Reimbursement for insurance expenses

NMFS/SEFSC/POP

OMB Control #0648-0593. Expires 11/30/2015

REIMBURSEMENT INVOICE FOR CONTRACT OBSERVERS
VESSEL NAME

TRIP NUMBER

ORGANIZATION CODE

DATES OF TRIP

TASK NUMBER

TO

RATE

DAYS AT SEA

MEAL EXPENSES
$25 / DAY
RATE

X

SUBTOTAL
DAYS AT SEA

LIABILITY INSURANCE
*ATTACH ENDORSEMENT AND BILLING STATEMENT

COMPANY NAME

AGENT NAME

PHONE
CORPORATION / OWNER NAME

TIN (Taxpayer Identification Number)

MAILING ADDRESS

PHONE

DATE

SIGNATURE

TOTAL

PAPERWORK REDUCTION ACT STATEMENT: Information collected through the observer program will be used to: (1) monitor catch and bycatch in commercial and recreational fisheries; (2) understand the population status and
trends of fish stocks and protected species, as well as the interactions between them; (3) determine the quantity and distribution of net benefits derived from living marine resources; (4) predict the biological, ecological, and economic
impacts of existing management action and proposed management options; and (5) ensure that the observer programs can safely and efficiently collect the information required for the previous four uses. In particular, the observer
program provides information that is used in analyses that support the conservation and management of living marine resources and that are required under the Magnuson-Stevens Fishery Conservation and Management Act (MSA), the
Endangered Species Act (ESA), the Marine Mammal Protection Act (MMPA), the National Environmental Policy Act (NEPA), the Regulatory Flexibility Act (RFA), Executive Order 12866 (EO 12866), and other applicable law.
Most of the information collected by observers is obtained through "direct observation by an employee or agent of the sponsoring agency or through non-standardized oral communication in connection with such direct observations".
Under the Paperwork Reduction Act (PRA) regulations at 5 C.F.R. 1320.3((h)(3), facts or opinions obtained through such observations and communications are not considered to be "information" subject to the PRA. The public
reporting burden for responding to the questions that observers ask and that are subject to the PRA is estimated to average 50 minutes per trip, including the time for hearing and understanding the questions, 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: National Marine Fisheries Service, F/SF1, 1315 East West Highway, Silver Spring, MD 20910. Providing the requested information is mandatory under regulations at 50 C.F.R. 600.746 for the
safety questions and at 50 C.F.R. Part 622.8, 50 CFR 229.7, and 50 CFR 222.401 for the other questions. All information collected by observers will be kept confidential as required under Section 402(b) of the MSA (18 U.S.C. 1881a
(b)) and regulations at 50 C.F.R. Part 600, Subpart E. Notwithstanding any other provision of the law, no person is required to respond to, nor shall any person be subject 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. This is an approved information collection under OMB Control No.
0648-0593 through 11/30/2015.