UTAH BIRD RECORDS COMMITTEE
VERIFICATION OF UNUSUAL SIGHT RECORD FOR UTAH
(Please fill in the information using your word processor 
and then email a copy as an attachment to utahbirds@gmail.com)

COMMON NAME:
SCIENTIFIC NAME:
DATE:
TIME:
LENGTH OF TIME OBSERVED:
NUMBER:
AGE:
SEX:
LOCATION:
COUNTY:
LATILONG:
ELEVATION:
DISTANCE TO BIRD:
OPTICS USED:
WEATHER: 
LIGHT CONDITIONS: 
DETAILED DESCRIPTION OF BIRD: 
SONG OR CALL AND METHOD OF DELIVERY:
BEHAVIOR:
HABITAT:
SIMILAR SPECIES AND HOW WERE THEY ELIMINATED:
PREVIOUS EXPERIENCE WITH THIS AND SIMILAR SPECIES:
REFERENCES CONSULTED:
DESCRIPTION FROM (notes, memory, photos etc.):
OBSERVER:
ADDRESS:
E-MAIL ADDRESS:
PERMISSION: I GIVE MY PERMISSION TO POST THIS SIGHTING RECORD ON THE INTERNET (yes / no):
DATE PREPARED:
ADDITIONAL MATERIAL (photo, tape, drawing, other – please email as attachment to address below):

EMAIL THIS FORM  (as an attachment) TO:	  utahbirds@gmail.com

By submitting this information, I agree that all material submitted, relating to this record  will become  the  property of the Utah Bird Records Committee unless otherwise requested (see “Permission” above).  The Committee will review and evaluate all materials submitted, retain all materials in its archives and display it on its internet pages which are open to the public, publish its findings in the "Utah Birds,"  Journal, on the internet or in any other appropriate publication, and make the Committee Comments available to any interested party upon request.