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pdfOMB Control # 0648-0376 Expires 05/31/2015
AFA Pollock Buyback Loan
Fee Collection Report
Fee Collector's Name
Mailing Address
City
State
Zip
Phone Number
Fee Collector's Permit or Buyer Code
Settlement Sheet Date
Month and Year of Landings
Contact Person
FOR ALL INSHORE COMPONENT POLLOCK LANDED1
Vessel Permit Number
Delivery Date Fish Ticket Number
Pounds Landed
Fee Collected ($)
$ ‐
$ ‐
$ ‐
$ ‐
$ ‐
$ ‐
$ ‐
$ ‐
$ ‐
$ ‐
$ ‐
Only enter late charges for which you have received a Bill of Collection. Late Charges: $
Totals:
0 $ ‐
1
Fee collector must separately record each vessel landing. The totals must equal the amount that the fee collector
disburses to NMFS.
Instructions:
1. Complete the fee collector's name, address, telephone number, fee collector's permit number, date of this fee
collection settlement sheet, and month of landings.
2. Record the vessel permit number, delivery date, fish ticket number, pounds landed and fee collected for each
vessel. The fee collected equals the the pounds of pollock landed for each vessel trip multiplied by $0.006.
3. Note that deliveries must occur within the same month. Use a separate report for a different month.
4. Payment of late charges for which you have received a Bill of Collection can be included with the fee payment.
Do not pay late charges in advance of receiving a Bill of Collection.
5. Use Pay.gov to remit fee due or mail a check payable to: "NOAA Inshore Component Pollock
Loan Subaccount" in the amount of the total fee collected to: P.O. Box 979002, St. Louis, MO 63197‐9000.
Paperwork Reduction Act Statement:
Public reporting burden for this collection of information is estimated to average one 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 Paul Marx, Chief, Financia
Services Division, NMFS, MB5, 1315 East West Highway, Silver Spring, MD 20910.
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.
OMB Control # 0648-0376 Expires 05/31/2015
BSAI Crab Buyback Loan Fee Collection Report
Fee Collector's Name
Mailing Address
City
State
Zip
Phone Number
Crab Receiver Permit No.
Month and Year of Landings
Check this box if payment is a
Price Adjustment
Fee Rate
FOR LANDINGS OF
Sub‐account
(%)
Aleutian Islands brown king
BSAI C. opilio and C. bairdi
BBCA‐002BK
BBCA‐002OB
5.0
5.0
Aleutian Islands red king
BBCA‐002AI
5.0
Bristol Bay red king
Pribilof red king and blue king
BBCA‐002BB
BBCA‐002PB
2.5
5.0
St. Matthew blue king
BBCA‐002SM
5.0
Catch (lbs.)
Only enter late charges for which you have received a Bill of Collection.
Price Adjustment Verification:
Gross Value ($)
Fee Collected ($)
Late Charges ($)
Total Fees ($)
By checking this box I certify that this payment is for the purposes of BSAI crab
price adjustment.
Instructions:
1. Complete the fee collector's name, address, phone number, crab receiver permit, and month of landings.
Check both the price adjustment box and verification box, if applicable.
2. Record the catch in pounds, gross value, and fee collected for each fishery. The fee collected equals the applicable
fee rate multiplied by the gross value of crab landed for each vessel trip.
3. Note that deliveries must occur within the same month. Use a separate report for a different month.
4. Payment of late charges for which you have received a Bill of Collection can be included with the fee payment.
Do not pay late charges in advance of receiving a Bill of Collection.
5. Use Pay.gov to remit fee collected or mail a check payable to: "NMFS BSAI Crab Buyback Loan"
in the amount of the total fees collected to: P.O. Box 979060, St. Louis, MO 63197‐9000.
Paperwork Reduction Act Statement:
Public reporting burden for this collection of information is estimated to average one 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 Paul Marx, Chief, Financial
Services Division, NMFS, MB5, 1315 East West Highway, Silver Spring, MD 20910.
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.
OMB Control # 0648-0376 Expires 05/31/2015
BSAI Non‐Pollock Buyback Loan Fee Collection Report
Company Name
Mailing Address
City
State
Zip
Phone Number
LLP License Number
Vessel Name
ADFG Vessel Number
Month and Year of Landings
Check this box if payment is for an
adjustment to previous fees paid
Contact Person
FOR LANDINGS OF
Sub‐account
Fee Rate per Pound
BSAI Pacific Cod
BBNA‐001A
$0.0111
BSAI Pacific Cod
BBNA‐001B
$0.0010
Only enter late charges for which you have received a Bill of Collection.
Gross Catch (lbs.)
Fee Due ($)
Late Charges ($)
Total Fees ($) $
Instructions:
1. Complete the company name, address, phone number, LLP license number, vessel name, ADFG vessel number,
month and year of landings, and check adjustment box if applicable.
2. Record the gross catch in round weight pounds and fee collected for the fishery. The fee due equals the fee rate
multiplied by the gross catch of Pcod landed for each vessel trip.
3. Use a separate report for catch in a different month.
4. Payment of late charges for which you have received a Bill of Collection can be included with the fee payment.
Do not pay late charges in advance of receiving a Bill of Collection.
5. Use Pay.gov to remit fee due or mail a check payable to "NMFS BSAI Non‐Pollock Buyback Loan"
in the amount of the total fee due to: P.O. Box 979028, St. Louis, MO 63197–9000.
Paperwork Reduction Act Statement:
Public reporting burden for this collection of information is estimated to average one 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 Paul Marx, Chief, Financial
Services Division, NMFS, MB5, 1315 East West Highway, Silver Spring, MD 20910.
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.
-
OMB Control # 0648-0376 Expires 05/31/2015
Pacific Coast Groundfish Buyback Loan Fee Collection Report
Fee Collector's Name
Mailing Address
City
State
Zip
Phone Number
State Buyer Code
Month and Year of Landings
FOR LANDINGS OF
Sub‐account
Fee Rate (%)
Pacific Coast Groundfish
California pink shrimp
BBGS‐001GF
BBGS‐001CS
5.00
5.00
Oregon coastal Dungeness crab
BBGS‐001OC
0.55
Washington coastal Dungeness crab
BBGS‐001WC
0.16
Only enter late charges for which you have received a Bill of Collection.
Gross Value ($)
Fee Collected ($)
Late Charges ($)
Total ($)
Fee Adjustment
By checking this box I certify that this payment is for a fee or price
adjustment.
Instructions:
1. Complete the fee collector's name, address, telephone number, state buyer code (fish buyer/processor license
number), and month and year of landings (MM/20XX).
2. Record the gross value and fee collected for each fishery. The fee collected equals the applicable fee rate multiplied
by the gross value of fish landed for each vessel trip.
3. Note that deliveries must occur within the same month. Use a separate report for a different month.
4. Payment of late charges for which you have received a Bill of Collection can be included with the fee payment.
Do not pay late charges in advance of receiving a Bill of Collection.
5. Check the fee adjustment box if this payment is for a fee or price adjustment.
6. Use Pay.gov to remit fee collected or mail a check payable to: "NMFS Pacific Coast Groundfish Buyback Loan" in
the amount of the total fees collected to: P.O. Box 979059, St. Louis, MO 63197‐9000.
Paperwork Reduction Act Statement:
Public reporting burden for this collection of information is estimated to average one 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 Paul Marx, Chief, Financial
Services Division, NMFS, MB5, 1315 East West Highway, Silver Spring, MD 20910.
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.
File Type | application/pdf |
Author | Liz.Ryan |
File Modified | 2015-01-26 |
File Created | 2015-01-26 |