redacted champlin claims copy

8/10/2019 Redacted Champlin Claims Copy

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5/55

!"#$ &'()*+,*)&(-.*!/0*11 2345+$67 (89-9*: ;&.>(? @"A$ B 3C 9B

Oyster

5. Provide

the

quantity

of

each species

of

Game and/or Seafood you fished and/or hunted in each time

period or season during the year before the Spill, including the amount you consumed and the amount

you gave

to

your

family

for their personal consumption

or

for the purposes

of

barter.

6.00 Sacks

6.

Identify

the

specific

family

members (including

you

who

relied on each

of

the

species

of

Game

or

Seafood that you hunted and/or fished before the Spill. List

each

family member

and

provide a description

of

his

or

her

relationship to

you

(e.g., wife, mother, daughter, aunt).

To

the extent that your or your family s reliance

on certain species

varies by

time

period

or season

describe

that variation

below.

Ray Herron (Step-Father);

Barry Herron

(Brother); Matt

Herron

(Brother); Michael Herron (Brother); Sheena Herron

(Step-Sister); Horse Maise (Father-In-Law); Nola

Maise

(Mother-In-Law); Cheryl Creppel (Sister-In-Law)

7. Provide a specific description

of

where you hunted and/or fished for each species in the Gulf

of

Mexico

before the Spill. In addition

to

the

written

description below, also provide a map that identifies where

you hunted and/or fished each species

in

the Gulf

of

Mexico before the Spill.

Plaquemines

Parish

10. Out

of

the total quantity

of

Game and/or Seafood you and your

family

relied on before the Spill,

FlO

v.1

approximately what

percentage

by

species and location came

from

areas that

were later

closed,

impaired, or harmed because of

the

Spill?

100

TO FILE YOUR CLAIM ONLINE VISIT WWW.DEEPWATERHORJZONSETTLEMENTS.COM


6/55

!"#$ &'()*+,*)&(-.*!/0*11 2345+$67 (89-9*: ;&.>(? @"A$ - 3B 9C

8. Do you fish or hunt to ha1Vest, catch, barter,

consume,

or trade

Gulf of Mexico natura l resources

includ ing Seafood and Game), in a

traditional

or

[fil

Yes D

No

customary manner, to sustain

your

basic personal

or

family dietary, economic security, shelter, tool,

or cloth ing needs?

f

you checked

Yes

for

Question 8, explain.

To provide groceries

as

a means of supplementing the dietary needs of both myself and my family.

9. Describe

the equipment

and methods you use to

hunt

and/or fish for subsistence use.

Trawl

nets

vessel traps.

CF1

v.1

TO FILE

YOUR CLAIM

ONLINE

VISIT

WWW.

DE

EP

WAT ERHO

RIZO

NSITTLEMEN

TS.CO

M


7/55

!"#$ &'()*+,*)&(-.*!/0*11 2345+$67 (89-9*: ;&.>(? @"A$ : 3B 9C

11. Did you continue to fish

and or hunt for

subsistence

D

Yes

IBl

No

purposes

l ferthe

Spill?

f you checked Yes, for Question 11, provide a specific description

of where

and what species you fished

and or

hunted

for subsistence purposes between Apri l 20, 2010 and December 31, 2011, and what

quantity

of

Game

and or

Seafood you

were

able

to

catch

over

that

period.

12. Did you stop fishing and or

hunting

for subsistence

purposes

in

areas that

where

closed, impaired,

or

IBl

Yes

D

No

harmed because of

the

Spill?

f you check Yes, for Question 12, identify the area, and your best estimate of when those areas were

closed, and

the

dates you resumed fishing and or

hunting

in those areas. f you are asserting that an

area

was

not closed but

was

impaired

or

harmed, also describe

the

impairment

or

harm.

(Attach additional

sheets if you need more

space.

