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Section B - Report of eagle injuries and mortality. <br />INSTRUCTIONS: Instructions for Section B: Report eagle injuries and mortality. Use a separate supplemental sheet for each discreet geographic area covered by your <br />permit (e.g. "South tract" or "Clark County" or "Management Area xxxx." Continue data entry for each geographic area on an additional Sec B Supplemental Sheet. (You <br />may need to copy or print more blank supplemental sheets. <br />MAKE SURE YOU SIGN & DATE THE CERTIFICATION STATEMENT BELOW BEFORE YOU SUBMIT YOUR REPORT <br />B. <br />GEOGRAPHIC AREA OF REPORTING: Did you enter this data into a FWS electronic reporting system? ❑ YES O <br />area (till_ \� 1 C' If "yes" select the system: <br />Identify project/activity ��UfjZ[f� ❑Avian Injury/Mortality Reporting System (AIMRS/EGOS) <br />❑ Bird Injury/Mor(ality Injury/MortalityReporting System (B MRS) <br />DATE SPECIFIC SPECIES STATUS OF EAGLE DISPOSITION ADDITIONAL COMMENTS <br />DISCOVERED LOCATION Bald or Golden Use: Use: Use this area to provide additional <br />(e.g. utility pole #xx) A- for injured. "NER" if sent to the National explanation, if needed. (e.g., name and <br />-'D" for dead, or Eagle Repository: permit number of rehabilitator ifyou <br />"C" for uninjured but caught or "PR" If transferred to permitted entered "PER" under "DISPOSITION' ). <br />trapped in equipment or eagle rehabilitator: <br />infrastructure -R- if released: <br />'TA" if transferred to USFWS or <br />State agency: <br />Other Pleasespecify) <br />J <br />CERTIFICATION: <br />I certify that the information in'this report is true and correct to the best of my knowledge I understand that any false statement herein may subject me to the <br />criminikWalties of 18 U.S.C, 100 1. <br />is /19 /�Ib <br />Signature btu ) o permiltee/prineipal officer. (No photocopied or stamped signatures) Date of of signature(mm/ddyyyy) <br />Form 3.202-15 OGY 12/2013) <br />OMB Control No. 1018-0022 Expires S/3112017 <br />00 <br />Q) <br />w <br />M <br />CL <br />