WILDLIFE COLLECTOR’S PERMIT REPORTING FORM* Please supply the following information on the specimens collected on the please Missouri Species of Conservation Concern Checklist, your last Wildlife Collector’s Permit. For species listed in complete a Rare Animal Reporting Form (see for a copy) for entry into the Missouri Natural Heritage Database. Please submit a map, preferably a 7.5-minute topographic map, with the Checklist capture site identified. We encourage you to submit your data in an Access database or Excel format using the fields listed below. The Excel spreadsheet may be downloaded from the address listed on the back of this page. Name of permittee: _________________ ____ Permit Number:________ Permit Year:_______ ☐CHECK HERE IF NOTHING WAS COLLECTED Provide all information requested or this form may be returned to you. Common Name Scientific Name Date Band_# or PIT tag # Number Number Number Number Check if Check if County Location Stream and/or Site Name captured permanently released Salvaged voucher tissue or TRS, UTM, Decimal degrees, removed specimen blood Degrees Minutes seconds or retained was Degrees Decimal Minutes collected Circle coordinate type above. Indicate coordinate source (GPS, Google Earth, etc) ___________ If UTM, enter datum:_________ and zone____
WILDLIFE COLLECTOR’S PERMIT REPORTING FORM* Please supply the following information on the specimens collected on your last Wildlife Collector’s Permit. For species listed in the Missouri Species of Conservation Concern Checklist, please complete a Rare Animal Reporting Form (see Checklist for a copy) for entry into the Missouri Natural Heritage Database. Please submit a map, preferably a 7.5-minute topographic map, with the capture site identified. We encourage you to submit your data in an Access database or Excel format using the fields listed below. The Excel spreadsheet may be downloaded from the address listed on the back of this page. Name of permittee: _________________ ____ Permit Number:________ Permit Year:_______ ☐CHECK HERE IF NOTHING WAS COLLECTED Provide all information requested or this form may be returned to you. Common Name Scientific Name Date Band_# or PIT tag # Number captured Number permanently removed Number released Number Salvaged Check if voucher specimen retained Check if tissue or blood was collected County Location TRS, UTM, Decimal degrees, Degrees Minutes seconds or Degrees Decimal Minutes Circle coordinate type above. Indicate coordinate source (GPS, Google Earth, etc) ___________ If UTM, enter datum:_________ and zone____ Stream and/or Site Name