Amendment to the Fuel Regulation for the National Non-Sport Commercial Fishing FleetReforma al Reglamento de Combustible para Flota Pesquera Nacional Comercial no Deportiva

APPLICATION FOR COMPETITIVELY-PRICED FUEL Date: ___________________________ of _________________________________ of ____________________________ Gentlemen Fuel Control and Administration Section Costa Rican Institute of Fisheries and Aquaculture In accordance with the legal provisions on the matter, I request the reimbursement of the following fuel:

Owner ________________________________________________________________ ID Nº _________________________________ Vessel _______________________________________________________________ Registration _________________________________ Diesel _____________________________________________ Liters Gasoline ______________________________________________ Liters Days of absence _______________________________ between _______________________ and ____________________ Catch: Fish _________________________ Kg. - Shrimp ________________________ Kg. - Others __________________________ Kg.

Applicant's name _______________________________________________________ ID Nº _________________________________ Registered Signature ____________________________________________________________________________________________________ _______________________________________________________________ FOR EXCLUSIVE USE OF THE CONTROL DEPARTMENT AND FUEL ADMINISTRATION Fishing period from ________________________________________ to ______________________________________ Diesel ( ) Gasoline ( ) Days of absence ___________________________________________ Multiplication factor _______________________________________ Authorized liters __________________________________________ Purchase Order Nº _________________________________________ OBSERVATIONS:______________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ __________________________________________________________ Received by­­­­­­­­­­­­­­­­­ ­­­­­­­­­­­­­­­____________________________

SALES INVOICE FOR THE LANDED PRODUCT Nº ______________

I. GENERAL INFORMATION

Date: _______________________________________ Place of Sale: ___________________________________________________________ Vessel: _________________________________ Registration: ______________________________________________________________ Owner: __________________________________ ID: ________________________________________________________________ Captain's Name: ___________________________ ID: ________________________________________________________________ Buyer or Receiving Station: _________________________________________________________________________________________ Fishing Gear: _________________________ Fishing Days: ________________________ Fishing Location: ___________________________

II. CATCH DETAIL

III. OPERATING

FISHER'S SIGNATURE: __________________________________________________________________

SWORN DECLARATION OF FISHING DAYS (Small-Scale Artisanal Vessels) Gentlemen Fuel Control and Administration Section Costa Rican Institute of Fisheries and Aquaculture The undersigned ______________________________________ holder of identity card _____________ for the purpose of processing competitively-priced fuel, under OATH and aware of the legal implications of false testimony, I proceed to provide the following detail of my fishing activities with the Vessel _________________ Registration _______, under the command of captain _____________________, holder of identity card _________ during the period from _____________ to _____________.

| Day _________________________________________ departure time ______________________ arrival time ____________________ | | --- | | Day _________________________________________ departure time ______________________ arrival time ____________________ | | Day _________________________________________ departure time ______________________ arrival time ____________________ | | Day _________________________________________ departure time ______________________ arrival time ____________________ | | Day _________________________________________ departure time ______________________ arrival time ____________________ | | Day _________________________________________ departure time ______________________ arrival time ____________________ | | Day _________________________________________ departure time ______________________ arrival time ____________________ | | Day _________________________________________ departure time ______________________ arrival time ____________________ | | Day _________________________________________ departure time ______________________ arrival time ____________________ | | Day _________________________________________ departure time ______________________ arrival time ____________________ | | Day _________________________________________ departure time ______________________ arrival time ____________________ | | Day _________________________________________ departure time ______________________ arrival time ____________________ | | Day _________________________________________ departure time ______________________ arrival time ____________________ | | Day _________________________________________ departure time ______________________ arrival time ____________________ | | Day _________________________________________ departure time ______________________ arrival time ____________________ | | Day _________________________________________ departure time ______________________ arrival time ____________________ | | Day _________________________________________ departure time ______________________ arrival time ____________________ | | Day _________________________________________ departure time ______________________ arrival time ____________________ | | Day _________________________________________ departure time ______________________ arrival time ____________________ | | Day _________________________________________ departure time ______________________ arrival time ____________________ | | Day _________________________________________ departure time ______________________ arrival time ____________________ | | Day _________________________________________ departure time ______________________ arrival time ____________________ | | Day _________________________________________ departure time ______________________ arrival time ____________________ | | Day _________________________________________ departure time ______________________ arrival time ____________________ | BENEFICIARY'S SIGNATURE: _____________________________________________________________________

