BSAI No-pollock monthly report

OMB Control # 0648-0376 Expires 06/30/2018
BSAI Non-Pollock Buyback Loan Fee Collection Report
Company Name
Mailing Address
City
State
Zip
Phone Number
Vessel Name
ADFG Vessel Number
Month and Year of Landings
FOR LANDINGS OF:		Sub-account	Fee Rate Per Pound	Gross Catch (lb.)	Fee Collected ($)
BSAI Pacific Cod		BBNA-001A	$0.0130
BSAI Pacific Cod		BBNA-001B	$0.0010
Only enter late charges for which you have received a Bill of Collection.				Late Charges ($)
				Total Fees ($)
Price Adjustment Verification:			By checking this box I certify that this payment is for an adjustment
Instructions:
1. Complete the company name, address, phone number, LLP License number, vessel name, ADFG vessel number,
Month of catch, and check the price 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 BSAI Pacific Cod 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 the fees collected or mail a check payable to: "NMFS BSAI Non-Pollock Buyback Loan"
in the amount of the total fee due to: BSAI Non-Pollock Loan P.O. Box 979002, St. Louis, MO 63197-9000.
6. Fees must reach NMFS by the 15th day after the end of each calendar month when fees have been collected.
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 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 06/30/2018
Privacy Act Statement:
Authority: The authority regarding establishment of Fishing Capacity Reduction Programs is 16 U.S.C. §1861 (b)-(e).
§§ 600.1000-600.1017 provides the Fishing Capacity Reduction Framework. Specific Fishery or Program Fishing
Capacity Regulations authorizations are §§ 600.1100-600.1108.
Purpose: NMFS requests information from fish buyers and sellers to ensure accurate management and repayment of
buyback loans.
Routine Uses: NMFS will enforce the collection of all fee payments and bring legal actions for collection enforcement
against any fish seller or fish buyer who fails to pay, collect, deposit, and/or disburse the fee in accordance with the
regulations. NMFS will audit ex-vessel landing records and fish buyer records for the purpose of determining and enforcing
compliance. NMFS will use this information to determine compliance with §§ 600.1000-600.1017. Disclosure of this
information is permitted under the Privacy Act of 1974 (5 U.S.C. Section 552a), to be shared within NMFS’ Financial
Services Division. Disclosure of this information is also subject to all of the published routine uses as identified in
Commerce/NOAA-21, Financial Services Division. (http://www.osec.doc.gov/opog/PrivacyAct/SORNs/noaa-21.html)
Disclosure: Furnishing this information is mandatory; failure to provide complete and accurate information may result in
penalties as described in §§ 600.1100-600.1108.