Form 3-2056J Waterfowl Hunting Record

OMB Control No. 1018-0023
Expires XX/XX/XXXX

Branch of Harvest Surveys
Division of Migratory Bird Management
10815 Loblolly Pine Drive
Laurel, Maryland 20708
301-497-5994
20390002
[20390002]
XXXXXXXX
XXXXXXXX
XXXXXXXX, XX XXXXX

Dear XXXXXXXX:
You have been selected to participate in this year's National Migratory Bird Harvest Survey. We only select a small
percentage of the nation's hunters for this annual survey, so your response is important EVEN IF YOU DO NOT HUNT
MIGRATORY BIRDS THIS SEASON.
We are asking you to tell us about your waterfowl hunting in Alaska during the XXXX-XXXX hunting season. Please use
the attached diary to record the details of your hunt each time you go waterfowl hunting in Alaska. Please read the
instructions on the diary form and fill it out completely. After the season is over or when you have finished hunting in
Alaska, send the completed form back to us in the enclosed postage-paid envelope. If you receive this survey too late for
you to remember all of the details of your hunts, please fill out the lower portion of the form labeled "SEASON TOTALS".
Your response is very important, whether you bag any birds or not. If you don’t hunt waterfowl at all this season, please
mark the “Did not hunt” box at the upper right portion of the form and return it to us. If you do hunt waterfowl, please report
ONLY YOUR OWN PERSONAL HUNTING activity and harvest. We also ask that you please keep track throughout the
season of birds that you knocked down, but could not retrieve. Record this total number on the lower portion of the form
labeled "SEASON TOTALS".
To protect your privacy, we will not associate your name with your hunting records after the survey is completed. If you
have any questions or need more information about this survey, please write us at the above address, call us toll-free at
1.800.419.2965 from 7:30am-4:00pm EST, or log-on to http://www.fws.gov/hip/. Thank you in advance for your time and
your participation in this year's National Migratory Bird Harvest Survey.

Sincerely,

Robert J. Blohm, Chief
Division of Migratory Bird Management
In accordance with the Privacy Act (5 U.S.C. 522a) and the Paperwork Reduction Act (44 U.S.C. 3501), please note the following information. This study is authorized
by the Migratory Bird Treaty Act (16 U.S.C. 706 et seq.). The information that you provide will be used for estimating migratory bird hunter activity and harvest in the
United States. It is our policy not to use your name for any other purpose. All names and identifying information will be removed when we compile the results, and only
summary information will be reported. The information is maintained in accordance with the Privacy Act. 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 current valid OMB control number. This information collection has
been approved by OMB and assigned clearance number 1018-0023. We estimate that it will take you about five minutes to read the instructions and keep a record of
your hunting depending upon the number of times you hunt. Comments on this form should be mailed to the Information Collection Clearance Officer, Mail Stop 222,
Arlington Square, U.S. Fish and Wildlife Service, Washington, D.C. 20240.
FWS Form 3-2056J
Rev 12/10

Waterfowl Hunting Record
1.

IF YOU DID NOT HUNT DUCKS, GEESE, OR BRANT THIS SEASON, please check the box to the right and mail this form.

2.

Please record your personal hunting activity for each day you hunted ducks, geese, or brant in the State specified in the
attached letter. Record the number of birds you personally bagged; DO NOT include birds shot by other people. Please
include ALL of your hunts for the birds listed; if you did not bag any birds during a hunt, record zero (0) for the birds you
hunted that day.

3.

IF YOU HUNTED DUCKS, GEESE, OR BRANT BUT DO NOT HAVE DETAILED RECORDS, check the box to the
right and go to question number 6 to record your Season Totals.

2 2

Please include additional comments on a SEPARATE SHEET of paper.
Please print all characters in BLACK ink using CAPITAL LETTERS ONLY as shown below.
4.

Number of Birds Killed
and Retrieved

A B C D E F GH I J K LMNO P Q R ST UV WX Y Z 0 1 2 3 4 5 6 7 8 9
Date of Hunt
Month
Day

State of
Hunt

County of Hunt

1

Sea
Ducks Ducks

Geese

,

2

,

3

,

4

,

5

,

6

,

7

,

8

,

9

,

10

,

11

,

12

,

13

,

14

,

5. IF YOU RUN OUT OF SPACE ON THIS FORM, you can request an additional survey form by logging on to
6. SEASON TOTALS:
Days
Hunted

Ducks
Sea Ducks
Geese
Brant

Birds
Killed and
Retrieved

Birds
Downed
but Lost

https://migbirdapps.fws.gov/hipweb or calling
1-800-419-2965 from 7:30 am to 5:00 pm EST. We
will ask you for the serial number located at the
bottom of this form.
Please report banded birds by calling
1-800-327-BAND or www.reportband.gov

Brant