FS-2300-26 Recreation Fee Envelope

Updated 28 April 09

SIDE
A
Personal
removeable
permit stub

Recreation Fee Site

3

PROOF OF
PAYMENT

Detach from envelope and hang
from rearview mirror this side out.

HANGTAG
of Recreation Fee

Valid for the days paid;
fill in date(s) of use

USDA Forest Service

*R7-05468-09

PROOF OF PAYMENT
of Recreation Fee

Valid for the days paid; fill in dates
of use as shown on original hangtag

Fold tab
for sealing
envelope:
place
adhesive
on underside
for moistening
and sealing
envelope

*R7-05468-09

Your
Region Permit
Numbering
System

6 1/2”W X 3 1/8”H
assembled

Recreation Fee Site
Detach and carry with you, see posted use instructions

STUB

*

Personal
removeable
permit
hangtag

Perforation
IMPORTANT: DETACH HERE.

See posted fee and information for this site.
To validate, complete the following:

1. Amount Enclosed

Fold and Seal

4. Vehicle License #

2. # of Day(s) Paid

5. State

6. Home Zip Code

Fee
Envelope

3. Time and Date Purchased

7. # In Party

8. Other Charges

Reference
FSM 2330
10. Interagency Pass / Golden Passport or Regional / Forest Pass #

11. Planned Departure Date

OMB #
0596-106
U.S. currency and checks drawn on U.S. banks accepted. Please do not
fold bills or checks. Make checks payable to USDA Forest Service.

Fold and Seal

1 PAYMENT ENVELOPE

*R7-05468-09

Fold both
side tabs
in, to nonprinted
side and
glue to form
envelope
pocket.

PRINT SAMPLE ON 8 1/2” X 14” legal size paper

After completing, detach proof of payment stub and deposit envelope into box provided.
FS- 2300-26 (9-2009)

Single Campsite
Group Campsite

Campsite # __________
Campsite # __________ # in group _________

For campsites please complete information below:
Site Name ________________________________________________________

2 SITE USE INFORMATION

Fold-in
to cover
non printed
side to
form bottom
pocked of
envelope

Box for
identical
sequential
numbers
beginning
with region,
ending
with year

Cheri Ziebart,
Business Graphics
Independent Resources Enterprise Team
USDA Forest Service
206-842-2737 or [email protected]
Laurie Thorpe, Team Leader
503-808-2427 or [email protected]

2- window
holes
for viewing
contents of
envelope

Cheri Ziebart,
Business Graphics
Independent Resources Enterprise Team
USDA Forest Service
206-842-2737 or [email protected]

Laurie Thorpe, Team Leader
503-808-2427 or [email protected]
You are responsible for your own safety.
Recreation use has inherent risks and you may
encounter a variety of unexpected and/or
dangerous conditions which may lead to serious
injury or death. It is your responsibility
to be informed and take precautions.

NOTICE:

According to the Paperwork Reduction Act of 1995, an agency may
not conduct or sponsor, and a person is not required to respond to
a collection of information unless it displays a valid OMB control
number. The valid OMB control number for this information
collection is 0596-0106. The time required to complete this
Information is estimated to average 3 minutes, including the time for
reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing the
collection of information. The U.S. Department of Agriculture
(USDA) prohibits discrimination in all its programs and activities
on the basis of race, color, national origin, gender, religion, age,
disability, political beliefs, sexual orientation, and marital or family
status. (Not all prohibited bases apply to all programs.) Persons
with disabilities who require alternative means for communication
of program information (Braille, large print, audiotape, etc.) should
contact USDA’s TARGET Center at 202-720-2600 (voice and TDD).
To file a complaint of discrimination, write USDA, Director, Office
of Civil Rights, 1400 Independence Avenue, SW, Washington DC
20250-9410 or call (800) 975-3272 (voice) or (202) 720-6382 (TDD).
USDA is an equal opportunity provider and employer.

www.fs.fed.us/recreation
or
http://www.fs.fed.us/passespermits/
accomplishments.shtml

SIDE
B

For more information, please visit:

Thank you, your fees are
making a difference!

Updated 28 April 09

PRINT SAMPLE ON 8 1/2” X 14” legal size paper
6 1/2”W X 3 1/8”H
assembled

Inside of fee Envelope and back site of hangtag permit

Perforation