3-2550 Urban Bird Treaty City Partnership Reporting Form

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Overview

Year 1
Year 2
NOTICES

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Sheet 1: Year 1

Section 1: Basic Information	Answer
Name of UBT City (send map/geographic delineation of the city)
State of UBT City
Name of UBT City PoC Filling Out Form
Title of PoC
Organization of PoC
Email of PoC
Phone of PoC
Date of Submission of Form - mm/dd/year
Name and Email of Two Other UBT City PoCs
Describe any plans to hold a UBT City signing or redesignation ceremony
Describe any plans to celebrate your city's UBT desingation anniversary
Section 2: UBT City Partnership Activity Metrics
Habitat Conservation	Number	Description
Acres of habitat restored/enhanced/created
Acres of habitat conserved/acquired
Miles of habitat along river/stream/other water body restored/enhanced (can also be reported as acres)
Number of native trees, shrubs, forbs planted
Acres of invasive/exotic species removed/controlled
Acres under improved management (i.e., ongoing management to promote bird or other wildlife or other benefits)
Number of habitat sites monitored
Number of nest/roost sites constructed/installed
Number of nest/roost sites monitored
Other
Hazard Reduction Metrics	Number	Description
Number of buildings participating in Lights Out Program
Number of buildings monitored for bird collisions
Number of buildings retrofitted to be bird safe
Number of buildings built/designed to be bird safe
Pounds of trash collected
Other
Community Education and Engagement Metrics	Number	Description
Number of people (adults and K-12 youth) engaged in conservation and science/monitoring activities
# of Adults engaged in conservation and science/monitoring activities
# of K-12 youth engaged in conservation and science/monitoring activities
Number of volunteers engaged in conservation and science/monitoring activities
Number of people (adults and K-12 youth) participating in recreation activities, education programs, festivals, and/or other public events
# of adults participating in recreation activities, education programs, festivals, and/or other public events
# of K-12 youth participating in recreation activities, education programs, festivals, and/or other public events
Number of teachers participating in training events
Number of people reached through communications and outreach
Number of jobs created
Other

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Sheet 2: Year 2

Section 2: UBT City Partnership Activity Metrics
Habitat Conservation	Number	Description
Acres of habitat restored/enhanced/created
Acres of habitat conserved/acquired
Miles of habitat along river/stream/other water body restored/enhanced (can also be reported as acres)
Number of native trees, shrubs, forbs planted
Acres of invasive/exotic species removed/controlled
Acres under improved management (i.e., ongoing management to promote bird or other wildlife or other benefits)
Number of habitat sites monitored
Number of nest/roost sites constructed/installed
Number of nest/roost sites monitored
Other
Hazard Reduction Metrics	Number	Description
Number of buildings participating in Lights Out Program
Number of buildings monitored for bird collisions
Number of buildings retrofitted to be bird safe
Number of buildings built/designed to be bird safe
Pounds of trash collected
Other
Community Education and Engagement Metrics	Number	Description
Number of people (adults and K-12 youth) engaged in conservation and science/monitoring activities
# of Adults engaged in conservation and science/monitoring activities
# of K-12 youth engaged in conservation and science/monitoring activities
Number of volunteers engaged in conservation and science/monitoring activities
Number of people (adults and K-12 youth) participating in recreation activities, education programs, festivals, and/or other public events
# of adults participating in recreation activities, education programs, festivals, and/or other public events
# of K-12 youth participating in recreation activities, education programs, festivals, and/or other public events
Number of teachers participating in training events
Number of people reached through communications and outreach
Number of jobs created
Other

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Sheet 3: NOTICES

NOTICES

Paperwork Reduction Act

In accordance with the Paperwork Reduction Act (44 U.S.C. 3501 et seq.), the U.S. Fish and Wildlife Service collects information necessary to designate Urban Bird Treaty cities or municipalities, 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 consider applications for designation as an Urban Bird Treaty city. 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

We estimate public reporting for this collection of information to average 3 hours to 80 hours per response, depending on activity, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Service Information Collection Clearance Officer, Division of Policy, Performance, and Management Programs, Fish and Wildlife Service, MS: PRB (JAO/3W), 5275 Leesburg Pike, Falls Church, VA 22041-3803, or via email at Info_Coll@fws.gov.