63	Charges for Employee's meals
	29	Boat and Motor Rental							lodgings and transportation
	30	Fuel and Oil						64	TOTAL GROSS RECEIPTS			-
	31	Boat and Motor Sales
	32	Boat Repair
	33	Dry Storage
	34	Other:
	35	MARINA DEPARTMENT TOTALS			-
	We collect this information under the authority of Title IV of the National Parks Omnibus Management Act of 1998 (Pub. L. 105–391). We use this information to determine the franchise fees of the concessioner. Your response is required to obtain or retain a benefit. We estimate that it will take you 4 hours to complete this form. This estimate includes time for reviewing instructions, gathering and maintaining data, and completing and reviewing the form.
	You may send comments on the burden estimate or any aspect of this form to the Information Collection Clearance Officer, National Park Service, 1849 C Street, NW. (2601), Washington, DC 20240. We may not collect or sponsor and you are not required to respond to a collection of information unless it displays a currently valid OMB control number.

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Sheet 3: B

	SCHEDULE B - INCOME STATEMENT
	CONCESSIONER:										YEAR ENDING: 12/30/99
TOTAL GROSS RECEIPTS		1		TOTAL GROSS RECEIPTS									-
COST OF SALES		2	a.	Eating Places
		2	b.	Souvenirs
		2	c.	General Merchandise
		2	d.	Fuel and Oil
		2	e.	Other:
		2	f.	Other:
		3		TOTAL COST OF SALES									-
GROSS PROFIT		4		GROSS PROFIT									-
OPERATING (DIRECT)		5		Direct Salaries, Wages, Payroll Taxes, and Benefits
EXPENSES		6		Commission Fee Expense
		7		Operating Supplies
		8		Equipment Purchase/Rental/Lease Expense
		9		Contract Labor
		10		Utilities Expense
		11		Licenses/Fees
		12		Repair and Maintenance
		13		Vehicle/Fuel Expense
		14		Transportation expense
		15		Expedition Food Expense
		16		Hay, Pasture and Feed
		17		Vet/Farrier Services
		18		Horse Rental
		19		Contract Transportation Expense
		20		Other:
		21		Other:
		22		TOTAL OPERATING (DIRECT) EXPENSES									-
GENERAL AND		23		Owners/Officers/Partners Salaries, Payroll & Benefits
ADMINISTRATIVE		24		Other (Administrative) Salaries, Payroll Taxes & Benefits
EXPENSES		25		Credit Card Charges
		26		Office Expense
		27		Travel, Meals and Entertainment
		28		Telecommunications Expense
		29		Legal Fees
		30		Accounting and Review/Audit Fees
		31		Advertising and Promotional Expense
		32		Dues/Subscriptions
		33		Bank Charges
		34		Other:
		35		Other:
		36		TOTAL GENERAL AND ADMINISTRATIVE									-
GOVERNMENT FEES /		37		Percentage of Gross Receipts Fee
SPECIAL ACCOUNT		38		Building Use Fee or Flat Fee
CONTRIBUTIONS		39		Other:
		40		TOTAL FEES AND CONTRIBUTIONS									-
FIXED EXPENSES		41		Property Rent/Lease Expense
		42		Property taxes
		43		Business/Liability/Property Insurance
		44		Interest Expense
		45		Depreciation
		46		Other:
		47		TOTAL FIXED EXPENSES									-
OTHER EXPENSES		48		Interest and Dividend Income
(INCOME)		49		Loss (Gain) on Sale of Assets
		50		Other:
		51		TOTAL OTHER INCOME (EXPENSES)									-
INCOME TAXES		52		Federal
		53		State and Local
		54		TOTAL INCOME TAXES									-
NET INCOME (LOSS)		55		NET INCOME (LOSS)									-

