Form FS-2700-19a Annual Land Use Fee Calculation for Ski Area Permits

USDA - Forest Service FS-2700-19a (XX/20XX)

OMB No. 0596-0082

USDA FOREST SERVICE ANNUAL LAND USE FEE CALCULATION FOR SKI AREA PERMITS 3. Payment Cycle Period	1. Permitee (Name and address)                  		2. SUDS Authorization ID      
ADJUSTED GROSS REVENUE CALCULATION
4. Lift Tickets 5. Season Passes 6. Ski School 7. Bartered Goods 8. Comp Lift Tickets SUB TOTAL (4+5+6+7+8)	ALPINE REVENUE	NORDIC REVENUE
	                              9.      	                              10.      
ALPINE 11. Alpine Revenue (9) 12. Slope Trans. Ft Per. (STFP) 13. STFP x Alpine Revenue (11x12)	                 	                 
NORDIC 14. Nordic Revenue (10) 15. Trail Length Percentage 16. Trail Length Percentage x Nordic Revenue (14 x 15)	                 	                 
17. Gross Ancillary Facilities and Operations Revenue (include barter/comp)	     	     
18. Adjusted Gross Revenue Add 13 + 16 + 17 = 18	     	     
FEE CALCULATION
19. Bracket 1 x .015 20. Bracket 2 x .025 21. Bracket 3 x .0275 22. Bracket 4 x .04 23. Total Fee Due (19+20+21+22) 24. Fee Paid Previously 25. Balance Due (23 - 24)	                                         	                                         

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 National Forest Ski Area Permit Act of 1986, 16 U.S.C. 497b. The time required to complete this information collection request is estimated to average 2 hours 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 National Forest Ski Area Permit Act of 1986, 16 U.S.C. 497b.

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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Instructions for Completing Form FS-2700-19a

1. Enter permittee name and address.

2. Enter SUDS Authorization ID.

3. Enter payment cycle for which fee is being calculated (usually holder's fiscal year).

4. Enter Alpine lift ticket revenue in the Alpine Block and Nordic ticket revenue in the Nordic Block.

5. Enter Alpine season pass revenue in the Alpine Block and Nordic season pass revenue in the Nordic Block.

6. Enter Alpine ski school revenue in the Alpine Block and Nordic ski school revenue in the Nordic Block.

7. Enter the market price of bardered goods for alpine ski areas in the Alpine Block and the market price of bardered goods for nordic ski areas in the Nordic Block.

8. Enter the market price of complimentary lift tickets for alpine ski areas in the Alpine Block and the value of complimentary tickets for nordic areas in the Nordic Block.

9. Enter the total of 4 through 8 for Alpine Revenue.

10. Enter the total of 4 through 8 for Nordic Revenue.

11 Enter alpine revenue from block 9.

12. Enter slope transport feet percentage (STFP). Follow the direction in FSM 2715.11c.

13. Enter the amount of block 11 multiplied by block 12.

14. Enter nordic revenue from block 10.

15. Enter nordic trail length percentage (trail length on National Forest devided by total trail length).

16. Enter the amount of block 14 multiplied by block 15.

17. Enter the revenue from ancillary facilities located on the National Forest.

18. Add blocks 13 plus 16 plus 17.

19. Multiply the amount of revenue in bracket 1 by .015 (see FSH 2709.11, sec. 38.12, exhibit 01).

20. Multiply the amount of revenue in bracket 2 by .025 (see FSH 2709.11, sec. 38.12, exhibit 01).

21. Multiply the amount of revenue in bracket 3 by .0275 (see FSH 2709.11, sec. 38.12, exhibit 01).

22. Multiply the amount of revenue in bracket 4 by .04 (see FSH 2709.11, sec. 38.12, exhibit 01).

23. Add blocks 19 plus 20 plus 21 plus 22.

24. Enter the amount of previous fee payments for the payment cycle (i.e. advances and interim payments).

25. Subtract block 24 from block 23.

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