Date You

Fishing or Hunting Area

Dates Closed or Impaired Harmed Resumed Hunting

and or Fishing

From _1_J_]J _j

2 1

to -1L _J__J

2 12

Plaquemines Parish

(Month/Day/Year) (Month/Day/Year)

1LJ_ __j

2 12

fnot basis of mpairment

(Month/Day/Year)

FlO

v.1

TO FILE YOUR CLAIM

ONLINE VISIT

WWW.DEEPWATERHORIZONSETTLEMENTS.COM


8/55


9/55


10/55

!"#$ &'()*+,*)&(-.*!/0*11 2345+$67 (89-9*: ;&.>(? @"A$ (( 3B 9C

Name: Sheena Herron

D Male

Iii Female

see Exhibit A

25

elationship: step-sister

Name: Horse Maise

Iii Male

D

Female

see

Exhibit

A

80

elationship: father in law

Name: Nola Maise

D Male

Iii Female

see Exhibit A

77

elationship: mother in law

9

see

Exhibit

A

Name: Cheryl Crepppel

D Male Iii Female

55

elationship: sis ter in law

Name:

D

Male

D

Female

0

Relationship:

Name:

D Male D Female

1

Relationship:

Name:

D

Male

D

Female

2

Relationship:

c

PERCENT OF

WEEKLY

PROTEIN SUPPUEO BY SUBSISTENCE

Acn vrrIES

You must state the total percent of weekly protein you consumed or supplied to each family member as a result of your

subsistence activities. For example, if the fish you caught provided half of the total protein a family member ate during

the week, then

you

would write or type 50% in the column labeled Percent

of

Weekly Protein for that family member.

Claimant

or Family Member Name

Percent of

Weekly

Protein

1 Kim Champlain - 70%

2

Ray Herron - 70%

3

Barry Herron - 70%

4

Matt

Herron - 70%

5

Michael Herron - 70%

6 Sheena Herron - 70%

7

orse Maise - 70%

D

NAME

OF T:HE PERSON WHO COMpLETED THIS FORM

In

the

space

below, print or type the date you completed this form, your name,

and

your relationship to the claimant

(e.g. self, attorney or

CADA

Team).

Date Completed:

SUB-2

v 1

Soren Gisleson

__: __: __;

12

Name (Printed or Typed)

(Month/Day/Year)

Attorney

Relationsh. Q_

to Claimant

WWW DEEPWATERHORIZONECONOMICSETTLEMENT COM

Page 2

of

2


11/55

!"#$ &'()*+,*)&(-.*!/0*11 2345+$67 (89-9*: ;&.>(? @"A$ (& 3B 9C

Claimant: Kim Champlin

Exhibit A: Species Detail

crab, shrimp, oyster, flounder, redflsh

Part 8. contd. Age and Gender Information

No. Species Claimant

or

Family

Member

Name and Gender Age

13

Name:

14

Name:

Relationship:

15

Name:

Relationship:

16

Name:

Relationship:

17

Name:

Relationship:

18

Name:

Relationship:

19

Name:

Relationship:

Part

C contd. Percent

of

Weekly Protein Supplied

by

Subsistence Activities

No

Claimant

or

Family

Member

Name

of

Protein

8

Nola Maise

70

9

Cheryl Creppel

7

1

11

12

13


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!"#$ &'()*+,*)&(-.*!/0*11 2345+$67 (89-9*: ;&.>(? @"A$ (9 3B 9C

Claimant

Signature

Date

Signed:

ttorney

Signature

Date

Signed:

SUB-2

v 2

DEEPWATER HORIZON

CLAIMS CENTER

ECONOMIC PROPERTY

OAM.\GE

.a.MMS

13

Month/Day/Year)

13

(M

onthfDay{Year)

Signature

Name Printed or Typed)

Signature

Soren Gisleson

Name Printed or Typed)

WWW DEEPWATERHORIZONECONOMICSETTLEMENT COM

Page 3 of 3

Claimant ID:

Claim ID:


15/55

!"#$ &'()*+,*)&(-.*!/0*11 2345+$67 (89-9*: ;&.>(? @"A$ (B 3C 9B

_before_ h e p ._111_:

. . .

I

--

Claimant s Position

Length of Claimant s Employment

Claimant s Wage Rate Per Trtp

Month/oayiYe

_

D

Hourly

;:

1

LJally D Weekly 0

Monthly

I provide my deckhand with a

portion of

my catch each

bip In

payment for labor.

Inltlal1

1

Address

dentify your

relatlonshlp

to

the Claimant.

