Sample Cordova Harvest Household Registration

20## April-May Cordova Bird and Egg Harvest

OMB Control No. 1018-0178 Expires ##/##/20##

Household Registration #:

Registration Holder
Last name (print):_____________________________ First name:_______________________ M.I._____
Permanent residency: City: ______________________________________ ZIP:____________________
Physical address: _____________________________________________________ PO Box:_________
Phone:________________ Agreed with terms of the registration: ________________________________
(signature of registration holder)
Vendor (last, first name):__________________________ Office:____________ Date issued:____/____/2020

Other household members authorized to hunt birds and gather eggs under this registration:
Last name
First name
Middle Initial

1
2
3
4
5
6
7
8
9
See "Notices" page for required Privacy Act, Paperwork Reduction Act, and Estimated Burden Statements



20## April-May Cordova Bird and Egg Harvest

Household Registration #:

OMB Control No. 1018-0178 Expires ##/##/20##

Registration Holder
Last name (print):_____________________________ First name:_______________________ M.I._____
Permanent residency: City: ______________________________________ ZIP:____________________
Physical address: _____________________________________________________ PO Box:_________
Phone:________________ Agreed with terms of the registration: ________________________________
(signature of registration holder)
Vendor (last, first name):__________________________ Office:____________ Date issued:____/____/2020

Other household members authorized to hunt birds and gather eggs under this registration:
Last name
First name
Middle Initial

1
2
3
4
5
6
7
8
9
See "Notices" page for required Privacy Act, Paperwork Reduction Act, and Estimated Burden Statements

Cordova April-May Harvest of Birds and Eggs - 20##
Eligible participants: permanent residents of Cordova, Chenega, and Tatitlek.
Bird hunters are required to carry: all waterfowl hunters 16 years or older are required to carry a current state duck
stamp and hunting license. Exemptions for state duck stamp include: disabled veterans, those 60 years or older,
and those that qualify for a low income hunting license. The state duck stamp and hunting license are not required
for harvest of gull eggs. The federal duck stamp is not required for this harvest of birds and eggs.
Cordova special registration: for April-May bird and eggs harvests, harvesters must also carry a valid annual
household registration, which is available at Cordova offices of the Native Village of Eyak and U.S. Forest Service.
The registration requires proof of residency. In a harvesting party, at least one person of each registered household
must carry a registration and all harvesters must be listed as household members on a registration.
Harvest area: bird and egg harvesting is permitted only on the Barrier Islands between Strawberry Channel and
Softtuk Bar (Game Management Units 6B and 6C).
Season: 2–30 April (bird hunting); 1–31 May (gull egg harvest).
Closure: 1 May–31 August (bird hunting); 2–30 April and 1 June–31 August (gull egg harvest).
Species open for hunting: greater white-fronted goose; snow goose; gadwall; Eurasian and American wigeon; bluewinged and green-winged teal; mallard; northern shoveler; northern pintail; canvasback; redhead; ring-necked
duck; greater and lesser scaup; king and common eider; harlequin duck; surf, white-winged, and black scoter; longtailed duck; bufflehead; common and Barrow’s goldeneye; hooded, common, and red-breasted merganser; and
sandhill crane. Species open for egg harvest: glaucous-winged, herring, and mew gulls.
Use of boats/all-terrain vehicles: hunting from any watercraft or motorized vehicles is not allowed.
You will receive a harvest survey by mail in early June and instructions on how to complete and return it.
For more information:
● Native Village of Eyak:
 (907) 424-7738. 110 Nicholoff Way, Cordova
● U.S. Forest Service:
 (907) 424-7661. 612 2nd Street, Cordova
● Native Village of Tatitlek:
 (907) 325-2311. Tatitlek
● Native Village of Chenega:
 (907) 569-5688. Chenega
● USFWS-AMBCC Program:  (907) 786-3887. Anchorage
● Alaska Migratory Bird Co-Management Council (AMBCC) website:
https://www.fws.gov/alaska/pages/co-management


