Form FS-2800-22D Paleontological Specimen Curation Form

Forest Service
U.S. DEPARTMENT OF AGRICULTURE

FS-2800-22D (REV. 03/2022)
OMB No. 0596-0081
EXP. 12/31/2024

_________________________________________________________________________________________________________________

Office Use Only
Authorization Number:

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Paleontological Specimen Curation Form
For each specimen collected provide the following information (form template may be duplicated as necessary):
1. Repository Name and Address:

4. Locality
name/number:

5. Field number:

2. Repository Institutional Acronym:

6. Accession
and/or Curation
number

7. Specimen
Identification

3. Name of Repository official, title, and contact information:

8. Legal land
survey
coordinates

9. Longitude or
UTM (X)
coordinates

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10. Latitude or
UTM (Y)
coordinates

11. Specimen
condition or
curation needs:

FS-2800-22D (REV. 03/2022)
OMB No. 0596-0081
EXP. 12/31/2024

USDA Forest Service
4. Locality
name/number:

5. Field number:

6. Accession
and/or Curation
number

7. Specimen
Identification

8. Legal land
survey
coordinates

9. Longitude or
UTM (X)
coordinates

10. Latitude or
UTM (Y)
coordinates

11. Specimen
condition or
curation needs:

BURDEN & NON-DISCRIMINATION STATEMENT
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 valid OMB control number. The
valid OMB control number for this information collection is 0596-0081. The time required to complete this information collection is estimated to average 6.5 hours per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, familial
status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual’s income derived from any public assistance. (Not all prohibited bases apply to
all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA’s Target Center at 202-720-2600 (voice
and TDD).
To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, DC 20250-9410, or call toll free at (866) 632-9992 (voice). TDD users can contact
USDA through local relay or the Federal relay at (800) 877-8339 (TDD) or (866) 377-8642 (relay voice). USDA is an equal opportunity provider and employer.
The Privacy Act of 1974 (5 U.S.C. 552a) and the Freedom of Information Act (5 U.S.C. 522) govern the confidentiality to be provided for information received by the Forest Service.

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Previous Version are Obsolete

USDA Forest Service

FS-2800-22D (REV. 03/2022)
OMB No. 0596-0081
EXP. 12/31/2024

INSTRUCTIONS:
Completing the Paleontological Specimen Data Form
For each specimen collected (or observed, if specimen was not collected) provide the following information (form template may be duplicated as necessary): This data table was designed to
facilitate recording of data for individual specimens. However, data may also be entered for single localities from which aggregates of taxa and/or individuals were collected in bulk. Data for
specimens and/or localities may be entered in the provided data form, or may be submitted in an alternative digital format, such as an ArcMap shapefile or GPS field unit data dictionary, provided
that such digital format contains all the requested information and is compatible with data management systems in use by the Forest Service paleontological resources management program.

1. Repository Name and Address: Enter the name and correspondence address of the repository institution. Alternatively, enter “see permit” if a copy of the signed Authorization to Conduct
Paleontological Resources Research or Collection containing this information is appended to this report.
2. Repository Institutional acronym: Enter the standard acronym of the repository institution. ex: Yale Peabody Museum of Natural History = YPM
3. Repository official name, title, and contact information: Enter the name, title, and correspondence address of the authorized repository officer who signed the repository agreement.
Alternatively, enter “see permit” if a copy of the signed Authorization to Conduct Paleontological Resources Research or Collection containing this information is appended to this report.
4. Locality name/number: Enter the name of the locality or locality number as used in the field and/or field notes, or as assigned by repository.
5. Field number: Enter the specimen-specific and/or location-specific field number assigned by the collector(s).
6. Accession and/or Curation Number: Enter the appropriate number(s) assigned by the repository to specimen(s) or bulk samples.
7. Specimen identification: Identify the taxon and anatomical part(s) to the most detailed extent practicable. If collected in bulk, describe the nature of the assemblage.
8. Legal land survey coordinates: Enter legal land survey coordinates for specimen or sample collection site. Ex: SW ¼, SW ¼, section #, T##S, R##W, County, State, 7.5” USGS geologic quadrangle
name.
9. Longitude or UTM (X) coordinates: provide longitude or UTM coordinates for the specimen collection site. Alternatively, one or more digital GIS shape files containing the requested coordinates
may be submitted. Digitally submitted GIS data must be compatible with existing Forest Service software and must be approved in advance by the FS project reviewer. If submitted digitally, the file
name(s) should be referenced in this block.
10. Latitude or UTM (Y) coordinates: provide latitude or UTM (Y) coordinates for the specimen collection site.
11. Specimen condition or curation needs: Enter any observation(s) related to need for curatorial care required to ensure preservation of the specimen or bulk sample.

Page 2 of 3
File Code: 2800

For technical questions and Section 508 accommodation, please contact [email protected]
Previous Version are Obsolete