American Samoa Trip expenditure form (captain)

NMFS Observer Programs' Information That Can Be Gathered Only Through Questions

17 Economic Data Form America Samoa

OMB: 0648-0593

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Why do we collect economic data? Because the National Marine Fisheries Service is required to conduct economic analyses.

AMERICAN SAMOA OBSERVER PROGRAM LONGLINE TRIP EXPENDITURE FORM

page 1 of 2

(Ask for information on the way home)

1. TRIP INFORMATION
DATE OF RETURN

DATE OF DEPARTURE

TRIP NUMBER

2 0

2 0

A S
VESSEL NAME

NO. OF SETS

2. FUEL
PRICE PER GALLON

$

GALLON USED

.

TOTAL COST OF FUEL

$

,

,

3. ENGINE OIL AND HYDRAULIC OIL
PRICE PER UNIT

UNIT (Check One)
Gallon

.

Bag/bucket (5 Gallons)

.

Drum (55 Gallons)

.

QUANTITY USED

TOTAL COST OF OIL

$

,

4. BAIT
TYPE OF BAIT (Check One)

Squid

Mackerel

Sardine

Anchovy

PRICE PER BOX

BOXES USED

TOTAL COST OF BAIT

$

$

,

Sanma

5. FREON AND OTHER FREEZER COSTS (amount spent for this trip to operate freezer)
$

,

6. FISHING GEAR COSTS (amount spent on re-supply vessel for this trip for hooks, lines, floats, raingear, etc.)
$

,

7. PROVISIONS COSTS (amount spent re-supply vessel for this trip on food, bottled water, cigarettes, etc.)
$
,
DON’T FORGET TO FILL OUT THE
BACKSIDE!
Form revised 1/20/15; OMB Control No. 0648-0593 exp. 12/31/2021

Why do we collect economic data? Because the National Marine Fisheries Service is required to conduct economic analyses.

AMERICAN SAMOA OBSERVER PROGRAM LONGLINE TRIP EXPENDITURE FORM

page 2 of 2

(Ask for information on the way home)

8. TRIP COMMUNICATIONS COST (amount spent for this trip on satellite phone and/or data calls, email, etc.)
$

,

9. FREIGHT OR EXPORT COST (the cost of transporting fish to other markets other than canneries)
$

,

10. MISCELLANEOUS COSTS (please list the details)

Details of misc. costs
Items

$

Cost

1.
2.

,

3.

11. TOTAL ESTIMATED COSTS (ask, don’t add)
Fish price
$

Species

,

GG

Round

Price

1. Albacore
2. Yellowfin

12. CAPTAIN OF THIS TRIP (check one)
Owner Operated

3. Bigeye

Hired Captain

4. Skipjack
5. Wahoo

13. CREW INFORMATION
Number of crew (DO NOT include captain) Number of foreign crew

14. CREW INFORMATION
A. Observer Section
Observer number:_____________
Captain or trip operator phone number: (
B. Debriefer Section

)

_

Debriefer initials________________

Check only one box
Economic data provided by captain
Only observed data at sea

If no economic data provided by captain, please provide

Only observed data in office

Form revised 1/20/15; OMB Control No. 0648-0593 exp. 12/31/2021


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AuthorJoan Koo
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File Created2016-02-08

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