10-356 Concessioner Annual Financial Report

INSTRUCTIONS FOR COMPLETING THE ANNUAL FINANCIAL REPORT
1 Enter your financial information in the dark grey cells on each of the following worksheets. Cells not highlighted in dark
grey are automatically calculated and should not be changed.
2 Since many Schedule A amounts are pulled from other schedules, it is suggested the information be input in the following
order: Schedule; G, H, J, I, P, Q, D, K, C, E, N (if needed), B then A. The input order of the remaining schedules is not
affected.
3 Use the tab key or arrow keys to move through the cells in each worksheet.
4 In the "Type of Entity" area on the Concessioner Information worksheet, make the appropriate selection using the
dropdown menu.
5 Manually enter the correct concessioner ID. Concessioner ID's take the form ABCD-###, where ABCD represents the
alphanumeric code for the park and the numbers are a contract number.
6 To move a comment box, place the cursor on the comment box, left click and hold, then drag the comment box to to
another place on the screen.
7 Generally, if there are not enough 'Other' lines, combine multiple amounts and input one number on the schedule;
provide a breakdown of the combined amounts on Schedule L unless otherwise directed.
8 The signature(s) on the Concessioner Info worksheet should be typed rather than written.
9 Do not enter zeroes, NA, dashes or anything else in cells which are not applicable to your operation. Leave these cells
blank.
10 For help, email [email protected]

OMB Control No. 1024-0029
Expiration Date: XX/XX/XXXX

NPS Form 10-356 (Rev. 12/2019)
National Park Service

CONCESSIONER: -

PERIOD ENDING: MM/DD/YYYY

For the Period from:

to:

Concessioner ID
Concessioner Name
Park Unit
Contract or Permit Number

Effective Date

Expiration Date

Type of Entity
Schedule A - Statement of Income
Schedule A-1 - Statement of Income & Comprehensive Income
Schedule B - Computation of Government Fees
Schedule C - Balance Sheet
Schedule D - Depreciable Fixed Assets (PI or LSI)
Schedule D-1 - Intangible Assets ASC Topic 853
Schedule E - Statement of Cash Flows - Direct Method
Schedule F - Notes to the Financial Statements
Schedule G - Detail of Gross Receipts

TABLE OF CONTENTS
Schedule H - Departmental Income and Expenses
Schedule I - General & Administrative Expenses
Schedule J - Info on Corporate Owners, Officers & Partners
Schedule K - Additions to & Disposals of Depreciable Fixed Assets
Schedule L - Supporting Schedule
Schedule M - Operational Statistics
Schedule P - Component Renewal/Replacement Reserve Annual Reconciliation
Schedule Q - Component Renewal/Replacement Reserve Expenditures

ANNUAL FINANCIAL STATEMENT CERTIFICATION (Either one or both of the certifications below may be completed)
COMPLETE THE CERTICATION BELOW IF YOU ARE THE CONCESSIONER AND COMPLETED THE ANNUAL FINANCIAL REPORT
By typing my name below, I certify that I am authorized to complete and submit this report. This report has been examined by me and to the best of my
knowledge and belief is a true, correct, and complete report.
Name of Person Responsible for Report Information
Title
Date
COMPLETE THE CERTIFICATION IF YOU ARE A CPA WHO HAS EITHER COMPILED, REVIEWED OR AUDITED THE CONCESSIONER'S FINANCIAL STATEMENTS
AND HAVE COMPLETED THE ANNUAL FINANCIAL REPORT.
By typing my name in the box below, I certify that I have been authorized to complete and submit this report on behalf of the concessioner. This report has
been completed and prepared under my supervision using data/information from the company's compiled/reviewed/audited financial statements and/or
other financial records and to the best of my knowledge and belief is a true, correct, and complete report.
Name of Person Responsible for Report Information
Title
Date
CONCESSIONER CONTACT INFORMATION

Mailing Address
City
State
Zip Code
Telephone
Email Address

RECORDS RETENTION. TEMPORARY. Destroy/Delete 3 years after closure. (NPS Records Schedule, Commercial Visitor Services, (Item 5D) (N1-79-08-4))

NPS Form 10-356 (Rev. 08/2019)
National Park Service

OMB Control No. 1024-0029
Expiration Date xx/xx/xxxx

NOTICES
PRIVACY ACT STATEMENT
Authority: 16 U.S.C. 5966, Commercial Use Authorizations.
Purpose: The purposes of the system are (1) to assist NPS employees in managing the NPS Commercial
Services program allowing commercial uses within a unit of the National Park System to ensure that business
activities are conducted in a manner that complies with Federal laws and regulations; (2) to monitor resources that
are or may be affected by the authorized commercial uses within a unit of the National Park System; (3) to track
applicants and holders of commercial use authorizations who are planning to conduct or are conducting business
within units of the National Park System; and (4) to provide to the public the description and contact information for
businesses that provide services in national parks.
Routine Uses: In addition to those disclosures generally permitted under 5 U.S.C.552a(b) of the Privacy Act,
records or information contained in this system may be disclosed outside DOI as a routine use pursuant to 5
U.S.C. 552a(b)(3) to other Federal, state and local governments, tribal organizations, and members of the general
public upon request for names, addresses and phone numbers of Commercial Use Authorizations (CUA) holders
conducting business within units of the National Park System for the purpose of informing the public of the
availability of the services offered by the CUA holder. In addition, records or information contained in this system
may be disclosed outside DOI based on an authorized routine use when the disclosure is compatible with the
purpose for which the records were compiled as described under the system of records notice for this system.
Disclosure: Voluntary, however, failure to provide the requested information may impede our ability to 1) manage
the National Park Service (NPS) Commercial Services Program allowing commercial uses within a unit of the NPS,
2) monitor resources that are or may be affected by the authorized commercial uses, and 3) provide the public the
description and contact information for businesses that provide services in national parks.
PAPERWORK REDUCTION ACT STATEMENT
We collect this information under the authority of Title IV of the National Parks Omnibus Management Act of 1998
(Pub. L. 105–391). We use this information to determine the franchise fees of the concessioner. Your response is
required to obtain or retain a benefit. We may not collect or sponsor and you are not required to respond to a
collection of information unless it displays a currently valid OMB control number. OMB has approved this
collection of information and assigned Control No. 1024-0029.
ESTIMATED BURDEN STATEMENT
We estimate that it will take you 15 hours to complete this form, including time to review instructions, gather and
maintain data, and complete and review the form. You may send comments on the burden estimate or any aspect
of this form to the Information Collection Clearance Officer, National Park Service at [email protected] (email).
Please do not send your completed form to this address.

