Form NOAA Form 34-82 NOAA Form 34-82 Capital Construction Fund Program Deposit/Withdrawal Rep

NOAA FORM 34-82
OMB NO 0648-0041
Expires: 08/31/2025
Mail report and tax return copy to:
NOAA Fisheries F/MB5
Capital ConstructionFund Program
1315 East-West Highway
Silver Spring, MD 20910-3282
301-713-2393
301-427-8728

U.S. DEPARTMENT OF COMMERCE
NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION
NOAA Fisheries

Prepare a separate Form 34-82 report for each account you maintain.
DEPOSITORY BANK, OR INVESTMENT FIRM

Capital Construction Fund Program
DEPOSIT/WITHDRAWAL REPORT

Name:

AGREEMENT HOLDER:

CCF CASE NUMBER

Name :

CCF -

City and State :

Due 30 days after filing date of Federal Tax Return (including
extensions). This report must be filed annually, whether or not
agreement activity took place. Attach a signed copy of the
Federal Income Tax Return, as filed with the IRS, to this report.

Did you reduce taxable income for the current tax year due to CCF activity?

Number :

Was a CCF deposit made during the current year for taxes deferred in the prior year?
Clearly identify this deposit in Account Activity section.

REPORT OF DEPOSITORY
ACTIVITY FOR TAX YEAR ENDED

Date Opened:

Type of Investment Account:

■

Savings

Money Market

Checklng

■

YES

■

YES

/
Telephone No:

Other : (describe)

NO

CLASSIFICATION OF DEPOSITS:

Amount deferred $

ORDINARY INCOME
(tax deferred)

NO

DEPOSIT

Notes :

CAPITAL
(funds not tax deferred )

CAPITAL GAIN
(tax deferred)

WITHDRAWAL

DEPOSIT

WITHDRAWAL

DEPOSIT

SUMMARY
BALANCE

WITHDRAWAL

BALANCE FORWARD - FROM PRIOR YEAR'S REPORT
(Should be same as last year's "Balance - End of Year" amount.
If different, attach a reconciling schedule.)
ACCOUNT ACTIVITY FOR THE TAX YEAR
Summarize interest and dividend deposits. For deposits of vessel income, provide name of
vessel and Schedule A page number. For all withdrawals, provide name of vessel and
Schedule B page number for project.
DATE

-

Address:

DESCRIBE

0.00
SCH. A
OR
SCH. B
PAGE #

1

1

2

2

3

3

4

4

5

5

6

6

7

7

8

8

9

9

10

10

TOTAL EACH COLUMN (incIude "Balance Forward" amount for each column)
WITHDRAWALS FOR THE YEAR (copy totals from adjacent column)
BALANCE - END OF TAX YEAR (net amounts and Summary Balance)

Public reporting burden for this collection of information is estimated to
average 2 hours 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
aspect of this collection of information, including suggestions for
reducing this burden, to NOAA Fisheries, F/MB5, 1315 East-West Hwy.,
Silver Spring, MD 20910.

NOAA FORM 34-82 CCF - DEPOSIT/WITHDRAWAL REPORT

0.00 (
(

0.00 )

0.00

0.00 (

0.00 )
(

0.00 )

0.00

0.00 (

0.00 )
(

0.00 )

0.00 )

0.00

0.00

I certify that for this tax year, there were no withdrawals or transfers other than those enumerated above for this Capital Construction Fund agreement. This report reflects true and complete
statements in accordance with all applicable rules and regulations issued or adopted by the Secretary of Commerce pertaining to Section 607 of the Merchant Marine Act of 1936, as amended.
Information on this report is complete,true and correct to the best of my knowledge and belief. (Following Information is required.)
SIGNATURE
representatlve

DATE

Agreement holder or officer

Authorized

/

PRIVACY ACT STATEMENT
Authority: The collection of this information is authorized by 46 U.S.C. 53503, 50 CFR Part 259 and Section 607 of the Merchant Marine Act, 1936, as amended. The data
collected is required pursuant to 50 CFR, Part 259.7, and P.L. 99-514 (The Tax Reform Act, 1986). The data will primarily be used for the evaluation of eligibility in connection
with application to establish a Capital Construction Fund Account. Establishment of the account will not be considered unless all requested information is furnished.
Purpose: In order to determine qualification for, and to administer, the Capital Construction Fund, the NOAA National Marine Fisheries Service (NMFS) requires financial
information, vessel owner contact information, date of birth, Tax Identifying Number and vessel descriptive information. Applicants are required to submit the deposit/
withdrawal report annually within 30 days after the due date of the year’s tax return, including extensions.
Routine Uses: NMFS uses this information to ensure that agreement holders are complying with fund deposit and withdrawal requirements established in program regulations
and properly accounting for fund activity on their federal income tax returns. NOAA Fisheries is required to provide information furnished on this form to the Internal Revenue
Service. The information may also be used for research to better understand the fishing industry and demands for the program. Disclosure of this information is permitted
under the Privacy Act of 1974 (5 U.S.C. Section 552a), to be shared within the Financial Services Division, in order to coordinate monitoring of the Agreements. Disclosure of
this information is also subject to all of the published routine uses as identified in Commerce/NOAA-21, Financial Services Division.
Disclosure: Furnishing this information is mandatory pursuant to 46 U.S.C. §53515. Failure to provide complete and accurate information will prevent the determination of
qualification for the program, and continued participation.