Falconry Hunting Take Report P.O

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State of California – Department of Fish and Wildlife License and Revenue Branch FALCONRY HUNTING TAKE REPORT P.O. Box 944209 DFW 360h (REV. 07/15/21) Page 1 of 2 Sacramento, CA 94244-2090

FOR ACTIVITIES FROM JULY 1, 2021 THROUGH JUNE 30, 2022

NAME: GO ID#: FALC. LIC. DOC#: D- -

ADDRESS: DAY TELEPHONE:

CITY: STATE: ZIP: EMAIL ADDRESS:

If you did not falconry hunt in California from July 1 through June 30 check the box and submit report. □ DID NOT HUNT INSTRUCTIONS: Using the codes below, report your falconry hunting take for the season. This report shall be submitted upon applying for the renewal of your falconry license or within 10 calendar days after the expiration of your falconry license, whichever comes first. 1. Report only on your falconry hunting activity from July 1 through June 30. 2. In Table 1, list only the game bagged in California by your bird(s) of prey. Report a zero if none bagged. 3. In Table 2, list the nongame species taken in California by falconry only, including inadvertent take (Page 2). 4. List the county where you hunted, not your county of residence (unless the same). 5. Submit report to the License and Revenue Branch by mail, email to [email protected] or online at www.ca.wildlifelicense.com/InternetSales/. SPECIES CODES AA PHEASANT – Excluding LGBCs* MM BAND-TAILED PIGEON - Southern Zone WW WHITE-TAILED PTARMIGAN BB PHEASANT – Harvested on LGBCs* NG NONGAME (birds, mammals, reptiles, other) XX WILD TURKEY – Fall, Excluding LGBCs* CC COMMON SNIPE NN CALIFORNIA (VALLEY) QUAIL YY WILD TURKEY – Spring, Excluding LGBCs* DD DUCKS OO MOUNTAIN QUAIL ZZ WILD TURKEY – Harvested on LGBCs* EE GEESE: DARK PP GAMBEL’S (DESERT) QUAIL PQ JACKRABBIT FF GEESE: WHITE QQ MOURNING DOVE – Sep. QR COTTONTAIL RABBIT GG COOT/MOORHEN UU MOURNING DOVE – Nov. through Dec. RS TREE SQUIRREL HH CHUKAR – Excluding LGBCs* TT SOOTY (BLUE) GROUSE XY AMERICAN CROW KK WHITE-WINGED DOVE TE THREATENED AND ENDANGERED *LGBCs (Licensed Game Bird Clubs) are clubs that release SPECIES pen-reared birds LL BAND-TAILED PIGEON - Northern (Inadvertent Take: Page 2, Table 2) Zone

COUNTY CODES 1 ALAMEDA 13 IMPERIAL 25 MODOC 37 SAN DIEGO 49 SONOMA 2 ALPINE 14 INYO 26 MONO 38 SAN FRANCISCO 50 STANISLAUS 3 AMADOR 15 KERN 27 MONTEREY 39 SAN JOAQUIN 51 SUTTER 4 BUTTE 16 KINGS 28 NAPA 40 SAN LUIS OBISPO 52 TEHAMA 5 CALAVERAS 17 LAKE 29 NEVADA 41 SAN MATEO 53 TRINITY 6 COLUSA 18 LASSEN 30 ORANGE 42 SANTA BARBARA 54 TULARE 7 CONTRA COSTA 19 LOS ANGELES 31 PLACER 43 SANTA CLARA 55 TUOLUMNE 8 DEL NORTE 20 MADERA 32 PLUMAS 44 SANTA CRUZ 56 VENTURA 9 EL DORADO 21 MARIN 33 RIVERSIDE 45 SHASTA 57 YOLO 10 FRESNO 22 MARIPOSA 34 SACRAMENTO 46 SIERRA 58 YUBA 11 GLENN 23 MENDOCINO 35 SAN BENITO 47 SISKIYOU 99 UNKNOWN 12 HUMBOLDT 24 MERCED 36 SAN BERNARDINO 48 SOLANO RAPTOR SPECIES CODES FALCONS F8 GYR/SAKER HAWKS KESTRELS GOSHAWKS F1 APLOMADO F9 MERLIN H1 COOPER’S K1 AMERICAN G1 EUROPEAN F2 BARBARY F10 MERLIN/PEREGRINE H2 FERRUGINOUS K2 EURASIAN G2 NORTHERN F3 GYR F11 PEALES PEREGRINE H3 HARRIS'S F4 GYR/BARBARY F12 PEREGRINE H4 RED-SHOULDERED OWLS F5 GYR/MERLIN F13 PRAIRIE H5 RED-TAILED O1 BARRED F6 GYR/PEREGRINE F14 PRAIRIE/PEREGRINE H6 SHARP-SHINNED O2 GREAT HORNED F7 GYR/PRAIRIE F15 TIERCEL/PEREGRINE TABLE 1 - SEASON HUNTING TOTALS (GAME AND NONGAME)

NOTE: If species used is not listed in the raptor species code, write the common name in the raptor field. EXAMPLE: If you hunted wild pheasant for five days in Yolo County with a Cooper's Hawk and bagged four, your entry would look like this: Species Days Hunted County Bag Raptor AA 5 57 4 H1 2021-2022 SEASON HUNTING TOTALS

IF YOU NEED ADDITIONAL SPACE TO REPORT TAKE, USE REVERSE

I certify under penalty of perjury under the laws and regulations of the State of California that the above information is true and correct. SIGNATURE DATE

State of California – Department of Fish and Wildlife FALCONRY HUNTING TAKE REPORT DFW 360h (REV. 07/15/21) Page 2 of 2

TABLE 1- SEASON HUNTING TOTALS TABLE 2 - INADVERTENT TAKE (Continued) (Threatened and Endangered Species) Species Days County Bag Raptor Species Tag # (if Sex Location Location County Raptor Hunted present) (M/F) (Lat) (Long)

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