Appendix 05 Sample Use Report

United States Department of Agriculture

Prospectus for Campground and Related Granger-Thye Concessions Chequamegon-Nicolet National Forest

Appendix 05: Sample Use Report

Appendix 5

Sample Use Report
Mondeaux Concession Special Use Permit
20__ Operating Season
Permit Fees Accounting Records
December __ , 20__
Factor on __% of adjusted gross revenue as described in permit Gross Revenue – defined as The total amount of receipts from the sale of goods or services Revenue Additions – defined as (a) The value of goods and services that are donated or bartered; and
(b) The value of gratuities, which are goods, services, or privileges that are not available to the

Land Use Fee to Government:

Holder Signature & Date

Government Official Signature & Date

Mondeaux Dam Lodge
Profit and Loss
January 1 – December 31, 20__
Gross Revenue
Income (Sales)

Income (Services)

Value of Donated/Bartered
Goods and Services
Value of Gratuities

Revenue Exclusions
Amts paid to State License
Authority
Revenue from sale of
Operating Equipment and
from Capitalized or Other
Assets
Refunds of Fees provided to
public by Holder

Alcoholic Beverages
Other Beverages
Food
Ice
Miscellaneous
Wholesale
Wood
Other
Boat Rental
FS Passes
Showers

Total

Total
Total
Total
Total Gross Revenue

Total
Total

Total
Total Cost of Revenue Exclusions