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HomeMy WebLinkAboutC13-045 USDA Work and Financial Plan and Cooperative Services Agreement WORK AND FINANCIAL PLAN COOPERATOR: EAGLE COUNTY, COLORADO TAX IDENTIFICATION NO.: 84- 6000762 COOPERATIVE AGREEMENT NO.: 13- 73 -08- 6538 -RA ACCOUNT NO.: AP.RA.RX08.73.0097 LOCATION: Eagle, CO (Eagle County Regional Airport) DATES: March 1, 2013 —June 30, 2014 Pursuant to Cooperative Service Agreement No13- 73 -08- 6538 -RA between the United States Department of Agriculture, Animal and Plant Health Inspection Service, Wildlife Services and Eagle County, Colorado this Work Plan sets forth the objectives, activities and budget for the Wildlife Hazard Assessment (WHA) to be performed from March 1, 2013 through June 30, 2014. Eagle County t will provide total funding for the 16 month program, up to $55,000.00. OBJECTIVES /GOALS: To conduct a comprehensive Wildlife Hazard Assessment (WHA) which will identify factors contributing to wildlife hazards at Eagle County Regional Airport. To create a Wildlife Hazard Management Plan (WHMP) within four months of the completion of the Wildlife Hazard Assessment. To give timely updates and interim recommendations to Eagle County Regional Airport officials on survey results and preliminary recommendations to reduce wildlife hazards. PLAN OF ACTION: WS will provide a Wildlife Biologist who will conduct a wildlife survey for a 12 -month period. Data gathered will include species present, species abundance, seasonal population trends, peak use periods, special hazard zones and natural and man -made attractants, and will be provided to the Eagle County Regional Airport's point of contact on at least a quarterly basis. Based on this data, a Wildlife Hazard Assessment and Wildlife Hazard Management Plan will be written. WS will keep Eagle County Regional Airport personnel informed of legal status of problem species and regulatory management requirements. WS will hold quarterly meetings, as necessary, with Eagle County Regional Airport's point of contact. In addition, WS will provide technical assistance and direct control as requested. REPORTS: APHIS -WS will be responsible for the preparation of periodic reports as specified in the Cooperative Service Agreement. STIPULATIONS AND RESTRICTIONS: a. All operations shall have the joint concurrence of APHIS -WS and Eagle County and shall be under the direct supervision of APHIS -WS. APHIS -WS will conduct the program in accordance with its established operating policies and all applicable state and federal laws and regulations. b. Control on Private Lands: An agreement for Control of Animal Damage on Private Property (ADC Form 12A) will be executed between APHIS -WS and the landowner, lessee, or administrator before any APHIS -WS work is conducted. COST ESTIMATE FOR SERVICES: Equipment, field personnel and supervision will be provided by APHIS -WS. A Wildlife Services Biologist will be employed by APHIS -WS, and will be assigned the primary responsibility for conducting the work under this Work Plan for Eagle County at the Eagle County Regional Airport in Colorado. WS shall submit quarterly bills for actual costs incurred to WS for performance of work as delineated in the Work Plan, not to exceed $55,000.00. Such costs may include, but are not limited to, salary/benefits, vehicle use, supplies /equipment, and APHIS overhead. An estimated itemization of expenses is listed below; however, funds may be distributed between itemized categories as needed. ESTIMATED COST FOR COOPERATIVE PROGRAM WILDLIFE BIOLOGIST POSITION COOPERATOR ESTIMATED COSTS OF SERVICES Salaries and Benefits $35,040.89 Travel and Vehicle $8,049.94 Supplies and Equipment $4,261.73 Subtotal $47,352.56 Overhead (16.15 %) $7,647.44 TOTAL $55,000.00 NOTE: In accordance with the Debt Collection Improvement Act (DCIA) of 1996, bills issued by WS are due and payable within 30 days of receipt. The DCIA requires that all debts older than 120 days be forwarded to debt collection centers or commercial collection agencies for more aggressive action. Debtors have the option to verify, challenge and compromise claims, and have access to administrative appeals procedures which are both reasonable and protect the interests of the United States. Notwithstanding anything to the contrary contained herein, Eagle County shall have no obligations under this Agreement, nor shall any payments be made in respect of any period after December 31st of each calendar year during the term of this Agreement, without the appropriation therefor by County in accordance with the budget adopted by the Board of County Commissioners in compliance with the provisions of Article 25, Title 30 of the Colorado Revised Statutes, the Local Government Budget Law (C.R.S. §29 -1 -101, et. seq.), and the TABOR Amendment (Colorado Constitution, Article X, Sec. 20). AUTHORIZATION: COUNTY OF EAGLE, STATE OF COLORADO, By and Through Its BOARD OF COUNTY COMMISSIONERS (i' A III., . 