D

Non-Relative

Claimant provides

th followlng

each

w k

for me:

(For Bartering Only) Clalmant provides

the

following each week for me:

DeScrlbe .......1_S_ ._\_ _ ....:...-t_r

Pound/Sacks:

r-o

6

S

In Exchange For:

Pound/sacks:

n

Exchange For:


16/55


17/55

!"#$ &'()*+,*)&(-.*!/0*11 2345+$67 (89-9*: ;&.>(? @"A$ (: 3B 9C

l

'

_ e fo re

he

I-

:

j

;

'

..

,-

Clalmant's Position

Length

of

Claimant's Employment

Clalmant's Wage Rate Per Trip

(Mcnt l/Daytyea

_

0

Hourly ::-..J ually

0

Weekly

0

Monthly

I provide

my deckhand

with

a

portion

of

my

catch each

b'lp In p ymentfor labor

Inltlals=

Address

Identify your relatJonshlp

t

the Claimant.

Clly

0 Non Relative

Claimant provides

the

followlng each week

for

me:

(For Bartering Only) Claimant

provides

the


Zip

Q1

Relative

Desa1be

Relatlonshlp: o __r_o_ r _ e

r_

Pound/Sacks:

z

0

0

\

n

Exchange For:

Pound/Sacks:

n Exchange For:


18/55

!"#$ &'()*+,*)&(-.*!/0*11 2345+$67 (89-9*: ;&.>(? @"A$ (. 3B 9C

I certify

and

declare under penalty of

perjury

pursuant

to 8

U.S.C. 746 th t all the Information I have proV ded In

this

st tement

(and

In

any

documents or other attachments submitted with this statement)

Is

true and correct

ate

Signed

utlit L

Month/Day/Year)

Name (Printed

o Typed)


19/55

!"#$ &'()*+,*)&(-.*!/0*11 2345+$67 (89-9*: ;&.>(? @"A$ &) 3B 9C

area(s) you

ftshed

_

J_h_u_nted_ w_o_re_th_e_5p _ _=

F .

j

J

r

Claimant s Position

Length ofClaimant s Employment

Claimant s Wage Rate er Trip

(Month/DayiY

_

D Hourly

..J wally

D

Weekly

0 Monthly

I provide my deckhand

with

a

portion

ofmy catch each

b1p In payment for labor

Initials:

Address

Identify your relattonshlp to

the Claimant.

0

Clalmant provides

the

follbwlng each

week for

me:

(For Bartering Only) Claimant

provides the

following

each

week for

me:

if'

Relative

Destt1be Relatlonshlp:- CIA......

Pound/Sacks:

In .Exchange For:

Pound/Sacks:

In Exchange For:


20/55

!"#$ &'()*+,*)&(-.*!/0*11 2345+$67 (89-9*: ;&.>(? @"A$ &( 3B 9C

/

_.

certify and declare under penalty of perjury pursuant to

28

U S C

1746

that all

the

Information have provided In this

Statement

(and In

any

documents

or

other attachments submitted with this Statement) Is

true

and

correct

ate

t

f I

,,__

Third Party Signature

igned

(Month/Day/Year)

VV\

\

.

k

f

rro\t\

Name (Printed or

fyped)


21/55

!"#$ &'()*+,*)&(-.*!/0*11 2345+$67 (89-9*: ;&.>(? @"A$ && 3B 9C

area(s)

you

ftshed

_

J_h_u_n_l ed

_

_befo__re_the p_m_

(

J

;

;

-

-

.

Clalmant s

Position

.

Length

of

Claimant s Employmeht

lMonuvOay1 rear)

Month/OayiYe

Claimant s

Wage

Rate

Per Trtp

_

0 Hourly ;. ually D Weekly 0 Monthly

I provide my deckhand

with a

portion of my catch each

Inltla1s=

b1p In

payment

for labor.

Address

Identify your

relatlonshlp

to

the Claimant.

0

Non-Relatlve

Claimant provides

the

following

each

week

for

me:

(For

Bartering Only Claimant

provides the


Relatlve

DeSa1be

Pound/Sacks:

n Exchange For:

Pound/Sacks:

n

Exchange For:


22/55

!"#$ &'()*+,*)&(-.*!/0*11 2345+$67 (89-9*: ;&.>(? @"A$ &8 3B 9C

i

certify and declare

under penalty

of

perjury pursuant

to 28

U.S.C.