CONCESSIONER: -

SCHEDULE A - COMBINED STATEMENT OF INCOME AND RETAINED EARNINGS
PERIOD ENDING: MM/DD/YYYY

1
2
3
4
5
6
7

DEPARTMENTAL INCOME
GROSS RECEIPTS (Schedule H, Column A, Line 2)
SALES RETURNS AND ALLOWANCES (Schedule H, Column A, Line 3)
NET SALES (Schedule H, Column A, Line 4)
COST OF SALES (Schedule H, Column A, Line 8)
GROSS PROFIT (Schedule H, Column A, Line 9)
TOTAL DIRECT EXPENSES (Schedule H, Column A, Line 34)
DEPARTMENTAL INCOME (LOSS) (Schedule H, Column A, Line 35)

8
9
10
11
12

INDIRECT OPERATING EXPENSES
General and Administrative Expenses (Schedule I, Line 29)
Government Fees (Schedule B, Line 32)
Special Account Contributions (Schedule N, Line 10)
TOTAL INDIRECT OPERATING EXPENSES
TOTAL INCOME (LOSS) FROM OPERATIONS BEFORE FIXED EXPENSES

13
14
15
16
17
18
19
20
21
22

FIXED EXPENSES
Rent
Property Taxes
Business/Liability/Property Insurance
Interest Expense
Depreciation (Schedule D, Column G, Line 13)
Amortization (Schedule D-1, Line 8)
(Other Fixed Expenses)
(Other Fixed Expenses)
TOTAL FIXED EXPENSES
INCOME (LOSS) BEFORE INCOME TAXES AND OTHER INCOME (EXPENSES)

23
24
25
26
27
28
29

OTHER EXPENSES (INCOME)
Interest and Dividend (Income)
Loss (Gain) on Sale of Assets
Commissions/Fees/Compensation from Subconcessioners (Income)(Schedule B, Line 30)
(Additional Other Expenses (Income))
(Additional Other Expenses (Income))
TOTAL OTHER EXPENSES (INCOME)
INCOME (LOSS) BEFORE INCOME TAXES

30
31
32
33

INCOME TAXES
Federal
State and Local
TOTAL INCOME TAXES
NET INCOME (LOSS)

34
35
36
37
38
39
40
41

This Period: YYYY Last Period: YYYY

RETAINED EARNINGS
Retained Earnings - Beginning of Year
Prior Period Adjustments
(Other Retained Earnings)
Net Income (Loss) (Line 33)
Dividends Paid
Retained Earnings - End of Year
Total Shares
Earnings Per Share
*The accompanying notes are an integral part of these financial statements.

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CONCESSIONER: -

SCHEDULE A-1 - STATEMENT OF INCOME AND COMPREHENSIVE INCOME
PERIOD ENDING: MM/DD/YYYY
This Period: YYYY

Last Period: YYYY

0

0

0

0

1 Net Income (loss) (Schedule A, Line 33)
2
3
4
5
6

List Other Comprehensive Income:
Foreign Currency Items
Holding Losses or Gains on Available-For-Sale-Securities
Excess of Additional Pension Liability
Changes in Market Value of Futures Contract
Total Comprehensive Income
*The accompanying notes are an integral part of these financial statements.

Page 5

CONCESSIONER: -

SCHEDULE B - COMPUTATION OF GOVERNMENT FEES

PERIOD ENDING: MM/DD/YYYY

1 FLAT FEE
2 BUILDING USE FEE (USE OF GOVERNMENT-OWNED IMPROVEMENTS)
PERCENTAGE FEE
3 Gross Receipts (Schedule A, Line 1)
4
5
6
7

0

PLUS: Gross Receipts of Subconcessioners
(Name of Subconcessioner)
(Name of Subconcessioner)
(Name of Subconcessioner)
Total Gross Receipts of Subconcessioners

0

8
9
10
11
12
13
14
15
16
17
18
19
20
21

LESS: Authorized Deductions (ONLY If Included in Gross Receipts)
Genuine Authorized Native Handicrafts (Schedule G, Line 12)
Intracompany Earnings
Charges for Employees’ Meals, Lodgings and Transportation (Schedule G, Line 66)
Cash Discounts on Purchases (Purchases Discounts)
Cash Discounts on Sales (Sales Discounts)
Returned Sales and Allowances (Sales Returns and Allowances) (Schedule A, Line 2)
Excise Taxes Added to Sales Price
Gasoline Taxes
Cost of Fishing Licenses Fees Sold
Cost of Postage Stamps Sold
Outside of Park Sales (Included in Gross Receipts)
(Other)
Total Authorized Deductions
Total Gross Receipts Per Contract Subject to Percentage Fee

