Scientific Collection Permit Threatened and Endangered Species Permit Salvage Permit

General Information

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Collection Permit Information
Permit #:
Affiliate Category:
Collection Category:
Permit Type:
Taxa Group: Select the Taxa Group of your Target Species. If there is no Target Species, select 'Not Applicable'

Target Species:
Species names are listed as 'common name - scientific name,' with the base of the common name listed first (e.g., 'Eagle, bald - Haliaeetus leucocephalus'). Search the dropdown box by starting to type the common name of the species. A generic common name followed by the scientific name is available for species with no common name (e.g., 'Millipede - Pseudotremia sublevis'). Multiple target species can be selected by holding the Ctrl key.

Coordinate/Geographic Information


Principal Permittee Information
First Name:
Last Name:
Phone Number(0-9 Only):
Email Address:
Data Entered By
 Same as Permittee
First Name:
Last Name:
Phone Number(0-9 Only):
Email Address:

Collection Site Information

Field Collectors Names
First Name:
Last Name:
  Select the 'Add Collector' button to add the entered collector name to the form. For multiple collectors, enter the next name and select 'Add Collector'
Collection Site and Methods
Your Site ID (optional): Site Description:    
Waterbody (Nearest Waterbody):
Collection Date (mm/dd/yyyy):  
Collection Method(s) and Effort(s)
Collection Method:
Collection Effort:
Select the 'Add Method/Effort' button to add the selected method and effort.

When multiple collectors use the same gear (i.e., dip net), effort is the number of hours multiplied by the number of collectors (e.g., 2 collectors survey for 3 hours = 6 hours total effort).    
Geographic Coordinates
Degrees Minutes Seconds


Longitude (-):



Detail Species Information

Species Information
Data for species records are submitted one at a time instead of all at once. Submit each species record individually by date and site. You will have the option to retain collection information between species submissions. View and export your records by selecting 'Search For Permit Record(s)' at the bottom of the form. If you notice any errors in your submission, email corrections to

Taxa Group: Select the Taxa Group of the Species to be entered. If Target Species was not observed, make an entry with Quantity = 0.

Species:   Quantity:

Condition When Collected/Observed:
Final Disposition:
Other Information
Field Tag Number(s) and Color(s) Observed or Captured Tagged Individuals OR Tags/Marks you applied. (Excludes ALL Color Coded Bird Bands. All tag numbers for the same species should be included in the Field Tag Number box and separated by semi-colons(;))
Overall Comments:
This form is required for all issued permits, in accordance with the permit agreement and VA wildlife regulations (examples: Collections, Surveys, Studies, Relocations and other related activities). A completed form for all taxa groups and all collections is required by January 31 for the previous years' collections.
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