CONTROL SLIP FOR COMPETITIVELY-PRICED FUEL EXPENSE Vessel: ______________________________________________ Registration: ___________________________________________ Owner's Name: _____________________________________ ID Nº: ___________________________________________ Name of person withdrawing: ___________________________________ID Nº: ___________________________________________ Distributor's Name: _________________________________________________________________________________________ Distributor's Stamp | Nº Purchase Order | Order issue date | Liters authorized INCOPESCA | Liters Withdrawn Station | Withdrawal Date of Fuel | Pump Balance | Tank Balance | Signature of Beneficiary or Authorized Person | | --- | --- | --- | --- | --- | --- | --- | --- | _______________________________________ BENEFICIARY'S SIGNATURE

PROOF OF INFORMATION TRANSFER WHEN THE VESSEL UNLOADS IN A PLACE OTHER THAN ITS OPERATING BASE Date: ______ / ______ / 20 _____. Office: _____________________________ Vessel Name: ____________________________________________________ Registration Nº: _______________________________ Operating Base: _________________________________________________________________________________________________ Owner: ____________________________________________________________ ID Nº: __________________________________ | Nº last Purchase Order | Order issue date | Liters authorized INCOPESCA | Registered Balance(s) | Last fishing period Counted (Departure and arrival) | Contract expiration date | | --- | --- | --- | --- | --- | --- | (Signature Registration Card attached) | Navigation Certificate expiration date | Fishing License expiration date | Annual payment expiration date | | --- | --- | --- | (Fishing license and income receipt attached) Observations:______________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ _______ Official's Name: ___________________________________________________________ Official's Signature: ______________________________________ Date: ___ / ___ / 20 ___ STAMP

FORM FOR THE RETURN OF INCOMPLETE DOCUMENTS FOR THE PROCESSING OF COMPETITIVELY-PRICED FUEL.

INDIVIDUAL PROCESS VESSEL _________________________________ REGISTRATION _____________________________ FILE ___________________________ MARK WITH AN X ( ) 1. Completed fuel application.

( ) 2. Previous Order.

( ) 3. Original departure clearance.

( ) 4. Photocopy of the logbook where the fishing zone is reported.

( ) 5. Sworn declaration of the fishing trip.

( ) 6. Fuel purchase invoice (original and copy).

( ) 7. Product sales invoice (two copies and original).

( ) 8. Certificate of Product Catch.

( ) 9. Photocopy of the Balance Control Slip (stamped and signed).

( ) 10. Registration and up-to-date in the CCSS Contributory Regime.

( ) 11. Validity of the Contract and submission of the respective documents.

( ) 12. Validity of the fishing permit.

( ) 13. Others _____________________________________________________ OBSERVATIONS_______________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ _________________________________________________________ You are informed that you have a period of 10 business days, according to Law Nº 8220, to resubmit the corresponding procedure in due form.

Received by user ________________________________________ Date _______________________________________ Official's Stamp and Signature

FORM FOR THE RETURN OF INCOMPLETE DOCUMENTS FOR THE PROCESSING OF COMPETITIVELY-PRICED FUEL.

FISHER ORGANIZATIONS

MARK WITH AN X ( ) 1. Completed fuel application.

( ) 2. Previous Order.

( ) 3. Original departure clearance.

( ) 4. Photocopy of the logbook where the fishing zone is reported.

( ) 5. Sworn declaration of the fishing trip.

( ) 6. Fuel purchase invoice (original and copy).

( ) 7. Product sales invoice (two copies and original).

( ) 8. Certificate of Product Catch.

( ) 9. Photocopy of the Balance Control Slip (stamped and signed).

( ) 10. Registration and up-to-date in the CCSS Contributory Regime.

( ) 11. Validity of the Contract and submission of the respective documents.

( ) 12. Validity of the fishing permit.

( ) 13. Others _________________________________________________________________________ OBSERVATIONS ______________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ __________________________________________________________ You are informed that you have a period of 10 business days, according to Law Nº 8220, to resubmit the corresponding procedure in due form.

Official's Signature _____________________________________________ Date ___________________________________ Official's Stamp and Signature

Final agreement.

SOLICITUD DE COMBUSTIBLE A PRECIO COMPETITIVO Fecha: ___________________________ de _________________________________ del ____________________________ Señores(as)

Instituto Costarricense de Pesca y Acuicultura De conformidad con las disposiciones legales sobre la materia, solicito el reintegro del siguiente combustible:

Propietario ________________________________________________________________ Nº cédula _________________________________ Embarcación _______________________________________________________________ Matrícula _________________________________ Diesel _____________________________________________ Litros Gasolina ______________________________________________ Litros Días de ausencia _______________________________ comprendidos entre el _______________________ y hasta el ____________________ Captura: Pescado _________________________ Kg. - Camarón ________________________ Kg. - Otros __________________________ Kg.

