Form 3-2326 Federal Subsistence Hunt Application, Permit and Report

OMB Control No. 1018-0075
Expires: XX/XX/XXXX

AUG

SEP

OCT

NOV

DEC

Unit(s) & Subunit(s)

Permit No.

JUL

Federal Subsistence Hunt Application

FEDERAL PERMIT

Federal Land Unit

Applicant’s Name (First, Middle Initial, Last)

Date of Birth

Regulatory Year:
UNIT(S):
SEASON:
HUNT NO:

Mailing Address

Physical Address

PERMIT NO:

Airplane
Horse/Dog Sled
Boat
3/4-Wheeler

5.
6.
7.
8.

Snowmachine
Other Offroad vehicle
Highway Vehicle
No vehicle used

15
13
11
6

See back of permit for conditions.

C. Subunit_______________ Drainages Hunted ___________________
Additional information for the species harvested

D. Specific Locations __________________________________________
E. Did you take an animal? Yes __ No __
3. A. Date taken ____________(mm/dd/yy)

Print NAME:

X
HUNTER’S SIGNATURE

B. Sex of animal: Male __ Female __
4. PLEASE MAIL  Thank You for Your Cooperation.
JAN

FEB

MAR

APR

FWS Form 3-2326

MAY

JUN

REV 10/09

3

4

5

31

1.
2.
3.
4.

Successful hunters must return their permit
report within
day(s) after taking an animal.
Unsuccessful hunters and those who did
not hunt must return their permit report
within
days after the close of the season.

30

you started walking.)

This permit must be in your possession while hunting or transporting
the animal taken. You must also
show this permit to any person
authorized to enforce Federal law
who requests it.

29

1. Did you hunt? Yes __ No __
Did you use a designated hunter where allowed? Yes __ No __
2. A. How many days did you hunt? (by season if applicable)
________________________
B. How did you get to hunt area? (Circle your primary method of getting to where

UNIT:
SEASON:

28

Permittee's Name ______________________________________

NON-TRANSFERABLE

27

Permit No.

26

Federal Subsistence Harvest Report

7

25

8

24

I certify that I am a rural resident as defined by 50 CFR 100.4 and 36 CFR 242.4. I have read
and understand the conditions on the permit and agree to comply with
them and applicable regulations as found in 50 CFR 100 and 36 CFR 242.

9

23

10

22

X

21

Issuing Agent (Print)

12

20

Applicant's Signature (for minors, parent/legal guardian)

2

Date Permit Issued (mm/dd/yy)

19

Telephone Number

14

18

AK Hunting License No.

1

Community of Primary Residence

17

City, State, Zip Code

16

Hunt Conditions

Additional Conditions of the Permit:

Additional Conditions of the Permit:

In accordance with the Privacy Act (5 U.S.C. 552a) and the Paperwork Reduction Act (44 U.S.C. 3501), please note the following information. This information collection is authorized by the Alaska National Interest Lands Conservation Act and associated regulations. The Federal Subsistence Board will use this information to manage fish and wildlife resources for subsistence uses. It is our policy not to use your name for
any other purpose. We will maintain this information in accordance with the Privacy Act. Your response is voluntary, but is required to obtain or retain a benefit. We may not conduct or sponsor and you are not
required to respond to an information collection unless it displays a currently valid OMB control number. OMB has approved this information collection and assigned OMB Control No. 1018-0075. We estimate
it will take you about 15 minutes to complete the application and record your harvest. This burden estimate includes time for reviewing instructions, gathering data, and completing and reviewing the form.
You may direct comments regarding the burden estimate or any other aspect of the form to the Service Information Collection Clearance Officer, Fish and Wildlife Service, Mail Stop 2042-PDM, Arlington Square,
Department of the Interior, 1849 C Street, NW., Washington D.C. 20240.

Return Address

Wildlife needs your
cooperation

NO POSTAGE
NECESSARY
IF MAILED
IN THE
UNITED STATES

BUSINESS REPLY MAIL

FIRST CLASS MAIL

Good management helps ensure that animals
will be available to hunt in future years.

PERMIT NO. 12874

ANCHORAGE AK

POSTAGE WILL BE PAID BY ADDRESSEE

Address

Harvest information is a tool that can be used
to help understand and maintain healthy
wildlife populations, thereby providing for
continued subsistence opportunity.

Post Office Bar Code