22
23
24
25
26

Fee Structure:
(Percentage fee)
(Percentage fee)
(Percentage fee)
(Percentage fee)
TOTAL PERCENTAGE FEE

27
28
29
30
31
32

COMMISSIONS/FEES/COMPENSATION FROM SUBCONCESSIONERS
(Name of Subconcessioner)
(Name of Subconcessioner)
(Name of Subconcessioner)
Total Commissions/Fees/Compensation From Subconcessioners
FIFTY PERCENT OF COMMISSIONS/FEES/COMPENSATION FROM SUBCONCESSIONERS
TOTAL GOVERNMENT FEES (Carry to Schedule A, Line 9)

% of
% of
% of
% of

(Gross Receipts)
(Gross Receipts)
(Gross Receipts)
(Gross Receipts)

=
=
=
=

*Schedule B is for computing Government Franchise Fees only. Computation of amounts due to the Component
Renewal/Replacement Reserve and Special Accounts should be done on Schedules P and N, respectively.

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CONCESSIONER: -

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22

23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45

SCHEDULE C - BALANCE SHEET

ASSETS
CURRENT ASSETS
Cash and Cash Equivalents
Marketable Securities
Inventories - Merchandise
Accounts Receivable
Notes Receivable - Related Party
Notes Receivable - Other
Prepaid Expenses
Component Renewal/Replacement Reserve (Schedule P, Lines 8 and 11)
Special Account Fund
(Other Current Assets)
TOTAL CURRENT ASSETS
FIXED ASSETS
Depreciable Fixed Assets (Schedule D, Column G, Line 5)
Less: Accumulated Depreciation (Schedule D, Column G, Line 15)
Net Depreciable Fixed Assets (Schedule D, Column G, Line 16)
Construction in Progress
Land
TOTAL FIXED ASSETS
Net Intangible Assets (Schedule D-1, Line 11)
Gross PI/LSI Subject to ASC Topic 853
(Other Assets)
TOTAL OTHER ASSETS
TOTAL ASSETS
LIABILITIES
CURRENT LIABILITIES
Notes Payable - Related Party
Notes Payable - Other
Accounts Payable
Current Maturities on Long - Term Debt
Government Fees Payable
Special Account Payable
Accrued Liabilities
Advance Deposits
(Other Current Liabilities)
TOTAL CURRENT LIABILITIES
LONG-TERM LIABILITIES
Long -Term Debt, Excluding Current Maturities
(Other Long-Term Liabilities)
TOTAL LONG-TERM LIABILITIES
TOTAL LIABILITIES

PERIOD ENDING: MM/DD/YYYY
This Period: YYYY

Last Period: YYYY

0

0

0

0

0
0
0

0
0
0

0
0
0

0
0
0

0
0

0
0

0

0

0
0

0
0

EQUITY
Partner’s or Proprietor’s Capital
Common and Preferred Stock
(Other Equity)
Additional Paid - In Capital
Less: Treasury Stock
Retained Earnings (Schedule A, Line 39)
0
Accumulated Other Comprehensive Income (Loss)
TOTAL EQUITY
0
TOTAL LIABILITIES AND EQUITY
0
*The accompanying notes are an integral part of these financial statements.

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SCHEDULE D - DEPRECIABLE FIXED ASSETS

CONCESSIONER: -

PERIOD ENDING: MM/DD/YYYY
FIXED ASSETS IN
WHICH LEASEHOLD
SURRENDER
INTEREST IS
CLAIMED

FIXED ASSETS IN WHICH POSSESSORY
INTEREST IS CLAIMED

COST
1 Depreciable Fixed Assets / Gross
PI subject to ASC 853, Prior Year
Balance

NPS Approved
Concessioner
Improvements
A

NPS Approved
Government
Improvements
B

NPS Approved
Capital
Improvements
C

FIXED ASSETS EXCLUDING OR NOT ELIGIBLE FOR POSSESSORY INTEREST OR
LEASEHOLD SURRENDER INTEREST

Other
Improvements

Transportation
Equipment

Furniture, Fixtures
& Equipment

Other Personal
Property

D

E

F

G

TOTAL

H

0

2 Adjustment(s) to Prior Year
Balance(s)

0

3 Additions this Year (Must be
itemized on Schedule K)

0

4 Disposals this Year (Must be
itemized on Schedule K)

0

5 Depreciable Fixed Assets, Ending
Balance (Carry Column G to
Schedule C, Line 12)

0

0

0

0

0

0

0

0

ACCUMULATED DEPRECIATION
11 Accumulated Depreciation, Prior
Year Balance

0

12 Adjustment(s) to Prior Year
Balance(s)

0

13 Depreciation this Year (Carry
Column G to Schedule A, Line 17)

0

14 Accumulated Depreciation on
Assets Disposed this Year

0

15 Accumulated Depreciation,
Ending Balance (Carry Column G
to Schedule C, Line 13)

0

0

0

0

0

0

0

0

16 Net Depreciable Fixed Assets,
End of Year (Carry Column G to
Schedule C, Line 14)

0

0

0

0

0

0

0

0

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CONCESSIONER: -

COST
1 Gross PI or LSI subject to ASC 853, Prior Year
Balance
1A ASC 853 Implementation Adjustment
2 Adjustment(s) to Prior Year Balance(s)
3 Additions this Year
4 Disposals this Year
5 Gross PI or LSI subject to ASC 853, Ending
Balance

