Form 566 Salmon Enhancement Tax (SET) Return Fill In
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

Amended Return Bonus Return Fisherman Licensed Buyer Year salmon exported/sold: (A) Pounds (attach explanation) (B) Value (C) Rate (D) Tax (Column B x C) (Totals on line 18 columns A and B must equal totals on line 9 columns A and B) 0405 566 Rev 06/17/13 16 43 400 2% ( 02) 2% ( 02) 2% ( 02) 3% ( 03) 566566 a special harvest area entry permit issued under AS agencies salmon hatcheries or a fishing derby Alaska AMENDED AND BONUS RETURNS ONLY taxes previously paid for this period by me and to the best of my knowledge and belief is true and complete Cell Phone Number Check if you are paying by OTIS (confirmation number ) Wire Transfer (date ) Check One Chignik Cook Inlet DEPARTMENT USE ONLY Department use only PMDValidation E mail Address Example: Salmon purchased from government Facility Location Fax Number Fisheries Business License # I certify under penalty of unsworn falsification that this return including all accompanying schedules and attachments has been examined Kodiak Mailing Address Month/Year bonus payment made Month/Year salmon purchased Month/Year salmon purchased: Month: Month: Year: Monthly tax due last day of month following month of purchase Northern Southeast Note: If your total combined liability exceeds $100 000 you must pay using the Online Tax Information System (OTIS) or by wire transfer or Vessel Name Outside Part 1 Region Where Caught (Required information see instructions) Part 2 Salmon Enhancement Tax Region from where Purchased or Exported Part 3 Exempt Purchases Pay online at www tax alaska gov or make check payable to State of AlaskaMail to: Alaska Department of Revenue PO Box 110420 Juneau AK 99811 0420 Phone Number Please note the different due dates Pounds of Salmon Prince William Sound Printed Name Region Salmon Enhancement Tax Return Signature Southern Southeast State Taxpayer Name Title Total (add lines 1 8) Total (add lines 10 17) TOTAL TAX LIABILITY (REFUND) DUE (subtract line 19 from line 18 column D) Use this section to report all salmon harvested under Value of Salmon Yakutat Year: Yearly tax due March 31st of following year Zip Code