Annual Economic Survey of Federal Gulf and South Atlanti

OMB Control # 0648-0591

Expires 05/31/2022

2021 Annual Economic Survey of Federal Gulf and South Atlantic Shrimp Permit Holders
Permit owner name: «PrimaryMailingRecipient»

Survey #: «SurveyNum»

Vessel name:

Vessel ID: «VESID»

«VesselName»

Even if this vessel was inactive in 2021 please complete this survey (especially Q7 - Q10, and Page 2).
Enter “0” if you did not have any expenses in a category. Do not leave blank!
Total 2021 Expenses:
 On this page we would like you to enter the total financial expenses (actual dollar payments) you
incurred during 2021 for the operation and keeping of the vessel listed above.
 For each question enter the sum of all 2021 expenses.
 Please consult the detailed instructions if you are unsure about any question.
1. Is the owner also the captain of this vessel?

 Yes

 No

2. If owner is captain, is the owner paid a captain’s share?  Yes  No  N/A
If Yes, total amount of captain’s share:
3. Total amount paid to HIRED crew and captain(s) of this vessel:

$ _ , _ _ _ , _ _ _ .00
$ _ , _ _ _ , _ _ _ .00

(Not to Owner! For example: from IRS Form(s) 1099-MISC or equivalent)

4. Total amount paid for fuel used by this vessel in 2021:
5. a) Estimated average price of fuel in 2021: $ _ . _ _

$ _ , _ _ _ , _ _ _ .00
per gallon

b) Total amount of fuel purchased: _ _ _ , _ _ _ , _ _ _ gallons
6. Total amount paid for all trip related supplies or expenses (other than fuel): $ _ , _ _ _ , _ _ _ .00
(For example: ice, groceries, oil and lubricants, freezing, packaging, and cleaning supplies)

7. a) Total amount paid for any vessel maintenance, repair, replacement,
new purchase or upgrade (including engine, gear, electronics, etc.):
b) The answer to Question 7 a) includes (check all that apply):
 Maintenance or regular repairs
 Major repairs or haul-out

$ _ , _ _ _ , _ _ _ .00
 New purchase or upgrade

8. Total amount paid for vessel insurance in 2021 (insurance premium):

$ _ , _ _ _ , _ _ _ .00

9. Total payments made for loans on the vessel in 2021:

$ _ , _ _ _ , _ _ _ .00

10. Overhead applicable to this vessel; such as dockage, licenses,
(share of) rent, utilities, professional services, truck expenses, etc.:
$ _ , _ _ _ , _ _ _ .00
Please Exclude: loan payments, insurance payments, depreciation, and income taxes.

11. Total 2021 Expenses (the above entries should sum to this value):
Page 1 of 2

$ _ _ , _ _ _ , _ _ _ .00

Other Important Economic Information (Survey #: «SurveyNum»):
12. Vessel insurance in 2021 (check all that apply):

 None

 Hull

If Hull insured, enter coverage level if vessel is lost:

 P&I
$ _ _ , _ _ _ , _ _ _ .00

(do not enter monthly or annual insurance premium here, instead  Question 8)

13. Appraised value of this vessel (if insured) or best estimate of this value (if not insured):
a) Market value of vessel including permits (anytime in 2021): $ _ _ , _ _ _ , _ _ _ .00
b) Market value of vessel without permits (anytime in 2021):

$ _ _ , _ _ _ , _ _ _ .00

c) Original purchase price of vessel:

$ _ _ , _ _ _ , _ _ _ .00

(estimate original value if gift or self-built)

14. Did you have any loan(s) on your vessel at any time during 2021:
If Yes:

a) Total amount you still owe at end of 2021:

 Yes

 No

$ _ _ , _ _ _ , _ _ _ .00

b) Please split total loan payments in 2021 (Question 9) into:
i) Interest paid in 2021:

$ _ _ , _ _ _ , _ _ _ .00

ii) Principal repaid in 2021:

$ _ _ , _ _ _ , _ _ _ .00
$ _ _ , _ _ _ , _ _ _ .00

16. During 2021 this vessel received revenue from (check all that apply):
 Shrimp Fishery
 Other Commercial Fisheries
 Other Non-Fishing Income Activities (include BP Oil Spill-related)

 Government
 None / Not Active

(Note: NMFS already collects shrimp revenue from Dealer Reports & Gulf Shrimp Landings Report)
17. Total gross revenue received by this vessel in 2021 from
a. commercial fishing other than shrimp AND
b. non-fishing income activities (including BP Oil Spill-related):

$ _ _ , _ _ _ , _ _ _ .00

18. Government payments received for this vessel in 2021; for example
due to imports and low shrimp prices (tariff money; trade assistance
adjustment payments) or hurricanes/disaster relief:

$ _ _ , _ _ _ , _ _ _ .00

I certify that the information contained on this form is accurate and complete to the best of my
knowledge:
_____________________________________

________________

Signature of person completing report

Date

_____________________________________

(_____)_______________

Printed name of person signing report

Phone number

Thank You! Please return this completed form in the enclosed prepaid envelope!
[Mail to: NMFS; Miami Lab; P.O. Box 491500; Key Biscayne, FL 33149]

____________
If you have any comments please use the reverse side or a separate piece of paper. Also, please make a note if
you would like to receive the results of this survey when they become available.

Page 2 of 2

( if none enter “0” )

15. Depreciation of vessel as claimed for tax purposes (2021):