SCHEDULE D - FINANCIAL ASSETS

PERIOD ENDING: MM/DD/YYYY

NON-FIXED ASSETS IN
WHICH LEASEHOLD
NON-FIXED ASSETS IN WHICH POSSESSORY INTEREST
SURRENDER INTEREST IS
IS CLAIMED - SUBJECT TO ASC TOPIC 853
CLAIMED - SUBJECT TO
ASC TOPIC 853
NPS Approved
NPS Approved Capital
NPS Approved Capital
Government
Improvements
Improvements
Improvements

0

0

0

0

0

0

0

0

0

VALUATION ADJUSTMENTS
6 PI or LSI valuation adjustment, Prior Year
Balance
7 Current Year PI or LSI valuation adjustment
(Carry Column H to Schedule A, Line 26)
8 PI or LSI valuation adjustment, Ending
Balance
9 PI or LSI subject to ASC 853 (Carry Column H
to Schedule C, Line 19)

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CONCESSIONER: -

SCHEDULE D - INTANGIBLE ASSETS

PERIOD ENDING: MM/DD/YYYY

1
1A
2
3
4
5

COST
Gross intangible, Prior Year Balance
ASC 853 Implementation Adjustment
Adjustment(s) to Prior Year Balance(s)
Additions this Year
Disposals this Year
Gross intangible, Ending Balance

0

6
7
8
9
10
11

ACCUMULATED AMORTIZATION
Accumulated Amortization, Prior Year Balance
Adjustment(s) to Prior Year Balance(s)
Amortization this Year (Carry to Schedule A, Line 18)
Accumulated Amortization on Assets Disposed this Year
Accumulated Amortization, Ending Balance
Net intangible (Carry to Schedule C, Line 18)

0
0

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CONCESSIONER: -

SCHEDULE E - STATEMENT OF CASH FLOWS - DIRECT METHOD
PERIOD ENDING: MM/DD/YYYY
This Period: YYYY

Last Period: YYYY

0

0

1
2
3
4a
4b
5
6
7
8
9

CASH FLOWS FROM OPERATING ACTIVITIES
Cash received from customers
Cash paid for merchandise
Cash paid for wages and other operating expenses
Cash received for interest
Cash paid for interest
Cash paid for taxes
Cash paid to National Park Service for franchise fees
(Other Cash from Operating Acitivities)
(Other Cash from Operating Acitivities)
Net Cash Flows Provided (Used) by Operating Activities

10
11
12
13
14
15
16

CASH FLOWS FROM INVESTING ACTIVITIES
Purchase of assets
Proceeds from sale of assets
(Other Cash from Investing Acitivities)
(Other Cash from Investing Acitivities)
(Other Cash from Investing Acitivities)
(Other Cash from Investing Acitivities)
Net Cash Flows Provided (Used) by Investing Activities

0

0

17
18
19
20
21
22
23
24

CASH FLOWS FROM FINANCING ACTIVITIES
Net increase/decrease in intracompany receivable account
Cash received from issuing stock
Cash paid to retire bonds
Cash paid for dividends
(Other Cash from Financing Acitivities)
(Other Cash from Financing Acitivities)
Net Cash Flows Provided (Used) by Financing Activities
NET INCREASE (DECREASE) IN CASH

0
0

0
0

0
0

0

0

0

0
0
0

0
0
0

25 CASH AT BEGINNING OF YEAR
26 CASH AT END OF YEAR (Schedule C, Line 1)
RECONCILIATION OF NET INCOME TO NET CASH PROVIDED BY OPERATIONS
27 Net Income (Loss) (Schedule A, line 33)
Adjustments to reconcile net income to net cash provided by operating activities
28
Depreciation expense (Schedule A, Line 17)
29
Amortization expense (Schedule A, Line 18)
30
Gain or loss on sale of assets (Schedule A, Line 24)
31
(Other non-cash expenses (income))
Changes in Assets and Liabilities:
32
Inventories
33
Accounts receivable
34
Prepaid expenses
35
Other current assets
36
Accounts payable
37
Government fees and contributions payable
38
Accrued liabilities
39
Advance deposits
40
Other current liabilities
41
(Other)
42
(Other)
43 Net Cash provided by operating activities
*The accompanying notes are an integral part of these financial statements.

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CONCESSIONER: -

SCHEDULE F - NOTES TO FINANCIAL STATEMENTS

PERIOD ENDING: MM/DD/YYYY

1
2
3
4
5
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7
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9
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12
13
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15
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18
19
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21
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30
31
32
33
34
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36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
*If the financial notes do not fit on this page, save them as a separate Word, Excel or PDF file and upload with the AFR. See
User's Guide for instructions.

