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pdfNMFS/SEFSC/POP
OMB Control #0648-0593. Expires 12/31/2021
REIMBURSEMENT INVOICE FOR CONTRACT OBSERVERS
VESSEL NAME
TRIP NUMBER
ORGANIZATION CODE
TASK NUMBER
DATES OF TRIP
TO
RATE
DAYS AT SEA
MEAL EXPENSES
$25 / DAY
RATE
SUBTOTAL
X
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
Public Burden Statement - Effective 4/30/2020
A Federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with an information collection subject to the requirements of the Paperwork
Reduction Act of 1995 unless the information collection has a currently valid OMB Control Number. The approved OMB Control Number for this information collection is 0648-0593. Without this approval, we could not conduct this
information collection. Public reporting for this information collection is estimated to be approximately 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 information collection. All responses to this information collection are mandatory. Send comments regarding this burden estimate or any other aspect of this information
collection, including suggestions for reducing this burden to the NOAA/NMFS/SEFSC at: 75 Virginia Beach Drive, Miami, FL 33149, Attn: Fisheries Biologist Andy Davis, Andrew.Davis@noaa.gov
File Type | application/pdf |
Author | Andrew D. Davis |
File Modified | 2020-08-14 |
File Created | 2020-06-24 |