Form 3-2495 Striped Bass Recapture Report

FWS Form 3-2495 (Rev. 07/2017)
U.S. Fish and Wildlife Service

OMB Control. No. 1018-0127
Expiration Date ##/##/####

STRIPED BASS RECAPTURE REPORT
Maryland Fish and Wildlife Conservation Office
177 Admiral Cochrane Dr., Annapolis, MD 21401
General (410) 263-2604
Tag Reports (800) 448-8322 or (888) 546-8587
Website: https://www.fws.gov/northeast/marylandfisheries/

Date Information Received:
Contact Method:
Phone
Interviewer: (Initials Only)
Tag #:

Letter

Other

Event:
Date Fish Caught: (mm/dd/yyyy)
Date Estimated?
Tag Removed:
Yes
No Color:
Red/Pink
Green
If “Y”,what portion?
Button
Streamer
Both

Other:

Disposition: (Was the fish?) (Check One)
Sold or Bought
Research Found Tag Only
Kept for Consumption
Capture Method (Check One)
Seine
Trawl
Other:

Anchor/Gill Net

Drift Gill Net

Released Alive

Found Dead

Electroshocking

Other Tag?
Yes
No
Tag#?
What type?
Body of Water, Closest City or Town:
State:
NOAA Code:
Type of Fisherman: (Recapturer) (Check One)
Commercial
cHarter
Research
Sport
Type of Reporter: (Check One)
Fish Given to (gift)
Recapturer

Unknown

Seafood Market

Other:

Found tag or fish

Size of Fish: Total Length (inches): or Fork Length (inches) and/or Weight (lbs)

Reward: (Check One)
Baseball Cap
Striped Bass Pin
Contact Information
Address (1):
Address (2):
City:
State:
Zip Code:
Comments

Other:

Accidental Death

Hook & Line

Killed for

TraP (Pound Net)

FWS Form 3-2495 (Rev. 07/2017)
U.S. Fish and Wildlife Service

OMB Control. No. 1018-0127
Expiration Date ##/##/####

Date Information Received:

NOTE: Bold lettering in choices to check indicate value to enter in computerized form.

NOTICES
PRIVACY ACT STATEMENT
Authority: The information requested is authorized by the Fish and Wildlife Act (P.L. 105-242), the Anadromous Fish Conservation Act
(P.L. 96-118), the Magnuson-Stevens Fishery Conservation & Management Reauthorization Act (P.L. 109-479), the Atlantic Striped
Bass Conservation Act (P.L. 98-613) and the Sustainable Fisheries Act of 1996 (P.L. 104-297).
Purpose: The contact information requested is to assist in the description and location of the individual’s capture of striped bass. The
capture location helps to determine migration patterns, distribution and the abundance of Striped bass and is used to develop
management techniques to maintain a sustainable striped bass fishery.
Routine Uses: The contact information requested may be used by Fishery Managers and FWS biologists to determine location of
capture. More information about the routine uses may be found in the Systems of Records Notice, FWS-21 Permits System.
Disclosure: The contact information requested is voluntary.
PAPERWORK REDUCTION ACT STATEMENT
We are collecting this information subject to the Paperwork Reduction Act (44 U.S.C. 3501) to collect vital information used by fishery
managers about the migration patterns, harvest levels, and abundance of striped bass along the Atlantic coast and to respond to
requests made under the Freedom of Information Act and the Privacy Act of 1974. Your response is voluntary. According to the
Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a
valid OMB control number. OMB has approved this collection of information and assigned Control No. 1018-0127.

ESTIMATED BURDEN STATEMENT
Public reporting for this collection of information varies with the convenient availability of the requested information. The relevant
burden to complete FWS Form 3-2495, “Striped Bass Recapture Report” averages 5 minutes. This burden estimate includes 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: BPHC, Falls Church, VA 22041-3803. Please do not send your completed form to this address.