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CONCESSIONER: -

1
2
3
4
5
6
7
8
9
10

SCHEDULE G - DETAIL OF GROSS RECEIPTS

PERIOD ENDING: MM/DD/YYYY
Reference to Table Column
on Schedule H

Amount

LODGING
Hotel and Motel
Cabins and Cottages
Hostels
Tent Cabins
LODGING DEPARTMENT TOTAL

0

FOOD AND BEVERAGE
Restaurant
Cafeteria
Snack Bar and Fast Food
FOOD DEPARTMENT TOTAL
Alcoholic Beverages

0

SOUVENIRS
11 Gifts, Curios
12 Genuine Authorized Native Handicrafts
13 SOUVENIR DEPARTMENT TOTAL

0

14
15
16
17
18

GENERAL MERCHANDISE
Grocery
Package Liquor
Camera and Photographic Supplies
(Other General Merchandise)
MERCHANDISE DEPARTMENT TOTAL

0

19
20
21
22
23

RECREATION VEHICLE PARKS AND CAMPSITES
Tents
RV Camping (without hook-ups)
RV Camping (with hook-ups)
RV Park
RV AND CAMPSITES DEPARTMENT TOTAL

0

AUTO SERVICE
24 Fuel and Oil
25 Parts, Service and Other
26 AUTO SERVICE DEPARTMENT TOTAL
27
28
29
30
31
32
33
34
35
36
37

0

MARINA
Covered Slips
Uncovered Slips and Mooring
Houseboat Rental
Boat and Motor Rental
Fuel and Oil
Boat and Motor Sales
Boat Repair
Dry Storage
(Other Marina)
(Other Marina)
MARINA DEPARTMENT TOTAL

0

TRANSPORTATION OF VISITORS
38 Water
39 Air

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CONCESSIONER: -

40
41
42
43

SCHEDULE G - DETAIL OF GROSS RECEIPTS

PERIOD ENDING: MM/DD/YYYY
Reference to Table Column
on Schedule H

Amount

Ground
(Other Transportation)
(Other Transportation)
TRANSPORTATION OF VISITORS DEPARTMENT TOTAL

0

HORSE AND MULE
44 Horse and Mule Pack Services
45
46
47
48
49
50
51
52
53
54

GUIDED TOURS
Float Trips and River Runners
Water
Ground (Vehicle/Tram/Bus)
Ground (Snowmobiles)
Air
Backcountry Horse Trail Rides
Backcountry Hiking
(Other Guided Tours)
(Other Guided Tours)
GUIDED DEPARTMENT TOTAL

0

CRUISE SHIPS
55 Cruise Ships
56
57
58
59
60
61
62
63
64
65
66

OTHER
Parking Lot
Vending Machine
Bathhouse/Health Spa Services
Rentals (Equipment, Video, Bicycles & Other)
Hunting Guides
Instructional Service (mountain climbing school; environmental
school, etc.)
Medical Care
Golf Course and Driving Range
Sports Facilities
(Other Departments)
(Other Departments)

EMPLOYEE CHARGES
67 Charges for Employee's meals, lodgings and transportation
68 TOTAL GROSS RECEIPTS

0

Page 14

SCHEDULE H - DEPARTMENTAL INCOME AND EXPENSES
CONCESSIONER: 1
2
3
4

DEPARTMENT
GROSS RECEIPTS
SALES RETURNS AND ALLOWANCES
NET SALES

5
6
7
8
9

COST OF SALES
Inventory, Beginning
Plus: Purchases
Less: Ending Inventory
TOTAL COST OF SALES
GROSS PROFIT

DIRECT EXPENSES
DIRECT LABOR
10 Direct Salaries, Wages, Payroll Taxes,
and Benefits
11 Maintenance Salaries, Payroll Taxes,
and Benefits
12 TOTAL DIRECT LABOR
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34

OTHER DIRECT
Laundry
Uniforms
China, Silver, Linen and Glass
Commissions
Music and Entertainment
Operating Supplies
Equipment Rental
Contract Services
Utilities Expense
Licenses and Fees
Repair and Maintenance Expense
Repair and Maintenance Expensed
from Component Renewal/
Replacement Reserve
Vehicle Expense
Spoilage
Travel and Trip Expense
Equipment Purchased
Hay, Pasture and Feed
(Other Direct Expenses)
(Other Direct Expenses)
(Other Direct Expenses)
TOTAL OTHER DIRECT
TOTAL DIRECT EXPENSES

35 DEPARTMENTAL INCOME (LOSS)

PERIOD ENDING: MM/DD/YYYY
A
Total All Columns

0
0
0

B
(Department)

C
(Department)

D
(Department)

E
(Department)

PERIOD ENDING: MM/DD/YYYY
F
(Department)

G
(Department)

H
(Department)

I
(Department)

PERIOD ENDING: MM/DD/YYYY
J
(Department)

K
(Department)

L
(Department)

M
(Department)

0

0

0

0

0

0

0

0

0

0

0

0

0
0

0
0

0
0

0
0

0
0

0
0

0
0

0
0

0
0

0
0

0
0

0
0

0

0

0

0

0

0

0

0

0

0

0

0

0
0
0
0
0
0
0
0
0
0

0
0

0
0

0
0

0
0

0
0

0
0

0
0

0
0

0
0

0
0

0
0

0
0

0

0

0

0

0

0

0

0

0

0

0

0

0

0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Page 15

CONCESSIONER: -

SCHEDULE I - GENERAL AND ADMINISTRATIVE EXPENSES

PERIOD ENDING: MM/DD/YYYY

This Period: YYYY
1 Owners, Officers and Partners Salaries, Payroll Taxes and Benefits (Schedule J,
Column I, Line 21)
2a
2b
2c
2d
2e
2f
2g
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29

