Seafood Marketing Assessment
2014
578
Annual Return
Form
Due April 1, 2015
Taxpayer Name
EIN
SSN
Check one:
Original
Amended
Bonus: Indicate below the month and year bonus payments were made.
Month:_____________Year:____________
(attach explanation)
C. Value of Seafood Products
A. Fish. Bus. Lic. #
B. Facility Location or Vessel Name
(Line 6, parts I & II, page 2 from
each fisheries tax return)
Total value of seafood products listed in column C. If less than $50,000, you are not required to file this form.
1
1
Stop here if less than $50,000.
Assessment. Multiply the value on line 1 by .5% (.005). This is your Seafood Marketing Assessment.
2
2
Amended and bonus returns
3
3
Tax payments made with original and previously filed bonus/amended returns.
4
Amount (Refund) due. Subtract line 3 from line 2.
4
Note: If your combined liability is $150,000 or more, you must pay using the Online Tax Information System (OTIS) at or
by wire transfer.
Check if you are paying by
OTIS (confirmation#________________________)
Wire transfer (date _________________)
I declare under penalty of unsworn falsification that the information provided in this return has been reviewed by me, and to the best of my knowledge
and belief is true, correct and complete.
Taxpayer/Officer/Member Signature
Printed Name
Date
Department use only PMD
Validation
Pay online at or make check payable to State of Alaska
DEPARTMENT USE ONLY
ENV
FSN
Mail to: Alaska Department of Revenue, PO Box 110420, Juneau AK 99811-0420
0405-578 Rev 01/01/15