3-2056J Waterfowl Hunting Record

United States Department of the Interior
FISH AND WILDLIFE SERVICE
Division of Migratory Bird Management
10815 Loblolly Pine Drive, Laurel, MD 20708-4028
1-800-419-2965 (phone) 301-497-5981 (fax)
8/20/2017

11720001
11720001
JOHN Q PUBLIC
1881 WATERFOWL SURVEY DRIVE
LAUREL, MD 20708

Dear JOHN PUBLIC,
You have been selected to participate in this year's National Migratory Bird Harvest Survey. We only select a
small percentage of the nation's hunters for this annual survey, so your response is important EVEN IF YOU DO
NOT HUNT MIGRATORY BIRDS THIS SEASON.
We are asking you to tell us about your waterfowl hunting during the 2017 hunting season. Please use the
attached diary to record the details of your hunt each time you go waterfowl hunting in Maryland. Please read the
instructions on the diary form, fill it out completely. After the season is over or when you are done hunting in
Maryland, send the completed form back to us in the enclosed postage-paid envelope. If you receive this survey
too late for you to remember all of the details of your hunts, please fill out the lower portion of the form labeled
"SEASON TOTALS."
Your response is very important, whether you bag any birds or not. If you don’t hunt waterfowl at all this season,
please mark the “Did not hunt” box at the upper right portion of the form and return it to us. If you do hunt
waterfowl, please ONLY REPORT YOUR OWN PERSONAL HUNTING activity and harvest. We also ask
that you please keep track throughout the season of birds that you knocked down, but could not retrieve. Record
this total number on the lower portion of the form labeled "SEASON TOTALS."
To protect your privacy, we will not associate your name with your hunting records after the survey is completed.
If you have any questions or need more information about this survey, please write us at the above address, call us
toll-free at 1-800-419-2965 from 7:30am-4:00pm EST, email us at [email protected], or
go to http://www.fws.gov/hip. You can request additional forms through this website:
http://migbirdapps.fws.gov/hipweb. Thank you in advance for your time and your participation in this year's
National Migratory Bird Harvest Survey.
Sincerely,

James B. Bortner, Chief
Division of Migratory Bird Management
In accordance with the Privacy Act (5 U.S.C.522a) and the Paperwork Reduction Act (44 U.S.C. 3501), please note the following information. This study is authorized by the Migratory Bird Treaty Act (16
U.S.C. 703 et seq.) The information that you provide will be used for estimating migratory bird hunter activity and harvest in the United States. It is our policy not to use your name for any other purpose. All
names and identifying information will be removed when we compile the results, and only summary information will be reported. The information is maintained in accordance with the Privacy Act. Your
response is voluntary. An agency may not conduct or sponsor, and a person is not required to respond to an information collection unless it displays a current valid OMB control number. The information
collection has been approved by OMB and assigned the clearance number 1018-002. We estimate that it will take you about 5 minutes to read the instructions and fill out this form. Comments on this form
should be mailed to the Information Collection Clearance Officer, U.S. Fish and Wildlife Service, 5275 Leesburg Pike, MS: BPHC, Falls Church, VA 22041-3803.
Form 3-2056J
Rev. 04/17

OMB NO. 1018-0023
Approval expires XX/XX/XXXX