Other Salaries, Payroll Taxes and Benefits:
Office / Manager's Office
Accounting / Finance
Human Resources / Personnel
Information System / Data Processing
Marketing / Promotion
(Other Salaries, Payroll Taxes and Benefits)
(Other Salaries, Payroll Taxes and Benefits)
Total Other (Administrative) Salaries, Payroll Taxes and Benefits
Employee Recruitment
Over and Short
Credit Card Fees
Bank Charges
Bad Debts
Office Expense
Data Processing
Postage and Freight
Dues and Subscriptions
Travel Expense
Telecommunications Expense
Donations
Complimentary
Management Fees
Corporate Overhead
Legal Fees
Accounting and Audit Fees
Advertising and Promotional Expense
Security Expense
Consulting Agreements
Training Cost
Other Personnel Expenses
(Other G&A Expenses)
(Other G&A Expenses)
(Other G&A Expenses)
(Other G&A Expenses)
TOTAL GENERAL AND ADMINISTRATIVE EXPENSES (Carry to Schedule A, Line
8)

Page 16

Last Period: YYYY

0

0

0

0

0

CONCESSIONER: A

SCHEDULE J - INFORMATION ON CORPORATE OWNERS, OFFICERS AND PARTNERS
PERIOD ENDING: MM/DD/YYYY
B

C

D

E
% of Ownership

F

% of Time
Devoted to Partnership Common Preferred
Business
Interest
Stock
Stock

Name
Title
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20 Individual Total of Columns G and H
21 Total Amount of Owners, Officers and Partners Compensation (Carry to Schedule I, Line 1)

Page 17

G

H

Total
Wages

Total
Benefits

0

I

0

Total Amount
of
Compensation
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

SCHEDULE K - ADDITIONS TO AND DISPOSALS OF DEPRECIABLE FIXED ASSETS AND PI/LSI ASSETS
CONCESSIONER: PERIOD ENDING: MM/DD/YYYY

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40

Asset
Description

NPS
Asset #

Date of
Acquisition
Type* or Disposal

Depreciation
Method

Years of
Useful
Life

Cost

Current Year
Depreciation

Accumulated
Depreciation
for Disposal

*Use the following letters in "Type" Column to describe the assets types for all appropriate additions and disposals:
C=
G=
L=
I=
M=
P=

Concessioner improvements with or eligible for Possessory Interest.
Government assigned improvements with or eligible for Possessory Interest.
Capital improvements with or eligible for Leasehold Surrender Interest.
Other improvements excluding or not eligible for Leasehold Surrender Interest or Possessory Interest.
Concessioner's contractually required Component Renewal/Replacement Reserve.
Personal Property.

Page 18

CONCESSIONER: -

SCHEDULE L - SUPPLEMENTAL INFORMATION

PERIOD ENDING: MM/DD/YYYY

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
*If the financial notes do not fit on this page, save them as a separate Word, Excel or PDF file and upload with the AFR. See
User's Guide for instructions.

Page 19

CONCESSIONER: -

SCHEDULE M1 - OPERATIONAL STATISTICS

PERIOD ENDING: MM/DD/YYYY

Site:
Period Covered:
1
2
3
4
5
6
7
8
9
10
11
12
13

LODGING
Number of Rooms in Facility
Total Number of Room Nights Available
Total Number of Room Nights Occupied
Occupancy Percentage
Average Daily Room Rate (ADR)
Revenue Per Available Room (RevPAR)
Total Number of Guests
Number of Lodging Employees

0%
0

FOOD AND BEVERAGE
Number of Seats
Total Square Feet of Seating Area
Total Customers
Average Check per Customer
Number of Food and Beverage Employees

GIFTS AND MERCHANDISE
14 Total Retail Square Feet (including storage)
15 Average Transaction / square foot
16 Total Number of Retail Employees
17
18
19
20
21
22

MARINAS
Covered Slips
Uncovered Slips
Rental Boats and Houseboats
Dry Storage Units
Linear Feet of Wet Moorage
Number of Marina Employees

23
24
25
26
27
28

TRANSPORTATION / TOUR / GUIDE SERVICE
(Type of Trip/Tour)
(Type of Trip/Tour)
(Type of Trip/Tour)
(Type of Trip/Tour)
(Type of Trip/Tour)
Number of Transportation Employees

CAMPGROUNDS
29 Campground Sites
30 Number of Campground Employees
CONCESSION EMPLOYEES
31 Permanent year around employees
32 Filled seasonal positions
33 Estimated total full-time equivalents (One FTE =
2,080 hours)
CONCESSION EMPLOYEE HOUSING
34 Employee Beds
35 Direct Housing Expense

Number Available

Average Occupied

Occupancy Rate

Annual Trips

Annual Riders

Riders per Trip

Number Available

Average Occupied

Occupancy Rate

Average Occupied

Occupancy Rate

0%
0%
0%
0%

0
0
0
0
0

0%

Annual

Number Available
Total

Page 20

Per Occupied Bed
0.00

0%

CONCESSIONER: -

SCHEDULE M2 - OPERATIONAL STATISTICS

PERIOD ENDING: MM/DD/YYYY

Site:
Period Covered:
1
2
3
4
5
6
7
8
9
10
11
12
13

LODGING
Number of Rooms in Facility
Total Number of Room Nights Available
Total Number of Room Nights Occupied
Occupancy Percentage
Average Daily Room Rate (ADR)
Revenue Per Available Room (RevPAR)
Total Number of Guests
Number of Lodging Employees

0%
0

FOOD AND BEVERAGE
Number of Seats
Total Square Feet of Seating Area
Total Customers
Average Check per Customer
Number of Food and Beverage Employees

