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Attachment B <br />LANDOWNER PERMISSION FOR WILDLIFE RESEARCH <br />(Pursuant to Section 12.103 of the Texas Parks and Wildlife Code) <br />Use of Information: I hereby grant approval for Texas Parks and Wildlife Department employees <br />to enter property I own or manage to conduct scientific investigations and research on wildlife and <br />to record and use (such as in analyses) site - specific information from the property. This may <br />include placing that information onto a topographic map and entering the information into a <br />Department database. Thus, the information could be viewed by the public. <br />(Landowner or authorized agent) <br />(Date) <br />2. Reporting of Information: I hereby grant approval for Texas Parks and Wildlife Department <br />employees to report (such as in publications or technical reports) the above approved information <br />in a manner that permits identification of the location of the specific parcel of property I own or <br />manage. <br />(Landowner or authorized agent) <br />(Date) <br />3. Other Conditions: List any other conditions that apply to this approval. <br />4. Name and Address: <br />(Name of Landowner or Authorized Agent) <br />(Address) <br />(City, State, Zip) <br />5. Optional: <br />(Name of Ranch or Tract) <br />(County) (Acreage) <br />(Home Phone) (Office Phone) (FAX) <br />Texas Parks and Wildlife Department maintains the information collected through this form. With few <br />exceptions, you are entitled to be informed about the information we collect. Under Sections 552.021 <br />and 553.023 of the Texas Government Code, you are also entitled to receive and review the <br />information. Under Section 559.004, you are also entitled to have this information corrected. For <br />assistance call 512 - 389 -4978. <br />Page 8 <br />PWD 8 A1500- (01/2011) <br />