Okaloosa County BOCC — May 17, 2016 — 050515 Sovereignty Submrgd Land Lease & Annual Wet Slip Rev Rpt 2015-2016 Documentation

SOVEREIGNTY SUBMERGED LANDS LEASE ANNUAL WET SLIP REVENUE REPORT As a submerged lands lessee, you are required to report annually to the Division of State Lands all income derived directly or indirectly from the lease area, to report the number and type of wet slips and to certify that all information provided is correct. This includes reporting any income collected by you or someone else. The three attached forms must be completed and returned by all lessees. Directions for completing forms WET SLIP INFORMATION FORM - This form is for reporting the number and type of wet slips. Please enter the correct number of each type of wet slip at the lease facility and total. GROSS INCOME REPORTING FORM - This form is for reporting direct and indirect income that has been generated within the lease boundary during the timeframe specified. This is required under the terms of your lease and under subsection 18-21.011(1)(a)2. Florida Administrative Code. Please enter the amount of both direct and indirect income generated by month within the lease boundary. The definition of income can be found at the bottom of the form. R AFION-FORN his-form-ts-the-lesseels-confirmatior .'.' ormati provided-is-true and correct: is N bootarized, LOAHLZZA7AW LS AL AWK SERUERELD BY 78E F2 25 /2K JINE AU iRs s 77k OF 78y 118y, 5 2o, Py £ AL, Genéral Lease Fee Information Income is defined in Rule 18-21.003, Florida Administrative Code, as the gross revenue derived directly or indirectly from the use of state-owned submerged lands such as slip rental, lease or sublease fees, dock or pier admission fees, club membership, stock ownership or equity interest in activities where increased revenue is attributable to the use of the submerged land. However, gross revenue shall not include pass-through fees for utility services, sale of the facility or sales of products not occurring on sovereignty submerged lands. Gross revenue shall include all future payments made for the transfer of the interest in a slip originally obtained from the Board's lessee, including transfer of slip rights by slip sublessee, slip "sellers", slip interest transfers, new club memberships, and other similar transactions. If you are required to pay 6% of the income generated on the lease areg, you will receive a supplemental invoice which will incluce 4 State and County Tax on any additional fees owed. To view Chapter 18-21 Florida Administrative Code, on Sovereignty Submerged Lands Management in its entirety go to: http://www.flrules.org/gateway/ChapterHome.asp?Chapter=18-21 FLORIDA DEPARTMENT OF ENVIRONMENTAL PROTECTION DIVISION OF STATE LANDS 3900 COMMONWEALTH BOULEVARD, MS 100 TALLAHASSEE, FLORIDA 32399-3000 (850) 245-2616 2015/2016 Wet Slip Information Form Lessee: Instrument No: I. INFORMATION ON WET SLIPS LOCATED ON STATE-OWNED LANDS 1. Number of Temporary Slips - Slips that are not rented and are used as fuel docking, launching or removing boats, restaurants, or store purchases. These slips should be Non revenue generating slips. 2. Number of Transient Slips- Slips that are rented on a short term basis. 3. Number of Public Slips - open to the public on a "first come, first automatic renewal rights or conditions. 4. Number of Slips Not Usable - Slips that are silted in or are in low water. 5. Number of Slips Sold, Subleased, Licensed, Assigned, etc. - Aftach a copy of the document which represents the sale, sublease, license or assignment. The document should include the sublessee's name, unit number, the slip number, and the amount of the transaction. 6. Number of Private Slips, not rented to the public - Slips used for personal mooring, Association common area, etc. served” basis. - Rental term shall be no longer than one year and with no % ’ Y/ I Total Number of Slips on State-Owned Lands, Add lines 1 through 6 /7 Is your facility a Pier with Admission Fees? /4;8) NO Circle One Boating has a tremendous economic impact on the State of Florida each year. In an