Form 3-154 State Fish and Wildlife Agency Hunting and Sport Fishing

FWS Form 3-154 (Rev. 03/2019)
U.S. Fish and Wildlife Service

OMB Control. No. 1018-0007
Expiration Date: xx/xx/xxxx

STATE FISH AND WILDLIFE AGENCY
HUNTING AND SPORT FISHING LICENSE CERTIFICATION
Part A: Certification of License Holders
1. State:
2. Certification for Apportionment Year:
3. Submission Type:
4. Hunting license certification period end date:
5. Total unique paid hunting license holders during certification period:
6. Sport fishing license certification period end date:
7. Total unique paid sport fishing license holders during certification period:
8. CERTIFICATION: By signing this form, I certify the information provided above is true, complete, and
accurate to the best of my knowledge per the Federal Aid in Wildlife Restoration Act, the Federal Aid in
Sport Fish Restoration Act, and the regulations of the Secretary of the Interior.
AUTHORIZED REPRESENTATIVE:
Printed Name (First & Last):
Title:
Signature:

Date Signed:

Part B: Supporting Information
Total Licenses* Issued
Resident Hunting

Total License* Sales Income

9a.

9b.

Nonresident Hunting

10a.

10b.

Hunting Totals

11a.

11b.

Resident Fishing

12a.

12b.

Nonresident Fishing

13a.

13b.

Fishing Totals

14a.

14b.

* For Part B-Supporting Information, “License” includes licenses, tags, stamps, and permits. See also page 2 instructions.
NOTICES
PAPERWORK REDUCTION ACT STATEMENT

Print

In accordance with the Paperwork Reduction Act (44 U.S.C. 3501), state fish and wildlife agencies must respond annually per 50 C.F.R. 80 in
order to obtain a benefit. The FWS uses the reported data to run the formulas in the Federal Aid in Wildlife Restoration Act (16 U.S.C. 669 et seq.)
and the Federal Aid in Sport Fish Restoration Act (16 U.S.C. 777 et seq., except 777e-1 and g-1) for apportioning Wildlife Restoration and Sport
Fish Restoration program funds among the states. The FWS also consolidates and publishes this data for the public. 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 currently valid OMB control number. OMB has approved this collection of information and assigned Control No. 1018-0007.
ESTIMATED BURDEN STATEMENT
We estimate public reporting for this collection of information to average 32 hours, including time for reviewing instructions, gathering and
maintaining data and completing and reviewing the form. Direct comments regarding the burden estimate or any other aspect of the form to the
Service Information Clearance Officer, Fish and Wildlife Service, U.S. Department of the Interior, 5275 Leesburg Pike, MS: AMAD-ARM-PPM,
Falls Church, VA 22041-3803, or via email at [email protected]. Please do not send your completed form to this address.
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FWS Form 3-154 (Rev. 02/2019)
U.S. Fish and Wildlife Service

OMB Control. No. 1018-0007
Expiration Date: xx/xx/xxxx

INSTRUCTIONS FOR COMPLETING FWS FORM 3-154
PART A: CERTIFICATION OF LICENSE HOLDERS: Provide and certify the data the U.S. Fish and
Wildlife Service (FWS) will use in statutory formulas for apportioning Wildlife Restoration and Sport Fish
Restoration program funds for the specified Apportionment Year. Set license certification periods and
count unique paid license holders per Title 50 C.F.R. part 80 regulations. Complete all fields, as follows:
1. Select your state, district, or territory.
2. Select the year for which FWS will apportion funds based on the completed certification.
3. Select "New" for a certification you are submitting for the first time. Select "Revision" for a certification
you are submitting to change or correct a previously submitted certification.
4. Enter the end date of the hunting license certification period for the year entered in field 1; in
dd/mm/yyyy format.
5. Enter the total unique paid hunting license holders during the certification period ending on date
entered in field 4.
6. Enter the end date of the sport fishing license certification period for the year entered in field 1; in
dd/mm/yyyy format.
7. Enter the total unique paid hunting license holders during the certification period ending on date
entered in field 6.
8. Enter name and title of the person authorized to certify the information provide on the form. This
person must sign and date.
PART B: SUPPORTING INFORMATION: Include all licenses, tags, stamps, and permits issued for
hunting (firearm and bow) and fishing (sport and recreation) in license totals. You may estimate the
distribution between resident and nonresident when a type of license is issued to both residents and
nonresidents.
Fields 9a, 10a, 12a, and 13a: Enter the total number of paid and nonpaid licenses, tags, stamps, and
permits issued for resident hunting, nonresident hunting, resident fishing,
and nonresident fishing in these fields, respectively. Include the number of
licenses that allow the holder to both hunt and fish in the hunting total and
again in the fishing total.
Fields 11a and 14a:

Enter the total hunting licenses (sum of fields 9a+10a) and the total fishing
licenses (sum of fields 12a+13a) in these fields, respectively. If you
complete the form electronically, these totals will automatically calculate
and display.

Fields 9b, 10b, 12b, and 13b: Enter the total sales income (cost to purchaser) from licenses, tags,
stamps, and permits issued for resident hunting, nonresident hunting,
resident fishing, and nonresident fishing in these fields, respectively.
Prorate the cost of combination licenses between hunting and fishing
based on the respective cost of each type of license.
Fields 11b and 14b:

Enter the total hunting license sales income (sum of fields 9b+10b) and the
total fishing license sales income (sum of fields 12a+13a) in these fields,
respectively. If you complete the form electronically, these totals will
automatically calculate and display.

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