2001 Poverty Guidelines And Reduced Permit Fee Application printable pdf download

2001 Poverty Guidelines and

COMMERCIAL FISHERIES ENTRY COMMISSION

8800 Glacier Highway, #109, Juneau, Alaska 99801

Reduced Permit Fee Application

(907) 789-6150 website

Please note: You must read this application to see if you qualify. A reduced fee for the annual renewal of each commercial

fishing permit is available to qualified low income applicants. Eligibility for the reduced fee is based upon two criteria, income and

asset limitation standards, from the food stamp program. The table below shows the income standards necessary to qualify. In

addition to meeting the gross earnings threshold, you must also meet the asset limitation threshold. To qualify, you must be

receiving food stamps or public assistance or you will be required to show you meet the income and asset limitations as estab-

lished by the food stamp program. A dependent minor's eligibility for the reduced fee is based upon his or her parent's income.

The reduced fee is $15.00 for Alaska residents and $45.00 for nonresidents (for each permit).

Income, for the purposes of qualifying for the reduced fee, includes all income reported as gross income on the tax return.

Income also includes the full amount of capital gains, even though only a portion of the gains may have been taxable. Some of

the deductions from schedule C such as depreciation and the cost of acquiring capital assets are not allowed so the net income

from self-employment may be greater than that listed at the bottom of Schedule C. For information on the asset limits, see the

back of this form for asset limits.

Alaska Region Definitions

Region 1:

Southeast, Yakutat, Anchorage, Matanuska-Susitna Borough

Region 2:

Kenai Peninsula Borough, Kodiak Area

Region 3:

Prince William Sound, Fairbanks North Star Borough

Region 4

Bristol Bay Region, Interior Copper River Area (AHTNA Region, except that part within the Mat-Su Borough),

Aleutian Region (except the part west of Unimak Pass and the Pribilofs)

Region 5:

North Slope Borough, NANA Region, Kotzebue, Bering Straits Region, Norton Sound, Upper Yukon and

Tanana River Area, Doyon Region (except the Fairbanks Borough), Calista Region (Lower Yukon and

Kuskokwim), Aleutian Region west of Unimak Pass and the Pribilofs

Alaska Region

Lower 48

No. In Family

States

Hawaii

$10,440

$11,223

$12,006

$12,789

$13,572

$8,352

$9,600

$14,064

$15,119

$16,174

$17,228

$18,283

$11,256

$12,936

$17,770

$19,028

$20,355

$21,683

$23,010

$14,160

$16,272

$21,324

$22,923

$24,523

$26,122

$27,721

$17,052

$19,620

$24,960

$26,832

$28,704

$30,576

$32,448

$19,956

$22,956

$28,584

$30,728

$32,872

$35,015

$37,159

$22,860

$26,292

For each addi-

tional member

ADD

$3,636

$3,909

$4,181

$4,454

$4,727

$2,904

$3,348

educed Fee Application

(This section MUST be completed in full if you are applying for the reduced fee.)

I _________________, certify that I qualify to pay the reduced fee based upon my income during the most recent tax year,

200___. My total family income that year was $__________________ and the number of people in my immediate family

was_____________.

My total assets (except those that are excluded from consideration) do not exceed $2,000 ($3,000 if age 60 or older).

To verify that you qualify to pay the reduced fee, you must send a complete copy of your 1999 or 2000 income

tax return or evidence showing that you currently qualify for food stamps or public assistance.

I certify that I currently qualify for food stamps or public assistance. I am submitting a copy of my most recent eligibility

determination and copy of my most recent check.

I certify that a true and correct copy of my latest (1999 or 2000) Federal Individual Incone Tax Return is attached.

________________________________

____________________________

_______________

Signature

Applicant's Name - Printed Clearly

Applicant's Social Security Number

Date

Form No.11-836www (Rev12/2000)

Note: Unsworn falsification is a Class A misdemeanor punishable by a fine of no more than $5,000 and / or imprisonment for no more than

one year.

2001 Poverty Guidelines And Reduced Permit Fee Application

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