Raptor Import Form

Please select one of the options below to begin, then enter all relevant information in the fields shown.

Transferred a bird to another permittee or to another permit you hold
Released a bird or Lost a bird due to its escape, theft, or death
Acquired a bird from another permittee
Captured a bird from the wild or Recaptured a previously captive (banded) bird
Rebanding a bird, either wild or captive-bred, for which the band was lost or removed

SPECIES:

USFWS BAND #:
(Enter AB000000 for yet to be banded birds)

Sex: Male Female Unknown

Source: Captive-bred Wild

Age: Nestling Immature Adult

Year of Hatch:

RECIPIENT (Person acquiring bird)

State Issued License#:

First Name:

Middle Name:

Last Name:

Address:

City:

State:

Zipcode:

E-mail Address:

Phone #:

License Type:

Falconry

Raptor Propagation

Other

Type of Acquisition:

Gift

Purchase

Loan

CAPTURE OR RECAPTURE (bird taken from the wild: provide band number in section 1)

Capture

Re-Capture

Date of Capture/Re-capture:(MM/DD/YYYY)

For all species, enter State of trapping location

County (or comparable subdivision)

For peregrine falcon nestlings, also provide either :
(a) name of local area (e.g., Bald Mt.), and mileage and direction from nearest town:
OR

(b) latitude and longitude in degrees, minutes and seconds. (Degree decimal. e.g. 99.999999)

RE-BANDING (to request the re-banding of wild or captive-bred bird)

Old Number:

Old Material:

Seamless Metal

Yellow Plastic

Black Plastic