Form 10-226 Investigator's Annual Report

NPS Form 10-226 (Rev. 03/2017) OMB Control No. 1024-0236

National Park Service Expiration Date ##/##/2020

INVESTIGATOR'S ANNUAL REPORT

If you are not using the automated system supporting this report process,

please fill out this form and return it to the appropriate park.

All or some of the information you provide may become available to the public.

Reporting Year

Park

Select the type of permit this report addresses:

     

     

Scientific Study Science Education Activity

Name of Principal Investigator or Responsible Official

Office Phone

Cell Phone

Dr. Ms. Mr. Mrs.

First Name

     

Last Name

     

     

     

Mailing Address

Office Fax

Email Address

     

     

     

Additional scientific study investigators: (first name, last name)

     

Project Title (maximum 300 characters)

     

Park-assigned Study or Activity #

Park-assigned Permit #

Permit Start Date

Permit Expiration Date

     

     

     

     

Scientific Study Starting Date

     

Estimated Scientific Study Ending Date

     

For either a Scientific Study or a Science Education Activity, the status is: (select one)

For a Scientific Study that is completed, please check each of the following that applies:

Completed (for a study, check only if all specimens are cataloged) Continuing Suspended Terminated before completion

Final report has been provided to the park or will be provided to the park within the next two years Copies of field notes, data files, photos, or other study records, as agreed, have been provided to the park All collected and retained specimens and retained material originating from such specimens have been cataloged into the NPS catalog system and NPS has processed loan agreements as needed

Activity Type: (select one) Research Inventory Monitoring Education Other:      

Subject/Discipline: (maximum 60 characters)      

Purpose of Scientific Study or Science Education Activity during the reporting year: (maximum 4000 characters)

     

Findings and status of Scientific Study (including collections made and catalog status of retained specimens and retained material originating from such specimens) or accomplishments of Science Education Activity during the reporting year: (maximum 4000 characters)
     
For Scientific Studies (not Science Education Activities), do you still retain any specimens collected from the park or material originating from such specimens that have not been destroyed during analysis? Yes No If “Yes”, identify each institution and type of material where the specimens or material originating from such specimens currently are housed:
     
Funding specifically used in this park this reporting year that was provided by NPS: (enter dollar amount)	Funding specifically used in this park this reporting year that was provided by all other sources: (enter dollar amount)
     	     
List any other U.S. Government Agencies supporting this study or activity and the funding each provided this reporting: year
     

NOTICES

Privacy Act Statement

Privacy Act Statement

Authority: 16 U.S.C. 1, National Park Service Organic Act; 16 U.S.C. 3, Rules and regulations of national parks, reservations, and monuments; timber; leases; 16 U.S.C. 5935, National Parks Omnibus Management Act.

Purpose: The two primary uses of the records maintained in the system are to administer scientific research and collecting within units of the National Park System, and to make Investigator’s Annual Reports available to the public.

Routine Uses: In addition to those disclosures generally permitted under 5 U.S.C.552a(b) of the Privacy Act, records or information contained in this system may be disclosed outside DOI as a routine use pursuant to 5 U.S.C. 552a(b)(3) to other federal, state, local, tribal or foreign governments and organizations, and members of the general public based on an authorized routine use when the disclosure is compatible with the purpose for which the records were compiled as described under the system of records notice for this system.

Disclosure: Voluntary, however, the Investigator’s Annual Report is required as a general condition of each permit issued; failure to provide the requested information may impede the processing and publication of the Investigator’s Annual Report and the processing of associated permit renewal requests.

Paperwork Reduction Act Statement

We are collecting this information subject to the Paperwork Reduction Act (44 U.S.C. 3501) and National Parks Omnibus Management Act of 1998 (NPOMA, Sections 201 (4), 201 (5), and 205 which govern the use of parks for study to benefit park management and broader science, and also publication of information derived from studies conducted in the National Park System. Scientific research, education and collecting activities within units of the National Park System that may impact parks invoke a permitting and reporting requirement per regulations at 36 CFR 1.6 (Permits), 36 CFR 2.1 (Preservation of Natural, Cultural and Archeological Resources), and 36 CFR 2.5 (Research Specimens). The National Park Service collects information about permit applicants and permittees to administer and document research, collecting, and reporting activities within parks. All applicable parts of the form must be completed in order for your request to be considered. Failure to provide the information may result in denial of your permit application. A Federal agency may not conduct or sponsor and you are 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 OMB Control No. 1024-0236.

Estimated Burden Statement

Public reporting burden for this form is estimated to average 15 minutes per response, including the time it takes for reviewing instructions, gathering and maintaining data, and completing and reviewing the form. Comments regarding this burden estimate or any aspect of this form should be sent to the Information Collection Clearance Officer, National Park Service, 12201 Sunrise Valley Dr. (MS-242), Reston, VA 20192. Please do not send your completed form to this address.

RECORDS RETENTION: TEMPORARY. Destroy/delete 3 years after closure. (NPS Records Schedule, Resource Management and Page 1 of 4

Lands (Item 1D) (N1-79-08-1))