Nombre del solicitante _______________________________________________________ Cédula Nº _________________________________ Firma Registrada ____________________________________________________________________________________________________ _______________________________________________________________ PARA USO EXCLUSIVO DEL DEPARTAMENTO DE CONTROL Y ADMINISTRACIÓN DEL COMBUSTIBLE Periodo de pesca del ________________________________________ al ______________________________________ Diesel ( ) Gasolina ( ) Días de ausencia ___________________________________________ Factor de multiplicación _______________________________________ Litros autorizados __________________________________________ Orden de Compra Nº _________________________________________ OBSERVACIONES:______________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ __________________________________________________________ Recibido por­­­­­­­­­­­­­­­­­ ­­­­­­­­­­­­­­­____________________________

FACTURA DE VENTA DEL PRODUCTO DESEMBARCADO Nº ______________

I. INFORMACION GENERAL

Fecha: _______________________________________ Lugar Venta: ___________________________________________________________ Embarcación: _________________________________ Matrícula: ______________________________________________________________ Propietario: __________________________________ Cédula: ________________________________________________________________ Nombre del Capitán: ___________________________ Cédula: ________________________________________________________________ Comprador o Puesto de Recibo: _________________________________________________________________________________________ Artes de Pesca: _________________________ Días de Pesca: ________________________ Lugar de Pesca: ___________________________

II. DETALLE DE CAPTURA

III. GASTOS DE OPERACIÓN

FIRMA DEL PESCADOR: __________________________________________________________________

DECLARACION JURADA DÍAS DE PESCA (Embarcaciones Artesanales en Pequeña Escala) Señores

Instituto Costarricense de Pesca y Acuicultura El suscrito ______________________________________ portador de la cédula de identidad _____________ para efecto de tramitar combustible a precio competitivo, bajo la FE DEL JURAMENTO y conocedor(a) de las implicaciones legales del falso testimonio, procedo a brindar el siguiente detalle de mis actividades de pesca con la Embarcación _________________ Matrícula _______, al mando del capitán _____________________, portador de la cédula de identidad _________ durante el período comprendido del _____________ hasta el _____________.

| Día _________________________________________ hora de salida ______________________ hora de llegada ____________________ | | --- | | Día _________________________________________ hora de salida ______________________ hora de llegada ____________________ | | Día _________________________________________ hora de salida ______________________ hora de llegada ____________________ | | Día _________________________________________ hora de salida ______________________ hora de llegada ____________________ | | Día _________________________________________ hora de salida ______________________ hora de llegada ____________________ | | Día _________________________________________ hora de salida ______________________ hora de llegada ____________________ | | Día _________________________________________ hora de salida ______________________ hora de llegada ____________________ | | Día _________________________________________ hora de salida ______________________ hora de llegada ____________________ | | Día _________________________________________ hora de salida ______________________ hora de llegada ____________________ | | Día _________________________________________ hora de salida ______________________ hora de llegada ____________________ | | Día _________________________________________ hora de salida ______________________ hora de llegada ____________________ | | Día _________________________________________ hora de salida ______________________ hora de llegada ____________________ | | Día _________________________________________ hora de salida ______________________ hora de llegada ____________________ | | Día _________________________________________ hora de salida ______________________ hora de llegada ____________________ | | Día _________________________________________ hora de salida ______________________ hora de llegada ____________________ | | Día _________________________________________ hora de salida ______________________ hora de llegada ____________________ | | Día _________________________________________ hora de salida ______________________ hora de llegada ____________________ | | Día _________________________________________ hora de salida ______________________ hora de llegada ____________________ | | Día _________________________________________ hora de salida ______________________ hora de llegada ____________________ | | Día _________________________________________ hora de salida ______________________ hora de llegada ____________________ | | Día _________________________________________ hora de salida ______________________ hora de llegada ____________________ | | Día _________________________________________ hora de salida ______________________ hora de llegada ____________________ | | Día _________________________________________ hora de salida ______________________ hora de llegada ____________________ | | Día _________________________________________ hora de salida ______________________ hora de llegada ____________________ | FIRMA BENEFICIARIO: _____________________________________________________________________

