A	B	C	D	E	F	G	H	I	J	K	L	M	N	O	P	Q
1	FEE CHANGE DETAIL REPORT
3	Fee Title/Description	ORS/ OAR	Who pays fee	Increase, Establish, Decrease?	Date/Amount of Last Change	Date Fee Expected to be Changed	Current fee	Proposed fee	Proposed fee change	Number 2011-13 transactions with new fee	Impact on 2011-13 revenue	Total 2011-13 revenue	Number 2013-15 transactions with new fee	Impact on 2013-15 revenue	Total 2013-15 revenue	Leg Concept Number	Policy Package Number
4	Major modification fee for municipal stormwater phase one permits	468.065	Local and State Government	Establish	Not Applicable	November 1, 2013	Not Applicable	$8,982	$8,982	Not Applicable	Not Applicable	Not Applicable	2 (estimate)	$17,964	$17,964	Not Applicable	Not Applicable
5	Major modification fee for underground injection control permits	468.065	Small and large business, local and state government	Establish	Not Applicable	November 1, 2013	Not Applicable	$5,106	$5,106	Not Applicable	Not Applicable	Not Applicable	0 (estimate)	$0	$0	Not Applicable	Not Applicable
8	This form and accompanying cover letter must be completed and submitted for three separate purposes:
9	1) Submitted to DAS with the Fee Approval Form (107BF21) when requesting DAS approval to change a fee administratively (Leg Concept/Policy Pkg columns not relevant).
10	2) Submitted to DAS with a Legislative Concept, if that concept would increase a fee or assessment (2011-13 columns not relevant).
11	3) Submitted electronically to BAM analyst, at same time as Agency Request Budget, if budget includes any fee establishment, increase, or decrease (2011-13 columns not relevant).
13	A cover letter is required that provides an overview of and provides context for the impact of the change or establishment.
14	See instructions below for more information.
20	Note: Shaded fields are reported on the Detail of Fee, License, or Assessment Revenue Increase in the budget binder (107BF08).
23	The cover letter should include the following information, when relevant, in order for DAS to review the proposal:
24	a. An explanation of why the fee change or new fee is required. For example, was the fee change necessary due to:
25	● Changes in Federal or Other Funds revenues?
26	● Increased program costs? If so, please overview what the increased costs were.
27	● Changes in transaction volumes or number of base fee payers? Provide trend information and FTE workload statistics.
28	● New fee created by statute?
29	● Policy changes? Regulatory streamlining? Please explain.
30	● Other?
31	b. A summary of program funding. For example, how much of the program is covered by fee revenues? How much by General Fund? Will the new fee level allow
32	replacement of General Fund? How much? Do statutes/rules require General Fund to constitute a minimum proportion of overall program funding?
33	c. How long is the proposed fee estimated to sustain the program?
34	d. If the fee is based on a sliding scale, provide a spreadsheet showing calculations.
35	e. A summary of who pays the fee and who are the stakeholders in the program.
36	f. An overview of stakeholder/fee payer participation including a summary of stakeholder impacts; any outreach done to garner stakeholder input prior to setting
37	the new fee level; and whether there is stakeholder approval or opposition to the new rate. If opposition, summarize those comments. If the only outreach
38	done was via public comment during rulemaking, please state so. Also, please identify if the fees relate to policy discussions/concerns raised during the
39	Legislative session, and provide a summary of those discussions/concerns if fees are related.