DI-9007 Repository Receipt of Collections (Paleontology)

DI Form 9007 (Rev. 02/2022) OMB Control No. 1093-0008

U.S. Department of the Interior Expires XX/XX/20XX

repository receipt of collections

(paleontology)

Part 1: Permittee’s Certification of Deposit of Collections
1. Permittee Name and Contact Information	2. Permit Number
3. List of Collections
4. By signing this receipt, the permittee certifies that all paleontological resources, including associated records, indicated on the list attached to this record have been deposited with the repository listed below. Signature of Permittee Date
Part 2: Repository’s Certification of Receipt of Collections
5. Repository Name and Address	6. Repository Accession Number(s)
7. Name of Repository’s Authorizing Official	8. Title of Repository’s Authorizing Official
9. By signing this receipt, the repository authorizing official certifies that all paleontological resources and associated records indicated on the attached list have been deposited with the repository under the terms of an existing valid agreement signed by an authorized official of the repository and an authorized official of the responsible Department of the Interior bureau prior to this deposit. Signature of Repository Official Date

Conditions:

1. Paleontological resources collected from Federal land under permit remain the property of the United States.

2. The repository official who acknowledges receipt of the collection may not be the same person listed on the permit and must be authorized by the repository to receive collections on behalf of the repository.

3. A bureau or U.S. Department of the Interior (DOI) official may contact the repository to verify the location and condition of collections deposited by the permittee.

4. Upon receipt, the repository agrees to curate and maintain collections in accordance with 43 CFR part 49, Department Manual 411, and the terms and conditions defined in a separate agreement between the bureau and the repository for the care and maintenance of the deposited collection.

5. Specific locality data will not be released by the permittee or repository without written permission from a bureau authorized officer.

Instructions

Repository Receipt of Collections (Paleontology)

General: After the permittee deposits the collection at the approved repository, the permittee must submit this form, or another receiving document containing the same information and conditions, to the Federal land manager. When the repository is a DOI facility, this form may be replaced with any form that provides the same information.

PART 1: Permittee’s Certification of Deposit of Collections.

1. Permittee Name and Contact Information. This is the principal investigator (PI) named in DI Form 9003, Paleontology Permit.

2. Permit Number. The number assigned by the bureau to the top of the Paleontology Permit.

3. List of Collections. Provide a complete listing of all specimens collected under the authority of the permit and associated records that are being deposited on the date indicated.

4. Signature of Permittee and Date. Permittee signature and date certifying that all paleontological resources and associated records on the list are included in the deposit.

PART 2: Repository’s Certification of Receipt of Collections.

5. Repository Name and Address. Identify the repository named on line 8 of the Paleontology Permit or subsequently authorized by the bureau Federal land manager in a written modification of that permit.

6. Repository Accession Number(s). Accession numbers are assigned by the repository. The bureaus need these in order to track and report on the federally-owned collections. These numbers may be different from the accession numbers assigned by the bureaus.

7. Name of Repository’s Authorizing Official. Print the name of the authorized repository official. This official cannot also be the permittee or named in line 7 of the Paleontology Permit. This is because a conflict of interest arises if the receiving repository official is also associated with the permitted work, preparation, and deposit of the collection at the repository. In such cases, another official of the repository with no ties to the permitted work must be the repository’s authorizing official.

8. Title of Repository’s Authorizing Official. The repository official must be authorized to receive collections on behalf of the repository.

9. Signature of Repository Official and Date. The repository official signs and dates to certify authorization to receive Federally-managed paleontological resources and associated records on behalf of the specified repository and that all paleontological resources and associated records listed on the attached inventory have been received and deposited at the repository.

NOTICES

Privacy Act Statement

Authority: 16 U.S.C. 470aaa.aaa-11, Paleontological Resources Preservation Act of 2009.

Purpose: The primary use of the records maintained in the system is to manage, protect, and preserve paleontological resources on Federal lands under the jurisdiction of the Department of the Interior. Information will be used to issue permits for the collection of paleontological resources and facilitate the management of activities under these permits.

Routine Uses: In addition to those disclosures generally permitted under 5 U.S.C. 552a(b) of the Privacy Act, records or information may be shared with partners and curators who have physical custody of Federally-owned collections of paleontological resources to manage the collections, permitted researchers to share relevant information from previous discoveries and scientific investigations, and other Federal agencies and non-Federal entities as necessary to maintain accurate and complete permit records as authorized under the Privacy Act and in the routine uses outlined in the system of records notice INTERIOR/DOI-20, Paleontological Resources Preservation System.

Disclosure: Providing information is voluntary; however, not providing the requested information may hinder the approval of the requested permit.

Paperwork Reduction Act Statement

In accordance with the Paperwork Reduction Act (44 U.S.C. 3501, et seq.), we collect the necessary information, under the applicable laws, to verify that the specimens that you collected under your permit are deposited in and received by an approved repository, as required by the Paleontological Resources Preservation Act of 2009. Your response is required to obtain or retain a benefit. Failure to provide all requested information may be sufficient cause to deny the request. We 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 Control No. 1093-0008.

Estimated Burden Statement

We estimate it will take you about 1 hour to complete this application, including time to maintain records, gather information, and complete the form. You may send comments on the burden estimate or any other aspect of this form to the Departmental Information Collection Clearance Officer, Office of the Chief Information Officer, 1849 C Street NW, Washington, DC 20240, or via email at DOI-PRA@ios.doi.gov. Please do not send your completed form to this email address.

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