Form 3-202-17 USFWS Bird and Bat Injury and Mortality Reporting System
Federal Fish and Wildlife Permit Applications and Reports--Migratory Birds; 50 CFR 10, 13, 20, 21
3-202-17 Rpt - Avian Injury-Mortality 03122020.xlsm
Avian Injury/Mortality Report (Form 3-202-17) - Private Sector
OMB: 1018-0022
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1018-0022 can be found here:
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2. ENTER CORE INFORMATION
3. ENTER MORT-INJ DATA
GLOSSARY OF TERMS
NOTICES
Overview
1. INSTRUCTIONS2. ENTER CORE INFORMATION
3. ENTER MORT-INJ DATA
GLOSSARY OF TERMS
NOTICES
Sheet 1: 1. INSTRUCTIONS
| USFWS Bird and Bat Injury and Mortality Reporting System (Excel Version) | |
| Data Sheet Instructions and Information | |
| *Please e-mail or call your regional Migratory Bird Permit Office with any questions about this report. | OMB Control No. 1018-0022, Expires 4/30/2021 Form 3-202-17, Rev. 9/2018 |
| Access the regional Migratory Bird Permit Office contact information for permit office phone, email and postal addresses. | |
| ABOUT THIS SPREADSHEET: | IF YOU DISCOVER AN EAGLE OR A THREATENED OR ENDANGERED (T&E) SPECIES |
| 1. REQUIRED FIELDS are indicated by orange column headers. These are fields that should be filled in at a minimum for each record. 2. REQUESTED FIELDS (fields with information we would like if you have it) are indicated by light grey column headers. At the very least, please try to populate all these fields, and any other applicable fields where possible, if that information is available. |
Please complete the following steps: If the animal is alive, step 1 is call your local migratory bird rehabilitation facility or a licensed veterinarian for instructions before handling the animal. Then follow steps 1-3 below. 1. If you have a permit, please follow the instructions in your permit conditions on how to proceed before collecting or moving the carcass or its parts. If you do not have a permit, please call the USFWS employee who is working with you on your monitoring process. If you do not know the appropriate USFWS contact, please call the OLE Office in your USFWS Region (see contact information at: http://www.fws.gov/le/regional-law-enforcement-offices.html) for instructions. You must contact OLE immediately, if possible, but not later than 48 hours after discovery, or at the beginning of the next business day to notify them of the mortality. |
| IMPORTANT NOTE ABOUT REQUIRED AND REQUESTED FIELDS: If you have a permit with the USFWS, your permit conditions may require you to fill in more than just the required and requested fields, or the fields that are required and requested may differ slightly than indicated in this spreadsheet. Please check your permit conditions to make sure you are providing all the information required for compliance with your permit. -DROP DOWN BOXES are provided with several of the fields for your convenience, and to support greater consistency of data for these fields. Please try to use one of the options provided within the drop down boxes for these fields. However, if you can not find the appropriate match in the drop down (or your selection is "Other - describe", you may enter your own text in the field as well. To enter your own text, click on the cell once and start to type your own text. To clear a field, click on the cell once and hit the Delete button. |
2. Fill out as many of the fields as possible on tab 3 of this workbook regarding the incident, have an official representative sign the signature block and enter the signature date in tab 2 (signatory does not have to be the Principal Officer, can also be the Primary Contact or other official company representative), and e-mail a copy of this entire workbook (all tabs included) to the individuals specified in your permit conditions (which may be a Migratory Bird Permit Office, and Ecological Services Field Office, or both). You must report eagle mortalities and injuries no later than 48 hours after discovery, or at the beginning of the next business day. T&E mortalities should be reported no later than 24 hourse after discovery, or at the beginning of the next business day. IN THE SUBJECT LINE OF THE E-MAIL, if you are reporting an eagle write "EAGLE REPORT - [Permittee Name]". If you are reporting a T&E species write "T&E REPORT - [Permittee Name]" e.g. Eagle Report - Windy Hill Wind Farm (if eagle) or T&E Report - Wind Hill Wind Farm (if T&E). If you do not have a permit, reports should be e-mailed to the USFWS contact who is working with you on your monitoring process. Please ALSO COPY the following e-mail address: [email protected]. |
| 3. IF YOU SELECT THE OPTION "OTHER" or contains the word "OTHER" or you have additional details about your choice: please try to provide additional details with your selection in the other details column provided next to it. 4. ON TAB 3, PLEASE SCROLL RIGHT TO VIEW ADDITIONAL DATA ENTRY FIELDS. There are more fields than are immediately viewable in tab 3. Please use the scroll bar at the bottom right hand side of the spreadsheet to view all fields. 5. TO SUBMIT YOUR INTERIM (ANNUAL) REPORT: Please e-mail this entire workbook (including all tabs) as an e-mail attachment to your Regional Migratory Bird Permit Office (see link to webpage with contact information in header above), AND copy the following e-mail addresss: [email protected]. Your interim (annual )report should include all injuries/mortalities logged at your facility site during the reporting period (including any eagle or T&E reports). IN THE SUBJECT LINE OF THE E-MAIL write "ANNUAL REPORT - [Permittee Name]". e.g. ANNUAL REPORT - Windy Hill Wind Farm. |