GIFTS AND MERCHANDISE
14 Total Retail Square Feet (including storage)
15 Average Transaction / square foot
16 Total Number of Retail Employees
17
18
19
20
21
22

MARINAS
Covered Slips
Uncovered Slips
Rental Boats and Houseboats
Dry Storage Units
Linear Feet of Wet Moorage
Number of Marina Employees

23
24
25
26
27
28

TRANSPORTATION / TOUR / GUIDE SERVICE
(Type of Trip/Tour)
(Type of Trip/Tour)
(Type of Trip/Tour)
(Type of Trip/Tour)
(Type of Trip/Tour)
Number of Transportation Employees

CAMPGROUNDS
29 Campground Sites
30 Number of Campground Employees

Number Available

Average Occupied

Occupancy Rate

Annual Trips

Annual Riders

Riders per Trip

Number Available

Average Occupied

Occupancy Rate

Page 21

0%
0%
0%
0%

0
0
0
0
0

0%

CONCESSIONER: -

SCHEDULE M3 - OPERATIONAL STATISTICS

PERIOD ENDING: MM/DD/YYYY

Site:
Period Covered:
1
2
3
4
5
6
7
8
9
10
11
12
13

LODGING
Number of Rooms in Facility
Total Number of Room Nights Available
Total Number of Room Nights Occupied
Occupancy Percentage
Average Daily Room Rate (ADR)
Revenue Per Available Room (RevPAR)
Total Number of Guests
Number of Lodging Employees

0%
0

FOOD AND BEVERAGE
Number of Seats
Total Square Feet of Seating Area
Total Customers
Average Check per Customer
Number of Food and Beverage Employees

GIFTS AND MERCHANDISE
14 Total Retail Square Feet (including storage)
15 Average Transaction / square foot
16 Total Number of Retail Employees
17
18
19
20
21
22

MARINAS
Covered Slips
Uncovered Slips
Rental Boats and Houseboats
Dry Storage Units
Linear Feet of Wet Moorage
Number of Marina Employees

23
24
25
26
27
28

TRANSPORTATION / TOUR / GUIDE SERVICE
(Type of Trip/Tour)
(Type of Trip/Tour)
(Type of Trip/Tour)
(Type of Trip/Tour)
(Type of Trip/Tour)
Number of Transportation Employees

CAMPGROUNDS
29 Campground Sites
30 Number of Campground Employees

Number Available

Average Occupied

Occupancy Rate

Annual Trips

Annual Riders

Riders per Trip

Number Available

Average Occupied

Occupancy Rate

Page 22

0%
0%
0%
0%

0
0
0
0
0

0%

CONCESSIONER: -

SCHEDULE M4 - OPERATIONAL STATISTICS

PERIOD ENDING: MM/DD/YYYY

Site:
Period Covered:
1
2
3
4
5
6
7
8
9
10
11
12
13

LODGING
Number of Rooms in Facility
Total Number of Room Nights Available
Total Number of Room Nights Occupied
Occupancy Percentage
Average Daily Room Rate (ADR)
Revenue Per Available Room (RevPAR)
Total Number of Guests
Number of Lodging Employees

0%
0

FOOD AND BEVERAGE
Number of Seats
Total Square Feet of Seating Area
Total Customers
Average Check per Customer
Number of Food and Beverage Employees

GIFTS AND MERCHANDISE
14 Total Retail Square Feet (including storage)
15 Average Transaction / square foot
16 Total Number of Retail Employees
17
18
19
20
21
22

MARINAS
Covered Slips
Uncovered Slips
Rental Boats and Houseboats
Dry Storage Units
Linear Feet of Wet Moorage
Number of Marina Employees

23
24
25
26
27
28

TRANSPORTATION / TOUR / GUIDE SERVICE
(Type of Trip/Tour)
(Type of Trip/Tour)
(Type of Trip/Tour)
(Type of Trip/Tour)
(Type of Trip/Tour)
Number of Transportation Employees

CAMPGROUNDS
29 Campground Sites
30 Number of Campground Employees

Number Available

Average Occupied

Occupancy Rate

Annual Trips

Annual Riders

Riders per Trip

Number Available

Average Occupied

Occupancy Rate

Page 23

0%
0%
0%
0%

0
0
0
0
0

0%

CONCESSIONER: -

SCHEDULE M5 - OPERATIONAL STATISTICS

PERIOD ENDING: MM/DD/YYYY

Site:
Period Covered:
1
2
3
4
5
6
7
8
9
10
11
12
13

LODGING
Number of Rooms in Facility
Total Number of Room Nights Available
Total Number of Room Nights Occupied
Occupancy Percentage
Average Daily Room Rate (ADR)
Revenue Per Available Room (RevPAR)
Total Number of Guests
Number of Lodging Employees

0%
0

FOOD AND BEVERAGE
Number of Seats
Total Square Feet of Seating Area
Total Customers
Average Check per Customer
Number of Food and Beverage Employees

GIFTS AND MERCHANDISE
14 Total Retail Square Feet (including storage)
15 Average Transaction / square foot
16 Total Number of Retail Employees
17
18
19
20
21
22

MARINAS
Covered Slips
Uncovered Slips
Rental Boats and Houseboats
Dry Storage Units
Linear Feet of Wet Moorage
Number of Marina Employees

23
24
25
26
27
28

TRANSPORTATION / TOUR / GUIDE SERVICE
(Type of Trip/Tour)
(Type of Trip/Tour)
(Type of Trip/Tour)
(Type of Trip/Tour)
(Type of Trip/Tour)
Number of Transportation Employees