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Sheet 4: C

		SCHEDULE C - BALANCE SHEET
		CONCESSIONER:				YEAR ENDING: 12/30/99
		(For Concessioners with Gross Receipts Between $250,000 and $500,000)
		ASSETS
1		Cash and Cash Equivalents
2		Inventories - Merchandise
3		Notes and Accounts Receivable
4		Prepaid Expenses
5		Depreciable Assets (Cost)
6		Less: Accumulated Depreciation
7		Net Depreciable Assets				-
8		Other:
9		Other:
10		TOTAL ASSETS				-			Warning: Assets should equal to Liabilities + Equity
		LIABILITIES
11		Accounts Payable
12		Notes Payable
13		Current Maturities on Long - Term Debt (Less than 1 Year)
14		Government Fees Payable
15		Accrued Liabilities
16		Advance Deposits
17		Long -Term Debt, Excluding Current Maturities (1 Year or more)
18		Other:
19		Other:
20		TOTAL LIABILITIES				-
		EQUITY
21		Partner’s or Proprietor’s Capital
22		Common and Preferred Stock
23		Additional Paid - In Capital
24		Less: Treasury Stock
25		Retained Earnings
26		TOTAL EQUITY				-
27		TOTAL LIABILITIES AND EQUITY				-			Warning: Assets should equal to Liabilities + Equity

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Sheet 5: M1

1

SCHEDULE M - OPERATIONAL STATISTICS #

1

2

CONCESSIONER:

YEAR ENDING: 12/30/99

3

4

5

Site:

High Season

from:

to:

6

Total Season

from:

to:

7

LODGING

1

Number of Rooms in Facility

2

Total Number of Room Nights Available

annual

high season

3

Total Number of Room Nights Occupied

annual

high season

4

Occupancy Percentage

annual

0.0%

high season

0.0%

5

Average Daily Room Rate (ADR)

annual

high season

6

Revenue Per Available Room (RevPAR)

annual

$-

high season

$-

7

Total Number of Guests

annual

guests / occupied night

-

8

Number of Lodging Employees

low season

high season

FOOD AND BEVERAGE

Restaurants

Cafeterias

Snack Bar/Fast Food

9

Number of Seats

10

Total Square Feet of Seating Area

11

Total Covers (i.e. customers)

12

Average Check per Cover

13

Total Number of Food & Bev. Employees

low season

high season

GIFTS AND MERCHANDISE

14

Total Retail Square Feet (including storage)

avg. transaction / sq. ft.

15

Total Number of Retail Employees

low season

high season

MARINAS

Occup %

16

Number of Covered Slips

avg. no. occupied

0.0%

17

Number of Uncovered Slips

avg. no. occupied

0.0%

18

Number of Rental Boats and Houseboats

avg. no. occupied

0.0%

19

Number of Dry Storage Units

avg. no. occupied

0.0%

20

Avg. Gross Receipts Per Occupied Slip (16 and 17 above)

21

Avg. Gross Receipts Per Occupied Dry Storage Unit (19 above)

22

Linear Feet of Wet Moorage (LF)

gross receipts / LF

23

Number of Marina Employees

low season

high season

TRANSPORTATION / TOUR / GUIDE SERVICE

# of Annual Trips

# of Annual Riders

Riders / Trip

24

Type of Trip/Tour

-

25

Type of Trip/Tour

-

26

Type of Trip/Tour

-

27

Type of Trip/Tour

-

28

Type of Trip/Tour

-

29

Number of Transportation Employees

low season

high season

CAMPGROUNDS

Occup %

30

Number of Campground Sites

avg. no. occupied

0.0%

31

Number of Campground Employees

low season

high season

TOTAL NUMBER OF CONCESSION EMPLOYEES

32

Filled permanent year around employee positions

33

Filled seasonal positions (high season)

34

Estimated number of full-time equivalents (FTEs)

EMPLOYEE HOUSING

Occup %

35

Number of Beds

avg. no. occupied

0.0%

36

Total Direct Housing Expense

expense per occupied bed

$-

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Sheet 6: - SUBMIT -

Submit AFR Short Form
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Step 1:			Create AFR Prepared Data File
a)		First, click the Browse button to choose a destination folder on your computer to store the Prepared AFR file:
		File Path:
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		Filename:	PreparedData-S_(_2021-01-28).xml
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c)		(Optional) Print out paper copy of the Annual Financial Report for record keeping.
Step 2:			Click the button below to sign your AFR
Step 3:			Submit AFR via NPS Website
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		Web link:	http://www.nps.gov/commercialservices/tools_afr.htm
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