Form MA-172 Financial Report of Ship Carriers (Part II)

Application and Reporting Elements for Participation in the Maritime Security Program

MA-172 Financial Report of Ship Carriers (Part II)

Application and Reporting Elements for Participation in the Maritime Security Program

OMB: 2133-0525

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OMB No. 2133-0005
Expiration Date: 7/31/2021

Schedule 220 - Restricted Funds
Balance
on Deposit

Fund Identification

Accrued for
Deposit

Total

Title XI Reserve/Restricted Fund
Capital Construction Fund
Construction Reserve Fund
Insurance Funds
Debt Retirement Funds
Escrow Funds
Construction Funds
Special Guarantee Funds
Other (Including Drilling Rig Reserve Funds)
TOTAL

Schedule 230 - Notes Payable and Debt Due Within One Year
Bank Loans - Notes Payable-Related Party - Notes Payable-Officers and Employees - Other Short Term Notes
1. Items $50,000 or more should be shown individually and grouped by the major classifications shown above.
2. Items less than $50,000 each in any account may be shown as a single entry under a caption ''Items under
$1 00,000 each.'' Such entries will contain data in the first and last columns shown below.
3. Include current portion of Long-Term Debt from Schedule 240.
Account Classification

Date of
Issue

Name of Debtor

Date of
Maturitv

Interest
Rate

TOTAL

8
MA-172 Rev. 10/2014

Ending
Balance

Schedule 240 -

Long-Term Debt, Operating Leases, Rentals

(A) Long-Term Debt Due After One Year
Mortgage Notes - Maritime Administration - Capital Lease Liabilities - U.S. Government Guaranteed
Debt - Operating Leases and Rental Commitments - Other Long Term Debt
1. Entries to both parts of this schedule should be grouped under the classifications shown above.
Indicate whether the debt is secured or unsecured by using an (s) or (u) respectively.
2. Items over $100,000 should be listed individually showing origination date, maturity date and interest date.

3. Items less than $100,000 under each classification may be shown in a single entry under a caption
''Items under $100,000'' for each of the classifications, indicating secured or unsecured here as well.

Name of Creditor

Character of Liability or
Description of Property

Original
Date

Maturity or
Expiration Date

Interest
Rate

Balance or
Total Future
Lease Payments

TOTAL

(B) Long-Term Debt Due Within One Year
Name of Creditor

Character of Liability or
Description of Property

Original
Date

Maturity or
Expiration Date

Interest
Rate

TOTAL

9

Balance or
Total Future
Lease Payments

Schedule 310 - Vessel Operating Statement
Berth Line Operations
for the Period from

to

(dollars in thousands)
Grand Summary

Type of Report:
Service Area:

Active Voyages

Idle Status

Vessel Type:

Number of Sailings: Outbound:

Inbound:

Total Voyage Days:
Fuel Used (Barrels): HVO (Bunker C)
Diesel

at Sea:
-at Sea:
-at Sea:
-at Sea:

IFO

Nautical Miles:
In Port:
In Port:
In Port:
In Port:

Idle:

(specify type)

Domestic

U.S. Foreign
Commerce
Outbound

Foreign
to
Foreign

U.S. Foreign
Commerce
Inbound

Total

CARGO CARRIED:

Number of Barges:
(identify)

Number of Containers

TEUs
Other

(
(

)
)
(identify)

Tonnage Carried Payable
Revenue Tons
Other (
)

(

)

(identify)

OPERATING REVENUE:

Freight
Charter Revenue
Other Revenue
Total Operating Revenue
OPERATING EXPENSES: Vessel

Expenses (Account 700) Wages
Subsistence
Stores
M&R
Insurance
Charter hire
Fuel
Other vessel expense
Total Vessel Expense
Less Operating Differential Subsidy
Total Vessel Expense After ODS
Vessel Port Call Expense (Account 750)
Cargo Handling Expenses (Account 760) Cargo, barge, container expense
Cargo handling
Cargo Freight Stations
Cargo Transportation (including inland transportation costs)
Total Cargo Handling Expense
Total Operating Expense
Vessel Depreciation
Vessel Financing Interest Cost
Idle Status Costs (Idle Status Reports only)
Gross Operating Profit or (Loss)

