Form FS-2700-8 Annual Gross Fixed Assets for Purposes of Annual Land Us

USDA - Forest Service FS-2700-8 (XX/202X)

OMB No. 0596-0082

USDA Forest Service				1. Name of Concessioner
ANNUAL GROSS FIXED ASSETS FOR PURPOSES OF ANNUAL LAND USE FEES CALCULATION (Reference FSM 2710)				     
				2.
				At , 20     
I. Description of Assets (GFA)			Booked Cost or Other Basis (a)		II. Adjustments +(-)			GFA for Fee Calculation (a)
GFA List (a)		Depreciation Schedule (b)			Amount (a)		Code (b)
Date Acq’d	(Cumulative Totals Carried Forward)		$	     	$	     	  	$	     
    	     	     	     		     		  		     
    	     	     	     		     		  		     
    	     	     	     		     		  		     
    	     	     	     		     		  		     
    	     	     	     		     		  		     
    	     	     	     		     		  		     
    	     	     	     		     		  		     
    	     	     	     		     		  		     
    	     	     	     		     		  		     
    	     	     	     		     		  		     
    	     	     	     		     		  		     
    	     	     	     		     		  		     
    	     	     	     		     		  		     
    	     	     	     		     		  		     
    	     	     	     		     		  		     
    	     	     	     		     		  		     
    	     	     	     		     		  		     
    	     	     	     		     		  		     
    	     	     	     		     		  		     
    	     	     	     		     		  		     
    	     	     	     		     		  		     
    	     	     	     		     		  		     
    	     	     	     		     		  		     
    	     	     	     		     		  		     
Grand (or cumulate page) Totals ——————————>			$	     	$	     	  		     
Fiscal Year change adjustment (FSM 22783.11a.R3-A3)								(	     	)
Net GFA (Block E, form FS-2700-19, also See permit)								$	     
Adjustment Codes A – Intangible asset (explain) B – Uncapitalized cost to provide utility service C – Expensed assets allowed by this Old permit D – Value of leased assets not capitalized E – To scale down value of assets used both on and off the permit (explain). F – Assets used during the year, but sold before yearend G – Not used in permitted activity, or allowed by Permit Terms (explain).

Instructional Sample

USDA Forest Service					1. Name of Concessioner
RECONCILIATION OF GROSS FIXED ASSETS (GFA) TO BOOKED AMOUNTS (Reference FSM 2710)					Sample
					2.
					At					,	20
I. Description of Assets (GFA)			Booked Cost or Other Basis (a)			II. Adjustments +/-				GFA for Fee Calculation (a)
GFA List (a)		Depreciation Schedule (b)				Amount (a)			Code (b)
Date Acq’d	(Beginning of the year Total Capitalized Assets)		$	1,215,000		$		(115,000)	D	$	1,100,000
2/19	Restaurant Goodwill	Goodwill		250,000				(250,000)	A		-0-
2/25	Restaurant equipment	(detail on actual list)		720.000							720,000
5/10	D-5 Dozer	Equipment		100,000				(60,000)	E		40,000
5/10	Cadillac Fleetwood	Vehicles		17,000				17,000	G		-0-
1975	D-6 Dozer (Sold in May )	Equipment		0				40,000	F		40,000
1975	Motel building Powerline	Model building		0				150,275	B		150,275
1976	Ski slope maint.	- - -		- - -				27,832	C		27,832
		Ending Balance Sheet Total
Grand (or cumulate page) Totals ——————————>			$	2,302,000		$		(223,893)			2,078,107
Fiscal Year change adjustment (FSM 22783.11a.R3-A3) —————————————————————>										(		)
Net GFA (Block E, form FS-2700-19, also See permit) ———————————————————————>										$	2,078.107
Ownership proration adjustment 100% - 96% = 4%
Adjustment Codes A – Intangible asset (explain) B – Uncapitalized cost to provide utility service C – Expensed assets allowed by this Old permit D – Value of leased assets not capitalized E – To scale down value of assets used both on and off the permit (explain). Rented out 60% of the time F – Assets used during the year, but sold before yearend G – Not used in permitted activity, or allowed by Permit Terms (explain). Used by wife who does not work in the business

PAPERWORK REDUCTION ACT STATEMENT

According to the Paperwork Reduction Act of 1995, a Federal agency may not conduct or sponsor, and a person is not required to respond to, an information collection request unless it displays a valid Office of Management and Budget (OMB) control number. The valid OMB control number for this information collection request is 0596-0082. Response to this information collection request is required to obtain or retain benefits, specifically, a special use authorization. The authority for this information collection request is the Organic Administration Act,16 U.S.C. 551. The time required to complete this information collection request is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, collecting and maintaining the data needed, and completing and reviewing the information collection request. Send comments regarding this burden estimate or any other aspect of this information collection request, including suggestions for reducing the burden, to Forest Service Information Collections Officer, [email protected], with OMB control number 0596-0082 in the subject line.

PRIVACY ACT STATEMENT

Pursuant to 5 U.S.C. § 552a(e)(3), this Privacy Act statement serves to inform you of the following concerning the collection of the information on this form.

Purpose:  The Privacy Act of 1974 requires that the Director of Recreation, Heritage, and Volunteer Resources staff and the Director of Lands, Minerals, and Geology Management staff provide the following statements to individuals from whom they request information.

Authority:  Collection of this information solicited on this form is authorized by the Organic Administration Act,16 U.S.C. 551.

Routine Uses:  The information collected will be used by Forest Service officials to ensure that your use of National Forest System lands is administered in accordance with applicable statutes, regulations, and directives. The information collected from you is retained in the Special Uses Data System (SUDS) and is retrieved by the Forest Service create reports for the Agency’s Special Uses Program, generate bills for collection of land use fees for your authorization, monitor compliance with your special use authorization, and other matters pertaining to administration of your special use authorization. SUDS is a component of the Forest Service’s Natural Resources Manager database (NRM). A complete list of the routine uses of NRM can be found in the system of records notice associated with this form, FS-24.

Disclosure:  The submission of this information is required to obtain or retain benefits, specifically, a special use authorization.

NONDISCRIMINATION STATEMENT

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs).  Remedies and complaint filing deadlines vary by program or incident.

Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the responsible agency or USDA’s TARGET Center at (202) 720-2600 (voice and TYY) or contact USDA through the Federal Relay Service at (800) 877-8339.  Additionally, program information may be made available in languages other than English.

To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at How to File a Program Discrimination Complaint and at any USDA office or write a letter addressed to USDA and provide in the letter all the information requested in the form.  To request a copy of the complaint form, call (866) 632-9992.  Submit the completed form or letter to USDA by (1) mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: [email protected]. 

USDA is an equal opportunity provider, employer, and lender.

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