FS-2700-19a Annual Land Use Fee Calculation for Ski Area Permits

USDA - Forest Service

FS-2700-19a (XX/20XX)
OMB No. 0596-0082

USDA FOREST SERVICE

ANNUAL LAND USE FEE
CALCULATION FOR SKI AREA
PERMITS
3. Payment Cycle Period

1. Permitee (Name and address)

2. SUDS Authorization
ID

ADJUSTED GROSS REVENUE CALCULATION
ALPINE REVENUE

4. Lift Tickets

NORDIC REVENUE

5. Season Passes
6. Ski School
8. Comp Lift Tickets
SUB TOTAL (4+5+6+7+8)

10.

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9.

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7. Bartered Goods

ALPINE

11. Alpine Revenue (9)

12. Slope Trans. Ft Per. (STFP)
13. STFP x Alpine Revenue
(11x12)

NORDIC

14. Nordic Revenue (10)

15. Trail Length Percentage

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16. Trail Length Percentage x
Nordic Revenue (14 x 15)

17. Gross Ancillary Facilities
and Operations Revenue
(include barter/comp)
18. Adjusted Gross Revenue
Add 13 + 16 + 17 = 18

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USDA - Forest Service

FS-2700-19a (XX/20XX)
OMB No. 0596-0082

FEE CALCULATION
19. Bracket 1 x .015
20. Bracket 2 x .025
21. Bracket 3 x .0275

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22. Bracket 4 x .04
23. Total Fee Due
(19+20+21+22)
24. Fee Paid Previously

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25. Balance Due (23 - 24)

PAPERWORK REDUCTION ACT STATEMENT

According to the Paperwork Reduction Act of 1995, a Federal agency may not conduct or sponsor, and a person is not required to
respond to, an information collection request unless it displays a valid Office of Management and Budget (OMB) control number.
The valid OMB control number for this information collection request is 0596-0082. Response to this information collection request
is required to obtain or retain benefits, specifically, a special use authorization. The authority for this information collection request is
the National Forest Ski Area Permit Act of 1986, 16 U.S.C. 497b. The time required to complete this information collection request is
estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, collecting
and maintaining the data needed, and completing and reviewing the information collection request. Send comments regarding this
burden estimate or any other aspect of this information collection request, including suggestions for reducing the burden, to Forest
Service Information Collections Officer, SM.FS.InfoCollect@usda.gov, with OMB control number 0596-0082 in the subject line.
PRIVACY ACT STATEMENT

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Pursuant to 5 U.S.C. § 552a(e)(3), this Privacy Act statement serves to inform you of the following concerning the collection of the
information on this form.
Purpose: The Privacy Act of 1974 requires that the Director of Recreation, Heritage, and Volunteer Resources staff and the
Director of Lands, Minerals, and Geology Management staff provide the following statements to individuals from whom they request
information.
Authority: Collection of this information solicited on this form is authorized by the National Forest Ski Area Permit Act of 1986, 16
U.S.C. 497b.
Routine Uses: The information collected will be used by Forest Service officials to ensure that your use of National Forest System
lands is administered in accordance with applicable statutes, regulations, and directives. The information collected from you is
retained in the Special Uses Data System (SUDS) and is retrieved by the Forest Service create reports for the Agency’s Special
Uses Program, generate bills for collection of land use fees for your authorization, monitor compliance with your special use
authorization, and other matters pertaining to administration of your special use authorization. SUDS is a component of the Forest
Service’s Natural Resources Manager database (NRM). A complete list of the routine uses of NRM can be found in the system of
records notice associated with this form, FS-24.
Disclosure: The submission of this information is required to obtain or retain benefits, specifically, a special use authorization.
NONDISCRIMINATION STATEMENT

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USDA - Forest Service

FS-2700-19a (XX/20XX)
OMB No. 0596-0082

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the
USDA, its agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from
discriminating based on race, color, national origin, religion, sex, disability, age, marital status, family/parental status, income
derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or
activity conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by
program or incident.
Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print,
audiotape, American Sign Language, etc.) should contact the State or local Agency that administers the program or contact USDA
through the Telecommunications Relay Service at 711 (voice and TTY). Additionally, program information may be made available in
languages other than English.
To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at
How to File a Program Discrimination Complaint and at any USDA office or write a letter addressed to USDA and provide in the
letter all the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit the completed
form or letter to USDA by (1) mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400
Independence Avenue, SW, Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: program.intake@usda.gov.

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USDA is an equal opportunity provider, employer, and lender.
.

Instructions for Completing Form FS-2700-19a
1. Enter permittee name and address.

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2. Enter SUDS Authorization ID.

3. Enter payment cycle for which fee is being calculated (usually holder's fiscal year).
4. Enter Alpine lift ticket revenue in the Alpine Block and Nordic ticket revenue in the Nordic Block.
5. Enter Alpine season pass revenue in the Alpine Block and Nordic season pass revenue in the Nordic
Block.
6. Enter Alpine ski school revenue in the Alpine Block and Nordic ski school revenue in the Nordic Block.
7. Enter the market price of bardered goods for alpine ski areas in the Alpine Block and the market price
of bardered goods for nordic ski areas in the Nordic Block.

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8. Enter the market price of complimentary lift tickets for alpine ski areas in the Alpine Block and the
value of complimentary tickets for nordic areas in the Nordic Block.
9. Enter the total of 4 through 8 for Alpine Revenue.
10. Enter the total of 4 through 8 for Nordic Revenue.
11 Enter alpine revenue from block 9.
12. Enter slope transport feet percentage (STFP). Follow the direction in FSM 2715.11c.
13. Enter the amount of block 11 multiplied by block 12.
14. Enter nordic revenue from block 10.
15. Enter nordic trail length percentage (trail length on National Forest devided by total trail length).

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USDA - Forest Service

FS-2700-19a (XX/20XX)
OMB No. 0596-0082

16. Enter the amount of block 14 multiplied by block 15.
17. Enter the revenue from ancillary facilities located on the National Forest.
18. Add blocks 13 plus 16 plus 17.
19. Multiply the amount of revenue in bracket 1 by .015 (see FSH 2709.11, sec. 38.12, exhibit 01).
20. Multiply the amount of revenue in bracket 2 by .025 (see FSH 2709.11, sec. 38.12, exhibit 01).
21. Multiply the amount of revenue in bracket 3 by .0275 (see FSH 2709.11, sec. 38.12, exhibit 01).
22. Multiply the amount of revenue in bracket 4 by .04 (see FSH 2709.11, sec. 38.12, exhibit 01).

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23. Add blocks 19 plus 20 plus 21 plus 22.
24. Enter the amount of previous fee payments for the payment cycle (i.e. advances and interim
payments).

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25. Subtract block 24 from block 23.

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