FS-2300-30 Visitor's Permit

Recreation Fee and Wilderness Program Administration

FS_2300_30 v04-2013

Recreation Fee and Wilderness Program Administration

OMB: 0596-0106

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U.S. Department of Agriculture

Forest Service


VISITOR’S PERMIT

(Ref. FSM 2323)

FS-2300-30

(v 04-2013)

OMB NO. 0596-0106

Exp. 04/30/2016


(15) TRAVEL PLAN


List or code all zones to be traversed, in sequence of travel, and number of nights to be spent in each zone.


In areas where specific campsites are assigned, list and code each site and the number of nights assigned.


TRAVEL

ZONES


(or campsite)

NIGHTS






WHEN SIGNED, THIS SINGLE – VISITOR PERMIT AUTHORIZES

(1) NAME (First, Middle Initial, and Last)







(2) MAILING ADDRESS (Optional)






(3) CITY AND STATE

(4)

ZIP

CODE











(5) TO VISIT (and to build campfires in accordance with regulations)










(6) DATES (Give best estimates of start and finish dates)

From

month/day










Through

month/day










(7) LOCATION OF ENTRY POINT









(8) LOCATION OF EXIT POINT









(9) PRIMARY METHOD OF TRAVEL








(10) NUMBER OF PEOPLE IN GROUP



(16) REMARKS

(11) NUMBER OF PACK AND SADDLE STOCK



(12) NUMBER OF DOGS



(13) NUMBER OF WATERCRAFT OR VEHICLES

(Check Regulations – Vehicles not allowed in many permit areas)




I agree to abide by all laws, rules and regulations which apply to this area and will do my best to see that everyone in our group does likewise.


(14) VISITOR’S SIGNATURE

DATE

(17) ISSUING OFFICER’S SIGNATURE






FOREST CODE


OFFICE CODE

VISITORS MUST HAVE THIS PERMIT IN POSSESSION DURING STAY IN REQUIRED PERMIT AREAS

FS-2300-30 (02/10)



BURDEN AND NONDISCRIMINATION STATEMENTS


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 collection is estimated to average 3 minutes per response.


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) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.




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