In accordance with 18 AAC 31.021(a)(4), the operator of an existing food establishment can use this form to make a written request to the department to establish a fee payment plan for fees incurred under 18 AAC 31.050.

Payment plans cannot be longer than six months.

Operators may not be eligible for a payment plan if they previously used a payment plan and did not fulfill it.

Questions?

Please contact the permit coordinator at dec.fsspermit@alaska.gov.

Acknowledgment

By submitting this request, I understand that I must make payments according to the schedule agreed upon with the department and that if I fail to meet the terms of the fee payment plan it could result in the immediate suspension of my permit or a civil action against me to collect the fee.