BOLETA CONTROL DE GASTO DEL COMBUSTIBLE A PRECIO COMPETITIVO Embarcación: ______________________________________________ Matrícula: ___________________________________________ Nombre del Propietario: _____________________________________ Cédula Nº: ___________________________________________ Nombre persona que retira: ___________________________________Cédula Nº: ___________________________________________ Nombre del Distribuidor: _________________________________________________________________________________________ Sello Distribuidor | Nº Orden de compra | Fecha emisión orden | Litros autorizados INCOPESCA | Litros Retirados Estación | Fecha de Retiro del Combustible | Saldo Bomba | Saldo Tanques | Firma del Beneficiario o Autorizado | | --- | --- | --- | --- | --- | --- | --- | --- | _______________________________________ FIRMA DEL BENEFICIARIO

CONSTANCIA DE TRASLADO DE INFORMACIÓN CUANDO LA EMBARCACIÓN DESCARGUE EN UN LUGAR DIFERENTE A SU BASE DE OPERACIÓN Fecha: ______ / ______ / 20 _____. Oficina: _____________________________ Nombre Embarcación: ____________________________________________________ Nº Matrícula: _______________________________ Base de Operación: _________________________________________________________________________________________________ Propietario: ____________________________________________________________ Nº Cédula: __________________________________ | Nº última Orden de compra | Fecha de emisión orden | Litros autorizados INCOPESCA | Saldo(s) registrados | Ultimo periodo de pesca Contabilizado (Salida y arribo) | Fecha de vencimiento del contrato | | --- | --- | --- | --- | --- | --- | (Se adjunta Tarjeta de Registro de Firmas) | Fecha vencimiento Certificado de Navegabilidad | Fecha de vencimiento Licencia de Pesca | Fecha del vencimiento del pago anual | | --- | --- | --- | (Se adjunta licencia de pesca y comprobante de ingresos) Observaciones:______________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ _______ Nombre Funcionario: ___________________________________________________________ Firma del Funcionario: ______________________________________ Fecha: ___ / ___ / 20 ___ SELLO

FORMULARIO PARA DEVOLUCIÓN DE DOCUMENTOS INCOMPLETOS PARA LA TRAMITACIÓN DE COMBUSTIBLE A PRECIO COMPETITIVO.

TRÁMITE INDIVIDUAL EMB. _________________________________ MATRÍCULA _____________________________ EXPED. ___________________________ MARQUE CON UNA X ( ) 1. Solicitud de combustible completa.

( ) 2. Orden Anterior.

( ) 3. Zarpe en original.

( ) 4. Fotocopia de la bitácora donde reporta la zona de pesca.

( ) 5. Declaración jurada del viaje de pesca.

( ) 6. Factura de compra de combustible (original y copia).

( ) 7. Factura de venta del producto (dos copias y original).

( ) 8. Constancia de Captura del Producto.

( ) 9. Fotocopia de la Boleta de Control de Saldos (sellada y firmada).

( ) 10. Inscripción y al día en el Régimen Contributivo de la CCSS.

( ) 11. Vigencia del Contrato y aporte de los documentos respectivos.

( ) 12. Vigencia del permiso de pesca.

( ) 13. Otros _____________________________________________________ OBSERVACIONES_______________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ _________________________________________________________ Se le informa que tiene un plazo de 10 días hábiles de acuerdo a la Ley Nº 8220 para que presente de nuevo el trámite correspondiente a derecho.

Recibido usuario ________________________________________ Fecha _______________________________________ Sello y Firma Funcionario

FORMULARIO PARA DEVOLUCIÓN DE DOCUMENTOS INCOMPLETOS PARA LA TRAMITACIÓN DE COMBUSTIBLE A PRECIO COMPETITIVO.

ORGANIZACIONES DE PESCADORES

MARQUE CON UNA X ( ) 1. Solicitud de combustible completa.

( ) 2. Orden Anterior.

( ) 3. Zarpe en original.

( ) 4. Fotocopia de la bitácora donde reporta la zona de pesca.

( ) 5. Declaración jurada del viaje de pesca.

( ) 6. Factura de compra de combustible (original y copia).

( ) 7. Factura de venta del producto (dos copias y original).

( ) 8. Constancia de Captura del Producto.

( ) 9. Fotocopia de la Boleta de Control de Saldos (sellada y firmada).

( ) 10. Inscripción y al día en el Régimen Contributivo de la CCSS.

( ) 11. Vigencia del Contrato y aporte de los documentos respectivos.

( ) 12. Vigencia del permiso de pesca.

( ) 13. Otros _________________________________________________________________________ OBSERVACIONES ______________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ __________________________________________________________ Se le informa que tiene un plazo de 10 días hábiles de acuerdo a la Ley Nº 8220, para que presente de nuevo el trámite correspondiente a derecho.

Firma Funcionario _____________________________________________ Fecha ___________________________________ Sello y Firma Funcionar

Acuerdo firme.