Capital Construction Fund Vessel Application

OMB Control No. 0648-0090
Expiration Date: 10/31/2010
FISHING VESSEL CCF APPLICATION

Date:

CCF Applicant Name:
Taxable Entity type:

Q Individual

Q C-Corporation

CCF application for the taxable year ending:

Q S-Corporation

Q Partnership

(date)

Social Security/Employer Identification Number:
Estimated initial CCF deposit attributable to Schedule A vessel(s) from:
Fishing Income $

Sale/Insurance Proceeds $

,

Name and Address of each CCF depository (bank, brokerage, etc.)

Depreciation $

to be used:

The following checked items are attached as a part of this application: (Note:
instructions)

*Required

**See

*NOAA Form 88-14, Interim Capital Construction Fund Agreement (2 signed forms)
*Completed Schedule A and Schedule B forms
**Evidence of ownership for all Schedule A eligible vessels to be a part of this CCF Agreement
**Evidence of lease for Schedule A vessel(s)
**Proof of U.S. citizenship (if Schedule A vessel leased, or 2 - 5 net tons)
**Evidence of debt for Schedule B vessel
*Federal tax return copies as filed with IRS for previous 2 years
**Signed and dated copy of IRS Automatic Extension notice, and copy of IRS approved Additional
Extension Request, if applicable to this taxable year application
I hereby give permission to the administrators of my Capital Construction Fund Agreement to release and
obtain any information about the CCF Agreement from the following representative:
Representative (Name, Firm, etc.)
Address:
Phone

(

)

Mail all CCF correspondence to:

FAX Phone

(

)

My Address

My Representative

Both

Applicant's Signature and Title
Address:
Phone

(

)

FAX Phone

(

)

Public reporting burden for this collection of information is estimated to average 30 minutes 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 NOAA Fisheries,
F/MB5, 1315 East West Hwy., Silver Spring, MD 20910.
The information collected is confidential under the Magnuson-Stevens Fishery Conservation and Management
Act, as amended in 2006, NOAA Administrative Order 216-100, which sets forth procedures to protect
confidentiality of fishery statistics and 15CFR259.38(b).
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.