Form 3-2436 Depredation and Control Orders - Annual Report

FWS Form 3-2436 (Rev. 03/2023)
U.S. Department of the Interior

DEPREDATION AND CONTROL ORDERS - ANNUAL REPORT
Migratory Bird Permit Office

OMB Control. No. 1018-0146
Expiration Date: ##/##/20##

BEFORE FILLING OUT THIS FORM, please access the Return Addresses (to
obtain the email/postal mail addresses where this form can be returned).
See the instructions on the following page for Order numbers and specific reporting requirements by Order. Continue on additional sheet(s) as needed.
Depredation/Control Order Number: 21. ___ ___
Reporting Person or Organization: ________________________________________________________________
Mailing Address: __________________________________________________________City__________________ State _____ Zip _______
Telephone Number:_______________ Email Address: _________________________________ Report for Calendar Year___________
Species
(include nontarget species)

Number
Taken

Take Method

Month

State

County
(HI: Use Island)

Purpose of the Take

Disposition
(e.g. left in place, buried,
trash, rehabilitation,
donation)

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.

Signature: _______________________________________________________________ Date: ______________________________________
INSTRUCTIONS.
Depredation Orders and Control Orders authorize the take of migratory birds without a permit in certain circumstances. The regulation outlines the purpose of
take, who can take, and the species, method, location, and other restrictions on take. Annual reports are required for most Orders. Below is a summary of the
reporting requirements for each Order. The regulations governing Depredation and Control Orders are located in 50 CFR 21.150-21.177.

OMB Control. No. 1018-0146
Expiration Date: ##/##/20##

FWS Form 3-2436 (Rev. 03/2023)
U.S. Department of the Interior

DEPREDATION AND CONTROL ORDERS - ANNUAL REPORT
Migratory Bird Permit Office

Submit annual reports to your Regional Migratory Bird Permit Office by January 31 for activities conducted the previous calendar year (January 1 and
December 31). Use of this form is not mandatory, but you must submit the information required in the regulation and the certification statement on the form.
Regulation
21.150
21.153
21.156
21.159
21.162
21.165
21.168
21.171
21.174
21.177

Order Name
Depredation order for blackbirds, cowbirds,
crows, grackles, and magpies
Depredation order for horned larks, house
finches, and white-crowned sparrows in
California.
Depredation order for depredating scrub jays
and Steller’s jays in Washington and Oregon
Control order for resident Canada geese at
airports and military airfields
Depredation order for resident Canada geese
nests and eggs
Depredation order for resident Canada geese
at agricultural facilities
Public health control order for resident
Canada geese
Control order for purple swamphen
Control order for Muscovy ducks in the United
States
Control order for invasive migratory birds in
Hawaii

Due
Date
1/31
1/31
1/31
12/31
n/a
n/a
12/31

Required Report Information
Species, Number, Method, Month, State, County, Purpose,
Disposition (50 CFR 21.43(i))
Species, Number, Method, Month, State, County, Purpose,
Disposition (50 CFR 21.44(e))

Methods of Take
Authorized
Shoot, trap/kill,
trap/release
Shoot, trap/kill,
trap/release

Species, Number, Method, Month, State, County, Purpose,
Disposition (50 CFR 21.46(f))
Species, Number, Method, Month, State, County (50 CFR
21.49(d)(8))
REGISTRATION REQUIRED. Use the Resident Canada
Goose Registration system at: https://epermits.fws.gov/ercgr/
NO REPORT REQUIRED.

Shoot, trap/kill,
trap/release
Shoot, trap/kill,
trap/release, Egg destroy

Species, Number, State, County (50 CFR 21.52(e)(9))

Shoot, trap/kill,
trap/release, Egg destroy

n/a
n/a

NO REPORT REQUIRED.
NO REPORT REQUIRED.

1/31

Species, Number, Method, Month, State, and Island (50 CFR
21.55(i))

Note: Missing regulation numbers are intentional. There is currently no regulation 21.42, 21.45, 21.47 or 21.48.

Shoot, trap/kill,
trap/release, Egg destroy

OMB Control. No. 1018-0146
Expiration Date: ##/##/20##

FWS Form 3-2436 (Rev. 03/2023)
U.S. Department of the Interior

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 monitor take and disposition of migratory
birds, 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-####.
ESTIMATED BURDEN STATEMENT
The relevant burden for a Depredation and Control Order report is 4 hours (3 hours for reporting and 1 hours for recordkeeping). 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: PRB (JAO/3W), Falls Church, VA 22041-3803, or via email at
[email protected]. Please do not send your completed form to this address. The email addresses and phone numbers for regional contacts regarding migratory bird permits can
be found at https://www.fws.gov/program/migratory-bird-permit/contact-us.
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 nonconfidential summary and remaining documents may be made available to the public under FOIA [43 CFR 2.26 – 2.33].