Form 0405-566 - Salmon Enhancement Tax Return
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Alaska
566
DEPARTMENT USE ONLY
Salmon Enhancement Tax Return
ENV
FSN
Check One
Month/Year salmon purchased:
Please note the different due dates
Licensed Buyer Month:___________ Year:_____________
Monthly tax - due last day of month following month of purchase
Fisherman
Year salmon exported/sold:_____________
Yearly tax - due March 31st of following year
Month/Year salmon purchased
Month/Year bonus payment made
Amended Return
Bonus Return
Month:_________ Year: _________
Month:_________ Year: _________
(attach explanation)
EIN
Fisheries Business License #
Phone Number
Fax Number
SSN
Taxpayer Name
Facility Location
or Vessel Name
Mailing Address
City
State
Zip Code
E-mail Address
Part 1. Region Where Caught (Required information - see instructions)
Region
(A) Pounds
(B) Value
Cell Phone Number
1 Southern Southeast
$
2 Northern Southeast
$
Part 3. Exempt Purchases
3 Prince William Sound
$
Use this section to report all salmon harvested under
4 Cook Inlet
$
a special harvest area entry permit issued under AS
5 Kodiak
$
16.43.400.
Example:
Salmon
purchased
from
government
6 Chignik
$
agencies, salmon hatcheries or a fishing derby.
7 Yakutat
$
Pounds of Salmon
Value of Salmon
8 Outside
$
1
2 $
9 Total (add lines 1-8)
$
Part 2. Salmon Enhancement Tax - Region from where Purchased or Exported
Region
(A) Pounds
(B) Value
(C) Rate
(D) Tax (Column B x C)
10 Southern Southeast
$
3% (.03)
10 $
0.00
11 Northern Southeast
$
3% (.03)
11 $
0.00
12 Prince William Sound
$
2% (.02)
12 $
0.00
13 Cook Inlet
$
2% (.02)
13 $
0.00
14 Kodiak
$
2% (.02)
14 $
0.00
15 Chignik
$
2% (.02)
15 $
0.00
16 Yakutat
$
2% (.02)
16 $
0.00
17 Outside
$
N/A
17
N/A
18 Total (add lines 10-17
$
N/A
18 $
)
0.00
(Totals on line 18, columns A and B must equal totals on line 9, columns A and B)
AMENDED AND BONUS RETURNS ONLY - taxes previously paid for this period.
19 $(
)
TOTAL TAX LIABILITY (REFUND) DUE (subtract line 19 from line 18, column D)
20 $
0.00
Note: If your total combined liability exceeds $100,000 you must pay using the Online Tax Information System (OTIS) or by wire transfer.
Check if you are paying by
OTIS (confirmation number ___________________)
Wire Transfer (date ________________)
I certify under penalty of unsworn falsification that this return, including all accompanying schedules and attachments, has been examined
by me and to the best of my knowledge and belief is true and complete.
Signature
Printed Name
Title
Date
Department use only PMD
Validation
Pay online at or make check payable to State of Alaska
566
Mail to: Alaska Department of Revenue, PO Box 110420, Juneau AK 99811-0420
0405-566 Rev 06/17/13
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