Annual Economic Survey of Federal Gulf and South Atlanti

Annual Economic Survey of Federal Gulf and South Atlantic Shrimp Permit Holders

Annual Ecnomic Survey of Federal Gulf and South Atlantic Shrimp Permit Holders

OMB: 0648-0591

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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):


File Typeapplication/pdf
File TitleMicrosoft Word - 2021 Instrument
Authornobody
File Modified2022-04-11
File Created2022-04-10

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