P R O J E C T P R O P O S A L A P P L I C A T I O N.

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P R O J E C T P R O P O S A L A P P L I C A T I O N Phone: 307-777-6781 Fax: 307-777-1943 E-mail: kent.drake@wyo.gov www.wyadmb.com The Wyoming Animal Damage Management Board (ADMB) has established the following criteria for ADMB Project Proposal Applications as a method to establish integrated animal damage management priorities in the State of Wyoming. Although all criteria may not be applicable to each project application, project proposal applicants are encouraged to carefully consider each of the criteria. An essential part of the ADMB=s project proposal selection process is based on these criteria. You will be required to submit an annual report, including benefits derived from the project. 1. Total costs for projects should be realistic. 2. Results of projects should be measurable and achievable. 3. The cooperator listing should reflect contact and / or agreement with the project between varying entities. 4. What is the percentage in relation to total funding of contributing funds (outside dollars) or in-kind services being provided? 5. Defined geographic area. 6. Benefits derived versus expenditures. 7. Research value. 8. The variety of methods employed. 9. Ability and confidence that project will be done. 10. Provide an itemized budget. PLEASE COMPLETE ALL OF THE REQUESTED INFORMATION IN ALL OF THE SECTIONS APPLICABLE TO YOUR SPECIFIC PROJECT PROPOSAL. (The ADMB reserves the right to reject any project proposal application that does not provide the requested information, or is otherwise not completed properly.) Section 1 Project Title: Project Summary Brief Description of Project: Submitted By / Affiliation: Mailing Address: City: Wyoming. Zip: Phone: Fax: Signature: E-mail: Date: Annual Funds Requested: Proposed Subsequent Funding: Duration of Project: $ $ ** Mail Completed Application To: ** For ADMB Use Only ADMB Date Received: 2219 Carey Avenue Dates of Review: / Cheyenne, WY 82002-0100 Approved: Yes No 1-6-15 ADMB Project Proposal Application Page 1 of 5 pages

Section 2 Project Description A. Type Of Proposed Project: (check all that apply) 1. G Research 2. G Education 3. G Field Management Please list all targeted and, if applicable, multiple species (i.e. coyotes and mountain lions): 4. G Offending Animals Only 5. G Population Management 6. G Other: *Predatory Animals: coyote, jackrabbit, porcupine, raccoon, red fox, skunk, stray cat. *Predacious Birds: English sparrow, starling *Depredating Animals: black bear, grizzly bear, mountain lion, badger, beaver, bobcat, marten, mink, muskrat, weasel, wolf B. Project Proposal Will Benefit: (check all that apply) 1. G Livestock... Species: 2. G Crops... Type: 3. G Wildlife... Species: 4. G Human Health / Safety... Type: 5. G Other: (describe) C. Geographic Size Of Proposed Project: 1. Total Area of Proposed Project in Acres: 2. Private Land in Acres: 3. Public Land in Acres: D. Method(s) Of Management To Be Implemented: (check all that apply) 1. G Lethal 2. G Non-Lethal 3. G Integrated management employing the following methods: (examples: guard dogs, aerial hunting, M-44s, etc.) Please list all specific planned methods for management. 1-6-15 ADMB Project Proposal Application Page 2 of 5 pages

Section 3 Wildlife (Attach additional sheets as needed.) A. Has loss of habitat or other environmental factors been a major influence on current problems? Please describe. B. If big game animals and / or other wildlife are proposed to receive benefit from the project, define the correct herd units or hunt area(s) [for each specie(s)] in which the project is to occur. C. Does adequate habitat exist to support an increase in the numbers of wildlife proposed? List source(s) of information (e.g. BLM, G&F, FS, FWS, private landowner.) D. Based on data provided by the Wyoming Game & Fish Department, what is the current post-season population estimate of the herd(s) in question? E. What is the current post-season population objective established by the Wyoming Game & Fish Commission of the herd(s) in question? F. Provide a detailed description of the benefit to the public. G. Please provide current baseline population data, if this information is relevant to your application. Include such information as: predator numbers, doe / fawn ratios, buck / doe ratios, 5 years of the herd population trend. Please list sources of information. Section 4 Livestock / Crops (Attach additional sheets as needed.) A. What are the livestock losses or crop damage in the proposed project area? List source(s) of information. (e.g. NASS, landowner, etc.) B. What is the calculated dollar value and head count loss on an annual basis? C. To date, what methods have been employed to alleviate losses? D. Please provide baseline data, for the proposed project area: percentage of losses, total number and value of livestock affected, trends in predation over the last 5 years, predator population numbers. List source(s) of information. Section 5 Health / Safety (Attach additional sheets as needed.) A. What is the extent of the health / safety issue and who is affected? 1-6-15 ADMB Project Proposal Application Page 3 of 5 pages

Section 6. Narrative & Map (Attach additional sheets as needed.) A. Please attach a detailed narrative and map of the proposed project. Narrative should include such things as: description of project area, time frame, specific and measurable goals and planned methods/procedures for evaluation. The map, preferably one of 1:100,000 scale topographic, should show the project area identified. Section 7. Other Concerns (Attach additional sheets as needed.) A. Please provide any additional information necessary to address concerns or issues regarding the proposed project which were not covered previously. Section 8. Financial Statement / Budget Sheet In this section, please provide the following financial information pertaining to the proposed project. Please attach any other substantiating, financial materials you deem necessary to validate your proposal. A. Annual funds requested from the ADMB: $ B. Proposed Subsequent Funding: FY20 $ FY20 $ C. What other services are requested from the ADMB? D. Please list the co-sponsors / contributors to the project and kind & amount of contribution. Co-Sponsors / Contributors Kind / Amount of Contribution 1. 2. 3. 4. 5. 6. 7. 8. Total Estimated Project Contributions $ 1-6-15 ADMB Project Proposal Application Page 4 of 5 pages

E. Have all the co-sponsors / contributors been offered the opportunity to review your proposal application and provide their input? Yes No (It is recommended that you ask the co-sponsor / contributor to provide their written comments on the viability or specifics and their relationship to the project. Please submit copies with this application.) F. Please provide a budget for the proposed project, listing all income and expenses. Income (List Sources) Proposed Actual 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Total Expenses (List Sources) Proposed Actual 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Total 1-6-15 ADMB Project Proposal Application Page 5 of 5 pages