Allegato A
                       Alla capitaneria di porto di ................
                    DICHIARAZIONE STATISTICA
NOME UNITA' ........................  MATRICOLA ....................
ANNO ...............................  MESE .........................
____________________________________________________________________
GIORNO |  ZONA DI | SPECIE | KG | GIORNO | ZONA DI  | SPECIE |  KG  |
       |   PESCA  |        |    |        |  PESCA   |        |      |
_______|__________|________|____|________|__________|________|______|
  1    |          |        |    |   17   |          |        |      |
_______|__________|________|____|________|__________|________|______|
  2    |          |        |    |   18   |          |        |      |
_______|__________|________|____|________|__________|________|______|
  3    |          |        |    |   19   |          |        |      |
_______|__________|________|____|________|__________|________|______|
  4    |          |        |    |   20   |          |        |      |
_______|__________|________|____|________|__________|________|______|
  5    |          |        |    |   21   |          |        |      |
_______|__________|________|____|________|__________|________|______|
  6    |          |        |    |   22   |          |        |      |
_______|__________|________|____|________|__________|________|______|
  7    |          |        |    |   23   |          |        |      |
_______|__________|________|____|________|__________|________|______|
  8    |          |        |    |   24   |          |        |      |
_______|__________|________|____|________|__________|________|______|
  9    |          |        |    |   25   |          |        |      |
_______|__________|________|____|________|__________|________|______|
 10    |          |        |    |   26   |          |        |      |
_______|__________|________|____|________|__________|________|______|
 11    |          |        |    |   27   |          |        |      |
_______|__________|________|____|________|__________|________|______|
 12    |          |        |    |   28   |          |        |      |
_______|__________|________|____|________|__________|________|______|
 13    |          |        |    |   29   |          |        |      |
_______|__________|________|____|________|__________|________|______|
 14    |          |        |    |   30   |          |        |      |
_______|__________|________|____|________|__________|________|______|
 15    |          |        |    |   31   |          |        |      |
_______|__________|________|____|________|__________|________|______|
 16    |          |        |    |        |TOTALE             |
       |          |        |    |        |COMPLESSIVO        |
_______|__________|________|____|________|___________________|
Legenda:     SPECIE            TOTALI
             VONGOLE      =  V   ..............
             LONGONI      =  L   ..............
             CUORI        =  CR  ..............
             CANNOLICCHI  =  CL  ..............
             FASOLARI     =  F   ..............