Reimbursement invoice for contract observers

NMFS/SEFSC/POP

MEALS

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

REIMBURSEMENT INVOICE FOR CONTRACT OBSERVERS
VESSEL NAME

ORGANIZATION CODE

TASK NUMBER

FN7100
RATE

*ATTACH ENDORSEMENT AND BILLING STATEMENT

Vessel ID:

TO

DAYS AT SEA

$25 / DAY

LIABILITY INSURANCE

DATES OF TRIP

P8LAE09P00

MEAL EXPENSES
AGR #:

TRIP NUMBER

1

X

33GENF160087

SUBTOTAL

DAYS AT SEA

#N/A

COMPANY NAME
AGENT NAME
PHONE
COMPANY / OWNER NAME

TIN (Taxpayer Identification Number)
TOTAL

MAILING ADDRESS

PHONE

DATE

SIGNATURE

PAPERWORK REDUCTION ACT STATEMENT: The information provided on this form will be used
to reimburse you for specific expenses during the observed trip identified on the form. That trip was observed
in order to collect 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 Edangered Species Act (ESA), the Marrine Mammal Protection Act (MMPA), the National Environmental
Policy Act (NEPA), the Regulatory Flexibility Act (RFA), Executive Order 12866 (EO 12866), and other applicable law.
The public reorting burden for this form is estimated to average 10 minutes per response, in cluding the time for
completing, reviewing, and transmitting the information on the form. Send comments regarding this burden
estimator and any other aspect of this collection of information including suggestinos for reducing the burden to
National Marine Fisheries Service, F/SF1, National Observer Program, 1315 East West Highway, Silver Spring, MD
20910. Providing the requested information is required to have the Central Administrative Support Center (CASC)
and United States Treasury process and pay the reimbursement. The information on this form 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. Not withstanding any other provision of the law, no person is required to respond to, nor shall any
person be subject to 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 OBM Control No. 0648-0593 through 11/30/2015.