Cordova April-May Harvest of Birds and Eggs - 20##
Eligible participants: permanent residents of Cordova, Chenega, and Tatitlek.
Bird hunters are required to carry: all waterfowl hunters 16 years or older are required to carry a current state duck
stamp and hunting license. Exemptions for state duck stamp include: disabled veterans, those 60 years or older,
and those that qualify for a low income hunting license. The state duck stamp and hunting license are not required
for harvest of gull eggs. The federal duck stamp is not required for this harvest of birds and eggs.
Cordova special registration: for April-May bird and eggs harvests, harvesters must also carry a valid annual
household registration, which is available at Cordova offices of the Native Village of Eyak and U.S. Forest Service.
The registration requires proof of residency. In a harvesting party, at least one person of each registered household
must carry a registration and all harvesters must be listed as household members on a registration.
Harvest area: bird and egg harvesting is permitted only on the Barrier Islands between Strawberry Channel and
Softtuk Bar (Game Management Units 6B and 6C).
Season: 2–30 April (bird hunting); 1–31 May (gull egg harvest).
Closure: 1 May–31 August (bird hunting); 2–30 April and 1 June–31 August (gull egg harvest).
Species open for hunting: greater white-fronted goose; snow goose; gadwall; Eurasian and American wigeon; bluewinged and green-winged teal; mallard; northern shoveler; northern pintail; canvasback; redhead; ring-necked
duck; greater and lesser scaup; king and common eider; harlequin duck; surf, white-winged, and black scoter; longtailed duck; bufflehead; common and Barrow’s goldeneye; hooded, common, and red-breasted merganser; and
sandhill crane. Species open for egg harvest: glaucous-winged, herring, and mew gulls.
Use of boats/all-terrain vehicles: hunting from any watercraft or motorized vehicles is not allowed.
You will receive a harvest survey by mail in early June and instructions on how to complete and return it.
For more information:
● Native Village of Eyak:
 (907) 424-7738. 110 Nicholoff Way, Cordova
● U.S. Forest Service:
 (907) 424-7661. 612 2nd Street, Cordova
● Native Village of Tatitlek:
 (907) 325-2311. Tatitlek
● Native Village of Chenega:  (907) 569-5688. Chenega
● USFWS-AMBCC Program:  (907) 786-3887. Anchorage
● Alaska Migratory Bird Co-Management Council (AMBCC) website:
https://www.fws.gov/alaska/pages/co-management

NOTICES
PRIVACY ACT STATEMENT
Authority: The Migratory Bird Treaty Act (MBTA) of 1918 (16 U.S.C. 703-712) and the Fish and Wildlife Act
of 1956 (16 U.S.C. 742d).
Purpose: The information collected will be used for the continuation of customary and traditional subsistence
uses of migratory birds in Alaska and to prescribe regional information on when and where the harvesting of
birds may occur.
Routine Uses: The information collected may be shared in accordance with the Privacy Act of 1974 and the
routine uses listed in the System of Records Notices INTERIOR/FWS-21 Permits System (June 4, 2008) 73
FR 31877 and INTERIOR/FWS/-26, Migratory Bird Population and Harvest Systems - 64 FR 29055 (May 28,
1999) available at https://www.doi.gov/privacy/doi-notices.
Disclosure: Furnishing this information is voluntary; however, failure to provide the requested information
may prevent the FWS from being able to determine the take’s legality or may limit FWS’ ability to monitor
migratory bird harvests.
PAPERWORK REDUCTION ACT STATEMENT
In accordance with the Paperwork Reduction Act (44 U.S.C. 3501 et seq), the U.S. Fish and Wildlife Service
collects information necessary as a required condition of permits requested and authorized under the
applicable laws governing the requested activity, 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. 1018-0178.
ESTIMATED BURDEN STATEMENT
We estimate public reporting for this collection of information to average 15 minutes, 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: PRB
(JAO/3W), Falls Church, VA 22041-3803, or via email at [email protected]. Please do not send your
completed form to this address.