_

1746

that

all the lnfomtatlon

have

provided In this

Statement

and

In any

documents

or other

attachments

submitted with this Statement) Is true and correct.

ate

t

t} l Q

.

lhifdrtYSlgnature

igned

Month/Day/Year)

R

\.\err-e>tt

Name

- nted

or Typed)


23/55

!"#$ &'()*+,*)&(-.*!/0*11 2345+$67 (89-9*: ;&.>(? @"A$ &? 3B 9C

I

area(s) you

tlshed_

f_h_u_.nted_

. _i>e_8to__re_the p_11_1=---------------

1

i .

;

,-

:

._:;:...__

Claimant s Position

I

Length

of

Clalmant s Employment

(Moouv Dllv1 (Month/Day/Ye

Clalmant s Wage Rate Per Trip

_ D Hourly ;.

..J

ually D Weekly D Monthly

I provide my deckhand with a portion ofmy catch each

trtp

In payment

for

labor

lnltlals

Address

Identify your relattonshlp to D

Non-Relative

the

Claimant.

Claimant provides

the

following each

weak

for

me:

(For Bartering Only) Claimant provides the

followlng each

week

for me:

D

Relative

Describe

Relationship: J

11 V

r

Pound/Sacks:

In Exchange For:

Pound/Sacks:

n .:xchange For:


24/55

!"#$ &'()*+,*)&(-.*!/0*11 2345+$67 (89-9*: ;&.>(? @"A$ &9 3B 9C

f

I -

I ertify

and

declare under penalty

o

perjury

pursuant

to 28 U.S.C. .1?46 tliatall thelnformatlon I have

provided

In this

Statement

and In

any

documents

or other

attachments submitted

with this Statement) Is true and correct.

b ,1:7-

ate


igned

Month/Day/Year)

R

I

a

A/

tf

f l

e;M.o J

Name Pr1nted or Typed


25/55

!"#$ &'()*+,*)&(-.*!/0*11 2345+$67 (89-9*: ;&.>(? @"A$ &B 3C 9B

I

1

f

:8 : .. ;;

_

. :

1cert: Fy

and declare

under

penalty

of perjury pursuant to 28 U.S.C. 1746 th t all the Information I

have

proVlded In this

statement

and

In any documents or other attachments submitted with this

Statement)

Is true and

rorrect.

l

, I? I 2-

Date


Month/Dav/Year)

tr/I //e v

/f_ //;////d

Name

{Printed

or

Typed)


26/55


27/55


28/55


29/55


30/55


31/55


32/55


33/55


34/55


35/55


36/55


37/55


38/55

!"#$ &'()*+,*)&(-.*!/0*11 2345+$67 (89-9*: ;&.>(? @"A$ 8. 3B 9C

6

7.

B

5c. Did the claimant identify his

or

her fishing and/or hunting grounds?

5d. Did the claimant describe the equipment he or she used to fish and/or hunt?

5e. Did the claimant identi fy the percentage of Subsistence resources he or she relied

on pre-Spill that came from areas that were closed or impaired due

to

or resulting

from the Spill?

5f. Did the claimant sign the Claim Form

or

Claimant Sworn Written Statement?

Identify the species and amount(s) of Seafood and/or Game the claimant could not

obtain for Subsistence

use?

Species

D

Yes

Yes

Yes

Yes

Not Provided

Species Weight

Percentage Distributed

Percent Bartered

as ood

Blue

Crab

500.00 100.00

Flounder

50.00 100.00

Oysters

6500.00 100.00

Redfish Red Drum)

50.00 100.00

Shrimp

800.00 100.00

Identify the information the claimant included in a Subsistence Claimant Sworn Written Statement for

Bartering Losses.

7a. Does the claimant barter exclusively under one or more Commercial Fishing Licenses?

7b. Identify the location(s) where the claimant bartered Seafood or Game.

0.00

0.00

0.00

0.00

0.00

D

Not Provided

D Not Provided

C ty St t Dealers/Fresh Products License Claimant Bartered with

a e Submitted? License Dealer?

f Did the claimant identify or submit: (1) rules that specifically authorize bartering activity; or (2)

rules that confirm that bartering activity is not prohibited in the claimed location(s)?

