WS Form 37 Migratory Bird Damage Project Report

OMB Control No. 0579-XXXX
U.S. DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
WILDLIFE SERVICES

PERMIT REVIEW

□ RENEWAL
Permit No:
□ Without Change
1. Name, Address, and Telephone Number

2. Location of Damage

3. County

4. State

Telephone † Home † Work
Fax/Email:
5. RESOURCE/DAMAGE ESTIMATE
A. Resources Damaged

B. Description of Damage

6. MIGRATORY BIRD SPECIES

7. PERMIT RECOMMENDATION

Depredating Species

Number
Involved

Take
Recommendation

1.

□

Yes

□

No

2.

□

Yes

□

No

3.

□

Yes

□

No

Number
Recommended

Methods

4.

□ Yes □ No
8a. PREVIOUS ACTIONS TO ADDRESS PROBLEM AND RESULTS OF THOSE ACTIONS:

8b. COMMENTS:

9. RECOMMENDED ACTIONS
Action:

□

Harassment

□

□

Capture and relocation

Habitat Alteration

□

□

Husbandry

Egg/nest destruction

□

□

Exclusion

□

□

Other:

Shooting

Lethal trapping

□

Chemical repellent

10A. WS Investigator Name and Address: (Print)

10B. WS Investigator Signature

Telephone Number:
Email:

Date:

WS Form 37(2006)

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