Weigh Out Slip Standard

In-Office Use Only

Schedule Number:_________________________________

Dealer Number:	Dealer Name:		Date Sold:
Vessel Number:	Vessel Name:
Trip VTR number

Please write the name of the species landed at the top of each column, and the weights below. Start a new column if some of the weights are aggregate, or if the carcasses have been processed in a different manner. Use as many pages as you need for a trip.

Species

Species

Species

Species

Species

Species

Species

PRA Burden Statement

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 0648-0371. Without this approval, we could not conduct this information collection. Public reporting for this information collection is estimated to be approximately 1 hour 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 pursuant to 50 CFR § 635.5(a). Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden to the National Marine Fisheries Service, F/SF1, 1315 East West Highway, Silver Spring MD 20910.

Page: _____ of ______ OMB Control Number: 0648-0371

Expiration Date: XX/XX/20XX