7g. Identify the rules the claimant submitted to verify his or her legal bartering activity.

7h. Did the claimant or claimant s attorney sign the Claimant Sworn Written Statement?

Identify the information a third party barterer included

in

his or her Third Party Sworn Written

Statement:

a

Did the third party identify the species and amount

of

each species he or she bartered with the

claimant?

Sb

. Did the third party identify the frequency in which he or she bartered with the claimant?

e Did the third party identify the types

of

items, services or goods the claimant received

in

exchange for Seafood or Game?

Bd . Did the third party sign the Sworn Written Statement?

D Not Provided

9.

Identify the Claimed

Loss

Period(s):

D

Not Provided

04/20/2010 12/31/2011 Unverified

10. Identify the claimant s fishing and/or hunting location Closure Period.

Not Provided


39/55

!"#$ &'()*+,*)&(-.*!/0*11 2345+$67 (89-9*: ;&.>(? @"A$ ?) 3B 9C

Fishing Closure s):

Location: Louisiana

losure

Hunting or Fishing Location

losure tart Date

losure nd Date

Fishing Louisiana 06 02 2010

01 12 2011

Fishing

Louisiana

05 20 2010 01 12 2011

Fishing

Louisiana

08 14 2010 01 12 2011

Fishing Louisiana 01 12 2011 01 12 2011

Fishing

Louisiana 06 15 2010

01 12 2011

Fishing Louisiana

05 09 2010 01 12 2011



Fishing

Louisiana

09 23 2010 01 12 2011

Fishing

Louisiana

07 07 2010 01 12 2011

Fishing

Louisiana

05 12 2010 01 12 2011

Fishing Louisiana

07 05 2010 01 12 2011

Fishing Louisiana

05 14 2010 01 12 2011

Fishing

Louisiana

05 15 2010 01 12 2011


Fishing Louisiana

07 02 2010

01 12 2011


01 12 2011


01 12 2011

Fishing

Louisiana

05 18 2010 01 12 2011

Fishing Louisiana

06 09 2010 01 12 2011

Fishing Louisiana

06 25 2010 01 12 2011

Fishing

Louisiana

06 23 2010 01 12 2011

Fishing

Louisiana

05 19 2010 01 12 2011

Fishing Louisiana

05 26 2010 01 12 2011

Fishing Louisiana

06 14 2010 01 12 2011

Fishing Louisiana

05 21 2010 01 12 2011

Fishing Louisiana

06 12 2010 01 12 2011


01 12 2011

Fishing Louisiana

06 03 2010 01 12 2011

Fishing Louisiana

06 08 2010 01 12 2011

Fishing

Louisiana

05 24 2010 01 12 2011

Fishing

Louisiana

05 28 2010 01 12 2011

Fishing

Louisiana

06 06 2010 01 12 2011

Fishing

Louisiana

05 27 2010 01 12 2011

Fishing

Lou

isiana

11 04 2010 01 12 2011

Fishing Lou isiana

05 18 2010 01 12 2011

Fishing Louisiana

12 07 2010 04 29 2011

Fishing Louisiana

10 25 2010 01 12 2011

Fishing

Louisiana

09 25 2010 01 12 2011


40/55

!"#$ &'()*+,*)&(-.*!/0*11 2345+$67 (89-9*: ;&.>(? @"A$ ?( 3B 9C ishing

Louisiana

08 21 2010 01 12 2011

ishing Louisiana

09 08 2010 01 12 2011

ishing

Louisiana

07 21 2010 01 12 2011

ishing

Louisiana

06 12 2010 01 12 2011

ishing

Louisiana

06 06 2010 01 12 2011

ishing

Louisiana

04 30 2010 01 12 2011

ishing

Louisiana

05 28 2010 01 12 2011

ishing

Louisiana 05 27 2010 01 12 2011

ishing

Louisiana

06 07 2010 01 12 2011

ishing

Louisiana

05 26 2010

01 12 2011

ishing

Louisiana

06 08 2010 01 12 2011

ishing

Louisiana

06 06 2010 01 12 2011

ishing

Louisiana

05 24 2010

01 12 2011

ishing

Louisiana

