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pdfOMB Control No. 0648-0016
Expiration Date: 08/31/2016
2015 Survey of Annual Expenses for Snapper-Grouper,
Reef Fish, Dolphin-Wahoo, Shark and Mackerel Permit Holders
Vessel Name:
Vessel ID:
Please report financial expenses (actual dollar payments) paid in 2015 for this vessel.
Enter “0” if you did not have any expenses in a category. PLEASE DO NOT LEAVE BLANK!
ACTIVITY REPORT FOR THIS VESSEL IN 2015
1. Vessel INACTIVE all year:
No
Yes (if Vessel was inactive all year, you can skip to Question 9)
Please enter the number of days spent away from port and the total gross revenues generated by this
vessel for the following activities in 2015:
2. Commercial fishing/seafood sales:
days
$
3. Chartering/For-hire fishing:
days
$
4. Vessel active but NOT fishing:
days
$
. 0 0
. 0 0
.
TOTAL TRIP-RELATED EXPENSES FOR THIS VESSEL IN 2015
5. Total paid for fuel:
$
6. Total paid for other trip-related expenses:
(Bait, ice, groceries, oil, lubricants, tackle, etc.)
$
. 0 0
. 0 0
7. Total paid for IFQ allocation transferred FROM another IFQ account:
$
. 0 0
8. (a) Did the vessel employ HIRED crew and/or HIRED captains?
(b) Total paid to HIRED crew and HIRED captain(s) of this vessel:
(Not to Owner! For example: from IRS Form(s) 1099-MISC or equivalent)
Yes
No (if No, continue with Q9)
. 0 0
$
(c) Which of the following best describes how the total amount paid to HIRED crew and HIRED captain(s) was
calculated for this vessel in 2015 (please check only one box)?
Share of total trip revenue without any deductions
Flat rate or salary
Share of total trip revenue less deductions
Other _________________________
(d) If a share system was used in 2015, what was the typical payout?
Vessel/owner _________% Captain _________% Crew _________% Other ____________________
TOTAL ANNUAL EXPENSES FOR THIS VESSEL IN 2015
9. (a) Total paid for any vessel maintenance, repair, replacement, new
purchase or upgrade (include hull, engine, gear, electronics, etc.)
(b) Does the amount in Question 6. (a) include a haul-out?
10. (a) Vessel insurance in 2015 (please check all that apply):
(b) Total paid for vessel insurance in 2015 (insurance premium):
11. Total loan payments for this vessel in 2015:
. 0 0
$
Yes
No
None
Hull
$
$
P&I
. 0 0
. 0 0
12. Overhead applicable to this vessel such as dockage, professional services,
$
licenses, (share of) rent, utilities, office and vehicle expenses, etc.
(Please exclude: insurance and loan payments, depreciation and income taxes.)
. 0 0
13. Please estimate the current market value of this vessel and its
associated gear and equipment (do NOT include IFQ quota share):
. 0 0
$
Please return completed form to:
National Marine Fisheries Service
Logbook Program
P.O. Box 491500
Key Biscayne, FL 33149-9875
I certify that the information contained on this form is accurate and complete to the best of my knowledge:
Signature of person completing report __________________________________________
Printed name of person signing report _________________________________
Phone Number (_____) ________________
Date _________________________
PAPERWORK REDUCTION ACT STATEMENT:
The NMFS requires this information for the conservation and management of marine fishery resources. This
reporting is required and is authorized under 50 CFR 622.5(a)(1)(v). These data will be used to evaluate the
economic effects of proposed regulations in the fishery. Public reporting burden for this collection of information
is estimated to average 30 minutes per response including the time for reviewing the instructions, searching the
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 aspects of this burden to Christopher
Liese, National Marine Fisheries Service, 75 Virginia Beach Drive, Miami, Florida 33149. Information submitted
will be treated as confidential in accordance with NOAA Administrative Order 216-100. 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 displays a currently valid OMB Control Number.
File Type | application/pdf |
File Title | Microsoft Word - SAMPLE 2015 Annual Expense Survey Form 2016-05-12 |
Author | christopher.liese |
File Modified | 2016-05-13 |
File Created | 2016-05-12 |