3. Please assign a Local Specimen Number in Column B of Tab 3 to ANY birds you hand off to a responding OLE agent or any other party that might receive the bird once it is transferred (rehabber, vet, lab, etc.). Make sure to give this Local Specimen Number to individual you hand the bird off to. If you can not assign your own unique specimen ID, please use the Source Record ID in Column A as your Local Specimen ID. If you do this, make sure you also put the Source Record ID in Column B to indicate to us you have used this as your local specimen number. |
Sheet 2: 2. ENTER CORE INFORMATION
| CORE INFORMATION | Required Fields | |
| Report Year (yyyy) | Requested Fields | |
| Project Name | ||
| FWS Permit Number (MB followed by up to 6 or 5 numbers and an upper case character, if present [e.g., MB13456B]) | ||
| Project Type | ||
| Project Subtype | ||
| If Project Type selected is "Other", please enter more details | ||
| Project Description | ||
| Primary Contact Name | ||
| Primary Contact Title | ||
| Primary Contact Business Phone Number (xxx-xxx-xxxx) | ||
| Form 3-202-17, Rev. 4/2017 | ||
| OMB Control No. 1018-0022, Expires 4/30/2021 | ||
| If you do not have any mortality/injury information to report for the current reporting cycle, please indicate this by checking the box in the cell to the right. | 
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| If you are using a structured survey protocol, please indicate this by checking the box in the cell to the right. Please attach any information about your protocol with this document when you submit it. | 
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| Proprietary? (select "Yes" or "No" below) | Describe Proprietary Information in box below | |
| Is injury/mortality information proprietary? Select "Yes" if take records for this project contain Business Confidential (proprietary) information the U.S. Fish and Wildlife Service should review when considering release of take data (for example, in response to Freedom of Information Act requests). If "Yes", please summarize exactly what fields you feel are proprietary, explaining why they should be withheld, and from whom. Specifying proprietary information here does not guarantee those fields will be withheld from release, but the information you provide will be attached to every record for this project and will be carefully considered during the handling of those records. For further information, see the Privacy and Freedom of Information Act (FOIA) statements on tab 6. | ||
| I certify that the information in this report is true and correct to the best of my knowledge. I understand that any false statement herein may subject me to the criminal penalties of 18 U.S. C. 1001. | ||
| Principal Officer Signature : X | ||
| Please type name in box above | ||
| Date of Signature: | ||
| Please type date (mm/dd/yyyy) of signature in box above | ||
Sheet 3: 3. ENTER MORT-INJ DATA
Sheet 4: GLOSSARY OF TERMS
| GLOSSARY OF TERMS |
| Brine Pond: A type of non-focusing solar collector consisting of a pool of salt water heated by the sun. |
| De-Oiled: A breakdown of the fine structure of a bird's feathers that makes them waterproof. This waterproof system works like a winter coat whose outer layer covers a thicker layer of material that traps air, keeping the wearer warm and dry. When this structure is disrupted, as can commonly occur when birds are oiled during an oil spill, the bird is no longer properly insulated from the cold air and water and can die from exposure to the elements. |
| Incidental Finding: is used to describe a bird was found any way other than a structured survey process (either a Mortality survey, Routine infrastructure survey, or Structured Research). Examples of incidental findings are: (1) the finding occurred as a result of a power outage; (2) an individual just happened upon a bird in the course of another activity; (3) an individual was out looking for birds, but not using any structure survey protocol or recording search time and effort (e.g. they may go out every day, but walk a different route and search for different periods of time and do not record either) |
| Mortality Survey: Refers to a structured survey designed to find dead/injured birds within a defined area and time. It includes a consistent and clearly defined search area, search times and intervals, and standardized search protocols. |
| Project Proponent: An entity with overall responsibility for the implementation and registration of projects. This is as opposed to the operating company who simply owns and finances these projects. For instance, project proponent Western Wind is a developer that is owned by the Terra-Gen Power LLC operating company. |
