(a) Complete and attach this evaluation to the revenue estimate form.

(b) A separate form must be completed for each revenue source.

(c) Detailed explanation of items:

(1) Item I -Services Provided. Briefly describe the kinds of services for which fees are being charged by the program.

(2) Item II -Clients Served. List the classes of persons or organizations that directly benefit from the services provided. The general public may be benefitted by regulatory and enforcement activities, but the beneficiaries to be reported in these instances are the licensees of those whose premises or processes are being inspected.

(3) Item III -Year and Authority to Establish Fee. All user charges should have a beginning point. If the fee was established by memorandum, state the date of the most recent memo, initiator’s name, nature of authority and attach copy of memo. If fee was created by law, cite the title and section number of the American Samoa Code.

(4) Item IV -Adequacy of Current Fees. Report dollars realized from the services provided and the total of all costs. It may be necessary to prorate the costs if the same resource is used to provide more than one type of service, i.e., if the same program/organizational unit receives revenues from more than one nontax revenue source.

(5) Item V -Recommended Fee Structure. List each different type of rate being charged, including a description, the current rate, the recommended rate, and whether legislation, administrative action or other action is required to achieve the changes.

(6) Item VI -Comments on Recommended Fee. Include the reasons for recommending or not recommending changes to the fee structure. If changes are recommended, include the proposed course of action and timetable for achieving the changes.

(7) Item VII -Net Effect of Recommended Fees. As in Item IV report all dollars realized from the services provided but this time on the basis of the revised fee structure.

(d) This form may also be used to recommend the establishment of fees for those services which are currently being provided without charge. In this case, Item IV need not be completed.

(e) If no change to the fee structure is being recommended, complete Items I, II, III, IV, V (reporting “no change”) and VI (with reasons for not recommending any change). Omit Item VII.

See Figure 14 and 15 for completed sample formats for general fund nontax revenues and local tax revenue estimates.

History: Rule 3-83, eff 4 Apr 83, § E.4 (part).