Form 7-FW-100 Village Harvest Survey Household Enrollment Form

PAPERWORK REDUCTION ACT STATEMENT
In accordance with the Paperwork Reduction Act (44 U.S.C. 3501 et seq.), please note
the following information. This study is authorized by the Migratory Bird Treaty Act (16
U.S.C. 703 et seq.) and by the Migratory Bird Treaty Act Protocol Amendment (1995)
and its letter of submittal from the Department of State to the White House, which
specifies the need for harvest monitoring. The information you provide will be used for
estimating subsistence migratory bird harvest in subsistence eligible areas of Alaska. No
names are placed on survey forms, and information will not be reported by household
number. Only summary information will be reported. Your response is voluntary. An
agency may not conduct or sponsor, and a person is not required to respond to, a
collection of information unless it displays a currently valid OMB control number. This
information collection has been approved by OMB and assigned clearance number 10180124, which expires XX/XX/XXXX. We estimate it will take about 1 minute to
complete each line of this form. Comments on this form should be mailed to the
Information Collection Officer, Mail Stop 222-ARLSQ, U.S. Fish and Wildlife Service,
4401 N Fairfax Dr., Arlington, VA 22207.