06 09 2010 01 12 2011

ishing Louisiana

05 22 2010 01 12 2011

ishing Louisiana

06 12 2010

01 12 2011

ishing Louisiana

06 14 2010

01 12 2011

ishing Louisiana

06 03 2010 01 12 2011

ishing

Louisiana

06 15 2010 01 12 2011

ishing

Louisiana

06 02 2010 01 12 2011

ishing

Louisiana

05 21 2010

01 12 2011

ishing

Louisiana

05 20 2010

01 12 2011

ishing Louisiana

06 23 2010

01 12 2011

ishing Louisiana

05 19 2010

01 12 2011

ishing

Louisiana

06 25 2010 01 12 2011

ishing Louisiana

05 18 2010 01 12 2011

ishing

Louisiana

07 01 2010 01 12 2011

ishing

Louisiana

05 16 2010

01 12 2011

ishing

Louisiana

07 02 2010 01 12 2011

ishing

Louisiana

05 15 2010

01 12 2011

ishing Louisiana

07 05 2010 01 12 2011

ishing

Louisiana

05 14 2010

01 12 2011

ishing

Louisiana

07 07 2010 01 12 2011

ishing

Louisiana

05 12 2010 01 12 2011

ishing

Louisiana

07 14 2010 01 12 2011

ishing

Louisiana

04 30 2010

01 12 2011

ishing

Louisiana

07 29 2010 01 12 2011

ishing

Louisiana

05 10 2010 01 12 2011

ishing

Louisiana

05 09 2010 01 12 2011

ishing Louisiana

08 20 2010 01 12 2011

ishing Louisiana

08 14 2010

01 12 2011

ishing

Louisiana

09 23 2010 01 12 2011


41/55


42/55

!"#$ &'()*+,*)&(-.*!/0*11 2345+$67 (89-9*: ;&.>(? @"A$ ?8 3B 9C11c.

Member

Name:

Herron Ray

11d

Age

Reported

on Interview Form:

67

11e

Date of Birth

Date

of Death

11f.

Social Security Number:

11g

Gender:

0 Male D Female D Not

Provided

11 h

Percent of Diet from Subsistence Activities

45 00

11a

Relationship:

D

Claimant

0

Family Member

11b

Name:

Barry Herron

11c

Member

Name:

Herron

Barry

11d

Age Reported on

Interview Form:

5

11e

Date

of Birth

Date o Death

11f


11g

Gender:

0 Male

D

Female

D

Not Provided

11 h.

Percent

of Diet from

Subsistence

Activities

45 00

11a

Relationship:

D

Claimant

0

Family Member

11 b

Name:

Matt Herron

11c.

Member Name:

Herron Matt

11d

Age Reported

on

Interview Form:

49

11e

Date of

Birth

Date

of Death

11f.

Social

Security Number:

11 g

Gender:

0

Male D

Female D Not Provided

11

h

Percent

of Diet from Subsistence Activities 45 00

11a Relationship:

D

Claimant

0

Family Member

11b

Name:

Michael Herron

11c

Member Name:

Herron Michael

11d

Age Reported on Interview Form:

36

11e

Date of Birth

Date

of

Death

11

f Social

Security Number:

11g

Gender:

0

Male

D Female D Not Provided

11h

.


45 00

11a Relationship:

D

Claimant

0

Family Member

11b

Name:

Sheena

Herron

11c .

Member Name:

Herron

Sheena

11d

Age Reported on Interview Form:

25

11e

Date

of Birth

Date of Death

11f

Social

Security Number:

11g

Gender:

D

Male

0 Female D

Not Provided

11 h


45 00


43/55

!"#$ &'()*+,*)&(-.*!/0*11 2345+$67 (89-9*: ;&.>(? @"A$ ?? 3B 9C

11a .

Relationship:

11b .

Name:

11c.

Member Name:

11d.

Age Reported on Interview

Form:

11e.

Date

of Birth

11f.


11g.

Gender:

11 h.


11a

.

Relationship:

11b.

Name:

11c.

Member Name:

11d.

Age

Reported

on Interview

Form:

11e

.

Date

of

Birth

11f.


11g. Gender:

11h.


11a

.

Relationship:

11b

.

Name:

11c .

