BSAI Non-Pollock Buyback Loan Fee Collection Report

OMB Control No.: 0648-0376; Expiration Date: 08/31/2008

BSAI Non-Pollock Buyback Loan Fee Collection Report
Company Name
Mailing Address
City
State
Zip
Phone Number
LLP License Number
Vessel Name
ADFG Vessel Number
Month of Landings
Check this box if payment is for an
adjustment to previous fees paid

FOR LANDINGS OF
BSAI Pacific Cod

Sub-account

Fee Rate per
Pound

BBNA-001A

$0.02

Gross Catch
(lbs.)

Fee Due ($)

Total Fees ($)
Instructions:
1. Complete the company name, address, phone number, LLP license number, vessel name, ADFG vessel number,
month of catch, and check adjustment box if applicable.
2. Record the gross catch in round weight pounds and fee collected for the fishery. The fee due equals the fee rate
multiplied by the gross catch of Pcod landed for each vessel trip.
3. Use a separate report for catch in a different month.
4. Use Pay.gov to remit fee due or mail a check payable to "NMFS BSAI Non-Pollock Buyback Loan"
in the amount of the total fee due to: P.O. Box 979060, St. Louis, MO 63197–9000.
Paperwork Reduction Act Statement:
Public reporting burden for this collection of information is estimated to average one hour per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining the
data needed, and completing and reviewing the collection of information. Send comments regarding this
burden estimate or any other suggestions for reducing this burden to Leo Erwin, Chief, Financial
Services Division, NMFS, MB5, 1315 East West Highway, Silver Spring, MD 20910.
Notwithstanding any other provisions of the law, no person is required to respond to, nor shall any person be
subjected to a penalty for failure to comply with, a collection of information subject to the requirements of the
Paperwork Reduction Act, unless that collection of information displays a currently valid OMB Control Number.