10

$

$
$
$
$

$
$

$

Schedule 320 - Other Shipping Operations
(Accounts 650 and 860)
This schedule may be omitted when revenue from other shipping operations is less than 1 0
percent of total shipping revenue.
Description

Revenue

Expense

$

Collection from pools
Revenue from cargo equipment operations
Revenue from cargo handling operations
Revenue from terminal operations
Agency and management fees, commissions and brokerage
Revenue from other shipping operations

$

Total - Other shipping operations revenue (Account 650)

$

Contribution to pools
Cargo equipment expense
Terminal expense
Expense of other shipping services

$

Total - Other shipping operations expense (Account 860)

$

Net other shipping operations income or (expense)

NOTE: Container leasing expenses, maintenance and repair costs, and costs of shipping activities which are directly related to
vessel operations, should be included in Cargo Handling Expense (Account 760) on Schedule 31 0.

11

Schedule 310 - Vessel Operating Statement
Tanker and Dry Bulk Vessel Operations
(Self-propelled and Fully Integrated Tug/Barge Vessels)
for the Period from

to

(dollars in thousands)
Vessel Type:

DWT:

Number of Nautical Miles Traveled:
Total Voyage Days:
Fuel Used (Barrels): HVO (Bunker C)
Diesel
IFO

at Sea:

In Port:

-at Sea:

In Port:

-at Sea:

In Port:

-at Sea:

In Port:

Idle:

(specify type)

Coastal
or Intercoastal

U.S. Foreign
Commerce
Outbound

Foreign
to Foreign

U.S. Foreign
Commerce
Inbound

Total

CARGO CARRIED:

Long Tons
Cubic Feet
OPERATING REVENUE:

Cargo Revenue
Charter Revenue
Other Revenue
Total Operating Revenue
OPERATING EXPENSES:

Vessel Expenses (Account 700) Wages
Subsistence
Stores
M&R
Insurance
Charter hire
Fuel
Other vessel expense
Total Vessel Expense
Less Operating Differential Subsidy
Total Vessel Expense After ODS
Vessel Port Call Expense (Account 750)
Cargo Handling Expenses (Account 760) Total Operating Expense
Vessel Depreciation
Vessel Financing Interest Cost
Idle Status Costs (Idle Status Reports only)
Gross Operating Profit or (Loss)

10

$

$
$

$

$

Schedule 320 - Other Shipping Operations
(Accounts 650 and 860)
This schedule may be omitted when revenue from other shipping operations is less than 1 0 percent
of total shipping revenue.
Description

Revenue

Expense

$

Collection from pools
Revenue from cargo equipment operations
Revenue from cargo handling operations
Revenue from terminal operations
Agency and management fees, commissions and brokerage
Revenue from other shipping operations

Total - Other shipping operations revenue (Account 650)

$

$

Contribution to pools
Cargo equipment expense
Terminalexpense
Expense of other shipping services

Total - Other shipping operations expense (Account 860)

$

$

Net other shipping operations income or (expense)

NOTE: Container leasing expenses, maintenance and repair costs, and costs of shipping activities which are directly
related to vessel operations, should be included in Cargo Handling Expense (Account 760) on Schedule 310.

11

Schedule 310 - Vessel Operating Statement
Drill Rig and Supply Boat Operations
for the Period from
to
(dollars in thousands)
Number
of Vessels

Total

Days 2

Number
of Vessels

Utilized

Semi-submersibles

Other Rigs

Jack-ups

Supply Boats

Drill Ships

Tug/Supply Boats

Barges

Other Boats

Total

CURRENT ASSETS
Drill rig operations
Tug and other supply boat operations
Charter revenue
Other revenue (detail each item over 5% of total gross revenue)

$

$

Total Other Revenue
Total Revenue

VESSEL EXPENSES
Labor and burden
Repairs and maintenance
Charter hire
Vessel depreciation
Vessel financing interest cost
Insurance
Other expenses (detail each item over 5% of total vessel expense)