CAMPGROUNDS
29 Campground Sites
30 Number of Campground Employees

Number Available

Average Occupied

Occupancy Rate

Annual Trips

Annual Riders

Riders per Trip

Number Available

Average Occupied

Occupancy Rate

Page 24

0%
0%
0%
0%

0
0
0
0
0

0%

CONCESSIONER: -

SCHEDULE M6 - OPERATIONAL STATISTICS

PERIOD ENDING: MM/DD/YYYY

Site:
Period Covered:
1
2
3
4
5
6
7
8
9
10
11
12
13

LODGING
Number of Rooms in Facility
Total Number of Room Nights Available
Total Number of Room Nights Occupied
Occupancy Percentage
Average Daily Room Rate (ADR)
Revenue Per Available Room (RevPAR)
Total Number of Guests
Number of Lodging Employees

0%
0

FOOD AND BEVERAGE
Number of Seats
Total Square Feet of Seating Area
Total Customers
Average Check per Customer
Number of Food and Beverage Employees

GIFTS AND MERCHANDISE
14 Total Retail Square Feet (including storage)
15 Average Transaction / square foot
16 Total Number of Retail Employees
17
18
19
20
21
22

MARINAS
Covered Slips
Uncovered Slips
Rental Boats and Houseboats
Dry Storage Units
Linear Feet of Wet Moorage
Number of Marina Employees

23
24
25
26
27
28

TRANSPORTATION / TOUR / GUIDE SERVICE
(Type of Trip/Tour)
(Type of Trip/Tour)
(Type of Trip/Tour)
(Type of Trip/Tour)
(Type of Trip/Tour)
Number of Transportation Employees

CAMPGROUNDS
29 Campground Sites
30 Number of Campground Employees

Number Available

Average Occupied

Occupancy Rate

Annual Trips

Annual Riders

Riders per Trip

Number Available

Average Occupied

Occupancy Rate

Page 25

0%
0%
0%
0%

0
0
0
0
0

0%

CONCESSIONER: -

SCHEDULE M7 - OPERATIONAL STATISTICS

PERIOD ENDING: MM/DD/YYYY

Site:
Period Covered:
1
2
3
4
5
6
7
8
9
10
11
12
13

LODGING
Number of Rooms in Facility
Total Number of Room Nights Available
Total Number of Room Nights Occupied
Occupancy Percentage
Average Daily Room Rate (ADR)
Revenue Per Available Room (RevPAR)
Total Number of Guests
Number of Lodging Employees

0%
0

FOOD AND BEVERAGE
Number of Seats
Total Square Feet of Seating Area
Total Customers
Average Check per Customer
Number of Food and Beverage Employees

GIFTS AND MERCHANDISE
14 Total Retail Square Feet (including storage)
15 Average Transaction / square foot
16 Total Number of Retail Employees
17
18
19
20
21
22

MARINAS
Covered Slips
Uncovered Slips
Rental Boats and Houseboats
Dry Storage Units
Linear Feet of Wet Moorage
Number of Marina Employees

23
24
25
26
27
28

TRANSPORTATION / TOUR / GUIDE SERVICE
(Type of Trip/Tour)
(Type of Trip/Tour)
(Type of Trip/Tour)
(Type of Trip/Tour)
(Type of Trip/Tour)
Number of Transportation Employees

CAMPGROUNDS
29 Campground Sites
30 Number of Campground Employees

Number Available

Average Occupied

Occupancy Rate

Annual Trips

Annual Riders

Riders per Trip

Number Available

Average Occupied

Occupancy Rate

Page 26

0%
0%
0%
0%

0
0
0
0
0

0%

SCHEDULE P - COMPONENT RENEWAL/REPLACEMENT RESERVE ANNUAL RECONCILIATION
CONCESSIONER: PERIOD ENDING: MM/DD/YYYY
1
2
3
4
5
6
7

8
9
10
11

CALCULATION OF COMPONENT RENEWAL/REPLACEMENT RESERVE
Gross Receipts (Schedule A, Line 1)
Less - Adjustments to Gross Receipts (Schedule B, Line 20)
Gross Receipts Subject to Reserve Calculation (Schedule B, Line 21)
Component Renewal/Replacement Reserve Percentage
Amount Due to Component Renewal/Replacement Reserve
(Other Method - Per Authorization (Specify Calculations))
Total Amount Due to Component Renewal/Replacement Reserve for the Current Year
COMPONENT RENEWAL/REPLACEMENT RESERVE RECONCILIATION
Balance in Component Renewal/Replacement Reserve from Prior Year
Total Amount Due to Component Renewal/Replacement Reserve for Current Year
Less: Total Expenditures Made in Current Year (Schedule Q, Line 40)
Balance in Component Renewal/Replacement Reserve at Year End

Page 27

0
0
0
0
0

0
0
0

CONCESSIONER: -

SCHEDULE Q - COMPONENT RENEWAL/REPLACEMENT RESERVE EXPENDITURES
PERIOD ENDING: MM/DD/YYYY

Expenditure Description

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40 TOTAL EXPENDITURES MADE IN CURRENT YEAR

Expenditures Made in
Current Year

AFR Reference*

0

*Identify which Schedule(s) and Line(s) each Expenditure is Reported on in the AFR

Page 28

NPS Approval
Date

Schedule K, Type
C
G
L
I
M
P

Concessioner Info, Type of Entity
C Corporation
S Corporation
B Corporation
Limited Liability Company
Partnership
Sole Proprietorship
Other