Member

Name:

11d.

Age

Reported

on Interview

Form:

11e .

Date

of Birth

11f.


11g. Gender:

11 h.

Percent

of Diet from

Subsistence

Activities

Step

2:

Summary

Family Member

Member Name

Age

Barry

Herron

Herron Barry

53

Cheryl Crepppel Crepppel

Cheryl

D Claimant 0

Family Member

Horace Maise

Maise

Horace

80

Date

of

Death

0

Male

D

Female

D

Not Provided

45 00

D

Claimant

0

Family Member

Nola Maise

Maise Nola

77

Date

of Death

D

Male

0

Female

D

Not Provided

45 00

Claimant

0 Family Member

Cheryl Crepppel

Crepppel

Cheryl

55

Date of Death

D

Male

0

Female

D

Not Provided

45 00

istribution

Gender

Male

Female

Percent o

Diet from

Subsistence

45 00

45 00

Reasonable Daily

Calorie

llowable

Consumption Subsistence

Calories

3200 00

1440 00

2400 00

1080 00

Status

of

SSN

Unverified

Tax ID

Not

Provided

Unverified

Tax ID

Not

Provided


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Horace

Maise

Kim Champlin

Matt Herron

Michael

Herron

Nola

Maise

Ray

Herron

Sheena

Herron

Totals

Species

Blue

Crab

Flounder

Oysters

Redfish Red

Drum)

Shrimp

Species

Blue

Crab

Shrimp

Oysters

Flounder

Redfish Red

Drum)

Unverified -

Maise, Horace 80 Male

45.00

2600.00 1170.00 Tax ID Not

Provided

Champlin,

Kim

50

Male

45.00 3700.00 1665.00

Verified

Unverifi ed -

Herron, Matt

49

Male

45.00 3300.00

1485.00

Tax ID Not

Provided

Unverified -

Herron, Michael

36

Male

45.00

3300.00 1485.00

Tax ID Not

Provided

Unverified -

Maise, Nola 77

Female

45.00 2200.00 990.00 Tax ID Not

Provided

Unverified -

Herron, Ray 67 Male 45.00 3000.00 1350.00 Tax ID Not

Provided

Unverified -

Herron, Sheena

25

Female

45.00

2600.00 1170.00

Tax ID Not

Provided

26300.00 11835.00

Harvest

Consumable

Gross Harvest

Loss lbs.)

Consumable

Portion

of

Harvest

Retail Avg Price

2010

Avg

Price

2011

Loss Days

0

/o Loss

2010

Loss 2011

Product

500.00

17 85.00

7.64

8.57

444 18.00%

82.00%

50.00 39 19.50 4.17 4.19 444

18.00%

82.00%

6,500.00 11 715.00 6.27

5.99

444

18.00% 82.00%

50.00

41

20.50 6.55

6.46

444 18.00%

82.00%

800.00 46 368.00 6.26 6.75

444 18.00%

82.00%

Totals

Consumed Bartered Calculations

Consumed

Bartered

Total

Total Caloric

Total

Total

Total Post

Total Retail

Total

Retail

D o

Kcal/lbs. Value

Retail

Retail

O o

Spill Retail

Value 2010 Value 2011 Consumed Value

Bartered

Consumed

2010

Value 2011

Value

116.89 597.33 100.00%

395.00

33,575.00

0.00

0.00 0.00%

714.22

414.66 2,036.88 100.00%

322.00

118,496.00

0.00

0.00 0.00%

2,451.54

806.95 3,511.94 100.00% 231.00 165,165.00 0.00 0.00 0.00% 4,318.89

14.64 67.00 100.00%

318.00

6,201.00

0.00

0.00 0.00%

81.63

24.17 108.59 100.00% 544.00

11,152.00

0.00 0.00 0.00% 132.76

Totals

334,589.00


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Calculation

Retail Value

-

Consumed

7,699.04

Retail Value

- Bartered

0.00

Loss Period in Days

444

Total caloric

Value Consumed

334,589.00

Daily

caloric Value

Consumed

753.58

Daily Allowable Subsistence

calories

11,835.00

Consumption to Distribution

Ratio

0.06

Value of

Lost

Harvest - Consumed if [CR]


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redacted champlin claims copy

Documents