$

Total Other Expense
Total Vessel Expense

$

Gross Operating Profit or (Loss)

$

1 Total

calendar days owned or controlled times number of vessels

2 Total

number of days vessels are under charter or in transit to and from site

10

1

Days 2
Utilized

Schedule 320 - Other Shipping Operations
(Accounts 650 and 860)
This schedule may be omitted when revenue from other shipping operations is less than 1 0
percent of total shipping revenue.
Description

Revenue

Expense

$

Collection from pools
Revenue from cargo equipment operations
Revenue from cargo handling operations
Revenue from terminal operations
Agency and management fees, commissions and brokerage
Revenue from other shipping operations

$

Total - Other shipping operations revenue (Account 650)

$

Contribution to pools
Cargo equipment expense
Terminal expense
Expense of other shipping services

$

Total - Other shipping operations expense (Account 860)

$

Net other shipping operations income or (expense)

NOTE: Container leasing expenses, maintenance and repair costs, and costs of shipping activities which are directly related to
vessel operations, should be included in Cargo Handling Expense (Account 760) on Schedule 31 0.

11

Schedule 310 - Vessel Operating Statement
Other Modes of Marine Operations
(including Coastal and Inland Waterways Operations)

for the Period from

to

Service Area
Number of Barges

and Boats

Number of Miles Cargo Carried
Total L/T Cargo Carried

Owned or Leased
Total Capacity of Barges L/T

Number of Vessel Days in Operations

Total Fuel Consumption (Barrels)

Total Horsepower

Average Number of Units (Car Floats)
Type and Number of Vessels Operated
Tugboats
Towboats
Midstreamers
Scows
Car Floats
Other

Barges:
Deck
Open Hopper
Dry Cargo
Liquid Cargo
LASH/SEABEE

OPERATING REVENUE:
$

Freight Carried (Inland)
Tow and Tug Operations
Other Voyage Revenue
Freight Carried (Coastal)
Charter Revenue
Total Operating Revenue

$

OPERATING EXPENSES: Vessel

Expenses (Account 700) $

Wages
Subsistence
Stores
M&R
Insurance
Charter hire
Fuel
Other vessel expense
Total Vessel Expense
Vessel Port Call Expense (Account 750)
Cargo Handling Expense (Account 760) Total Operating Expense

$

$

Vessel Depreciation
Vessel Financing Interest Cost
Idle Status Costs (Idle Status Reports only)
Gross Operating Profit or (Loss)

$
10

Schedule 320 - Other Shipping Operations
(Accounts 650 and 860)
This schedule may be omitted when revenue from other shipping operations is less than 1 0
percent of total shipping revenue.
Description

Revenue

Expense

$

Collection from pools
Revenue from cargo equipment operations
Revenue from cargo handling operations
Revenue from terminal operations
Agency and management fees, commissions and brokerage
Revenue from other shipping operations

$

Total - Other shipping operations revenue (Account 650)

$

Contribution to pools
Cargo equipment expense

Terminalexpense
Expense of other shipping services

$

Total - Other shipping operations expense (Account 860)

$

Net other shipping operations income or (expense)

NOTE: Container leasing expenses, maintenance and repair costs, and costs of shipping activities which are directly related to
vessel operations, should be included in Cargo Handling Expense (Account 760) on Schedule 31 0.

11

OATH

State of
County of

makes oath and says that as
(Name)

of
(Official Title)

(Exact name of Respondent)

that I have carefully examined the foregoing report, and that to the best of my knowledge and belief the said report has
been prepared in accordance with the instructions embodied in this form in conformance with generally accepted
accounting principles applied on a consistent basis and is a true and correct statement of the financial affairs of the
Respondent for the period covered by this report. Moreover, all of the supporting Schedules required in this form have
been completed with the exception of the Schedules listed below.

(S~qnature of afflant)

Subscribed and sworn to before me, a

I

in and for the State and County above named, this

day of

120

My commisssion expires

(Signature of official authorized to administer oath)

Schedule Number

Reason - N/A (not applicable), or None (no information to report)

Official of Respondent with whom the Administration may contact regarding this report:
Name

Title

Telephone Number

12

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