| Routine Infrastructure Survey: Refers to a routine and systematic facility or infrastructure survey (e.g., monitoring of buildings, electric utility lines, wind turbine pads, towers, oil pits, pipes, fences) that includes a consistent and clearly defined search area, search times and search intervals. For example, if maintenance staff goes out every week day (Mon-Fri) for 4 hours and walks the same route to systematically inspect each turbine pad in a wind energy facility, that qualifies as a Routine infrastructure survey. If consistent search areas, times and intervals such as these cannot be applied to the monitoring being conducted at the time of the finding, then the option Incidental finding should be used. |
| Structured Research: Refers to research activities such as field work, bird re-release and use of telemetry (satellite, VHF, PTT). |
| Sub-Adult: A bird that has some adult characteristics but is not yet sexually mature. The term Sub-Adult usually refers to larger birds such as gulls and raptors that may take several years to reach full maturity and recognizable adult plumage. |
Sheet 5: NOTICES
| NOTICES |
| PRIVACY ACT STATEMENT |
| Authority: The information requested is authorized by the following: the Bald and Golden Eagle Protection Act (16 U.S.C. 668), 50 CFR 22; the Endangered Species Act (16 U.S.C. 1531-1544), 50 CFR 17; the Migratory Bird Treaty Act (16 U.S.C. 703-712), 50 CFR 21; the Wild Bird Conservation Act (16 U.S.C. 4901-4916), 50 CFR 15; the Lacey Act: Injurious Wildlife (18 U.S.C. 42), 50 CFR 16; Convention on International Trade in Endangered Species of Wild Fauna and Flora (TIAS 8249), 50 CFR 23; General Provisions, 50 CFR 10; General Permit Procedures, 50 CFR 13; and Wildlife Provisions (Import/export/transport), 50 CFR 14. Purpose: The collection of contact information is to verify the individual has an eligible permit to conduct activities which affect protected species. The information the individual provides helps the FWS monitor and report on protected species and assess the impact of permitted activities on the conservation and management of species and their habitats. Routine Uses: The collected information may be used to verify an applicant’s eligibility for a permit to conduct activities with protected wildlife; to provide the public and the permittees with permit related information; to monitor activities under a permit; to analyze data and produce reports to monitor the use of protected wildlife; to assess the impact of permitted activities on the conservation and management of protected species and their habitats; and to evaluate the effectiveness of the permit programs. More information about routine uses can be found in the System of Records Notice, Permits System, FWS-21. Disclosure: The information requested in this form is voluntary. However, submission of requested information is required to process applications for permits authorized under the listed authorities. Failure to provide the requested information may be sufficient cause for the U.S. Fish & Wildlife Service to deny the request. |
| PAPERWORK REDUCTION ACT STATEMENT |
| In accordance with the Paperwork Reduction Act (44 U.S.C. 3501), the U.S. Fish and Wildlife Service collects information necessary to consider a permit application, under the applicable laws governing the requested activity, for which a permit is requested, and to respond to requests made under the Freedom of Information Act and the Privacy Act of 1974. Information requested in this form is purely voluntary. However, submission of requested information is required in order to process applications for permits authorized under the above laws. Failure to provide all requested information may be sufficient cause for the U.S. Fish and Wildlife Service to deny the request. 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. 1018-0022. |
| ESTIMATED BURDEN STATEMENT |
| We estimate public reporting for this collection of information averages: Original submission - paper-based: 5 hours (reporting) and 1 hour (recordkeeping) Original submission - electronic: 4 hours (reporting) and 1 hour (recordkeeping) These estimates include 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: PRB/PERMA (JAO), Falls Church, VA 22041-3803, or via email at [email protected]. Please do not send your completed form to this address. |
| FREEDOM OF INFORMATION ACT |
| For organizations, businesses, or individuals operating as a business (i.e., permittees not covered by the Privacy Act), we request that you identify any information that should be considered privileged and confidential business information to allow the Service to meet its responsibilities under FOIA. Confidential business information must be clearly marked "Business Confidential" at the top of the letter or page and each succeeding page and must be accompanied by a non-confidential summary of the confidential information. The non-confidential summary and remaining documents may be made available to the public under FOIA [43 CFR 2.26 – 2.33]. |
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |
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