Attachment B_Form-10-355-Financial-Information-for-Revenue-Producing-Uses-508-Compliant.pdf

NPS Form 10-355 (Rev. 08/2017) OMB Control No. 1024-0233 National Park Service Expiration Date 08/31/2020

FINANCIAL INFORMATION FOR REVENUE-PRODUCING USES

NPS Leasing Program Commercial Services Division

1849 C Street, NW Washington, DC 20240

RECORDS RETENTION: TEMPORARY. Destroy/delete 3 years after closure. (NPS Records Schedule, Resource Management and Page 1 of 2 Lands (Item 1D) (N1-79-08-1))

I. START UP COSTS

Working Capital Utility Hookups

Improvements FF&E

Marketing Legal

Total Start Up Costs

Explain the basis of all estimates. The estimates must credibly demonstrate your understanding of the start-up costs associated with this lease opportunity.

II. Stabilized Operating Proforma

Revenue Expenses

General/Administrative Operations

Building Maintenance Grounds Upkeep

HVAC Utilities

Security

Other Expenses:

Total Expenses Net Income After Expenses

Annual Cost of Debt and Equity Rent to NPS

Net Cash Flow

Explain the basis of all estimates. These estimates must credibly demonstrate that your net revenue will be sufficient to permit payment of the proposed rent and otherwise demonstrate that your proposal is financially viable.

NPS Form 10-355 (Rev. 08/2017) OMB Control No. 1024-0233 National Park Service Expiration Date 08/31/2020

NOTICES

PAPERWORK REDUCTION ACT STATEMENT

Paperwork Reduction Act Statement. We collect this information under the authority of Title IV of the National Parks Omnibus Management Act of 1998 (Pub. L. 105-391). We use this information to evaluate proposals received in response to leasing opportunities. Your response is required to obtain or retain a benefit. We estimate that it will take you 1 hour to complete this form.

This estimate includes time for reviewing instructions, gathering and maintaining data, and completing and reviewing the form.

You may send comments on the burden estimate or any aspect of this form to the Information Collection Clearance Officer, National Park Service, 1849 C Street, NW, (2601), Washington, DC 20240. We may not collect or sponsor and you are not required to respond to a collection of information unless it displays a currently valid OMB control number.

ESTIMATED BURDEN STATEMENT

We estimate that it will take you 1 hour to complete this form, including time to review instructions, gather and maintain data, and complete and review the form. You may send comments on the burden estimate or any aspect of this form to the Information Collection Clearance Officer, National Park Service, 12201 Sunrise Valley Drive, Mail Stop 242, Reston, VA 20192. Please do not send your completed form to this address.