3-2056K Dove and Band-Tailed Pigeon Hunting Record

United States Department of the Interior
FISH AND WILDLIFE SERVICE
Division of Migratory Bird Management
10815 Loblolly Pine Drive, Laurel, MD 20708-4028
1-800-419-2965 (phone) 301-497-5981 (fax)
8/20/2012

11720001
JOHN Q. PUBLIC
10815 LOBLOLLY PINE DR.
LAUREL, MD 20708

Dear John Public,
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 dove and band-tailed pigeon hunting during the 2012 hunting season.
Please use the attached diary to record the details of your hunt each time you go dove or band-tailed pigeon
hunting in Maryland. Please read the instructions on the diary form, fill it out completely. After the season is
over or when you are done hunting in Maryland, 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 doves or band-tailed
pigeons 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 doves or band-tailed pigeons, please ONLY REPORT 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 go to http://hip.fws.gov. You can request additional
forms through this website: http://migbirdapps.fws.gov/hipweb. Thank you in advance for your time and your
participation in this year's National Migratory Bird Harvest Survey.
Sincerely,

James B. Bortner, 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. 703 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. We estimate that it will take you about four minutes to read the instructions and keep a record of your hunting depending upon the number of times you hunt. An agency may not conduct or
sponsor, and a person is not required to respond to an information collection unless it displays a currently valid OMB control number. The information collection has been approved by OMB and assigned
OMB Control Number 1018-0023. Comments on this form should be mailed to the Information Collection Clearance Officer, Mail Stop 2042-PDM, U.S. Fish and Wildlife Service, Washington D.C. 20240.
Form 3-2056K
Rev. 04/11

OMB CONTROL NO. 1018-0023
Approval expires 4/30/2014

Dove and Band-Tailed Pigeon Hunting Record

1. IF YOU DID NOT HUNT DOVES OR BAND-TAILED PIGEONS 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 doves or band-tailed pigeons in the State specified
in the included 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 DOVES OR BANDED-TAILED PIGEONS BUT DO NOT HAVE DETAILED RECORDS, check the box
to the right and go to question number 6 to record your Season Totals.
1 1
4. Please include additional comments on a SEPARATE SHEET of paper.

Please print all characters in BLACK ink using CAPITAL LETTERS ONLY as shown below.
Date of Hunt
Month
Day

State
of Hunt

County of Hunt

1

,

2

,

3

,

4

,

5

,

6

,

7

,

8

,

9

,

10

,

11

,

12

,

13

,

14

,

Number of Birds Killed
and Retrieved
Mourning
Doves

WhiteWinged
Doves

5. IF YOU RUN OUT OF SPACE ON THIS FORM, you can request an additional survey form by logging on to
https://migbirdapps.fws.gov/hipweb or calling
1-800-419-2965 from 7:30 am to 4:00 pm EST.
6. SEASON TOTALS:
We will ask you for the serial number located at
Birds
Birds
the bottom of this form.
Days
Killed and
Downed
Hunted

Retrieved

but Lost

Mourning Doves

Please report banded birds by calling
1-800-327-BAND or www.reportband.gov

White-Winged
Doves
Band-Tailed
Pigeons

code 39 barcode

hunter number

state name

print job identifier

Band-Tailed
Pigeons