2 Jon Stavney airman Date UNITED STATES DEPARTMENT OF AGRICULTURE ANIMAL AND PLANT HEALTH INSPECTION SERVICE WILD ERVICES / (lok , 2r 1gA3 S -te Director, Color o Date Dir ctor, W err�e �on + �� Date r r 3 I I 3 l i I APHIS Agreement No: 13 - 73 - 6538 - Account Code: AP.RA.RX08.73.0097 COOPERATIVE SERVICE AGREEMENT REIMBURSABLE between EAGLE COUNTY, COLORADO (COOPERATOR) and UNITED STATES DEPARTMENT OF AGRICULTURE ANIMAL AND PLANT HEALTH INSPECTION SERVICE WILDLIFE SERVICES (APHIS -WS) ARTICLE 1 - PURPOSE The purpose of this agreement is to facilitate wildlife damage management (WDM) program activities for Eagle County, Colorado at the Eagle County Regional Airport in Colorado to manage conflicts caused by wildlife. The activities will include employing available technologies h an operational program as well as information transfer. ARTICLE 2 - AUTHORITY APHIS WS has statutory authority under the Act of March 2, 1931 (46 Stat. 1468; 7 U.S.C.426426b) as amended, and the Act of December 22, 1987 (101 Stat. 1329-331, 7 U.S.C. 426c), for the Secretary of Agriculture to cooperate with States, individuals, public and private agencies, organizations, and institutions in the control of wild mammals and birds that are reservoirs for zoonotic diseases, or are injurious or a nuisance to, among other things, agriculture, horticulture, forestry, animal husbandry, wildlife, and public health and safety. ARTICLE 3 - MUTUAL RESPONSIBILITIES The Cooperator and WS agree: a. Eagle County has requested APHIS -WS to conduct a comprehensive Wildlife Hazard Assessment (WHA) which will identify factors contributing to wildlife hazards atEagle County Regional Airport over a 12 -month period. APHIS -WS will then create a Wildlife Hazard Management Plan (WHMP) within four months of the completion of the Wildlife Hazard Assessment. The project is expected to take a total of 16 months. b. APHIS -WS will formulate, in writing, a Work and Financial Plan which addresses thesixteen months of the project. The Cooperator and APHIS -WS must mutually agree to acceptable terms and conditions, and sign, the Work and Financial Plans which upon execution will be incorporated into this Agreement. c. When either of the Cooperating parties address the media or incorporate information into reports and /or publications, both Cooperating parties mustmutually agree, in writing, to have their identities disclosed when receiving due credit related to the activities covered by this Agreement. d. That APHIS -WS has advised the Cooperator that other private sector service providers may be available to provide wildlife management services and notwithstanding these other options, Cooperator requests that APHIS -WS provide wildlife management services as stated under the APHIS Agreement No: 13 - 73 - 6538 - Account Code: AP.RA.RX08.73.0097 terms of this Agreement. ARTICLE 4 - COOPERATOR RESPONSIBILITIES The Cooperator agrees: a. To designate, Greg Phillips, Airport Manager, Eagle County Regional Airport, P. 0. Box 850, Eagle CO 81631, 219 Eldon Wilson Road Gypsum, Eagle, CO 81637; 970 - 328 -2687 as the authorized representative who shall be responsible for collaboratively administering the activities conducted in this Agreement All financial or other obligations of Eagle County under this Agreement must be approved by the County Manager or Eagle County Boart of County Commissioners in accordance with County policy. b. To reimburse APHIS -WS for costs, not to exceed the approved amount specified in the Work and Financial Plan attached here to as Exhibit A If costs are projected to exceed the amount reflected in the Financial Plan, the Work and Financial Plan shall be formally revised and signed as mutually agreed by both parties before services resulting in additional costs are performed. The Cooperator agrees to pay all costs of service submitted via an invoice within 30 days of the date of the submitted invoice or invoices as submitted by APHISWS. Late payments are subject to interest, penalties, and administrative charges and costs as set forth under the Debt Collection Improvement Act of 1996. If the Cooperator is delinquent in paying the full amount of the due service costs submitted by APHIS: WS, and /or is delinquent in paying the due late payments, and /or is delinquent in paying the interest, penalties, and /or administrative costs on any delinquent due service costs, APHIS -WS will immediately cease to provide the respective service associated with the submitted service costs. APHIS_WS will not reinstate or provide the respective service until all due service costs, and /or due late payments, and /or due interest, penalty, and /or administrative costs are first paid in full. c. To provide a Tax Identification Number or Social Security Numberin compliance with the Debt Collection Improvement Act of 1996. Notwithstanding the foregoing, APHIS -WS acknowledges that Eagle County is a tax exempt entity. d. As a condition of this Agreement, The Cooperator ensures and certifies that it is not current debarred or suspended and is free of delinquent Federal debt. e. Notwithstanding anything to the contrary contained in this Agreement, Eagle County shall have no obligations under this Agreement, nor shall any payments be made in respect of any period after December 31st of each calendar year during the term of this Agreement, without the appropriation therefor by County in accordance with the budget adopted by the Board of County Commissioners in compliance with the provisions of Article 25, Title 30 of fie Colorado Revised Statutes, the Local Government Budget Law (C.R.S. §29 -1 -101, et. seq.), and the TABOR Amendment (Colorado Constitution, Article X, Sec. 20). ARTICLE 5 — APHIS -WS RESPONSIBILITIES APHIS -WS agrees: a. To designate WS Colorado State Director; 303 -236 -5810; 12345 West Alameda Parkway, Suite 2 • APHIS Agreement No: 13- 73 -08- 6538 -RA Account Code: AP.RA.RX08.73.0097 204, Lakewood, CO 80228 as the authorized representative who shall be responsible for collaboratively administering the activities conducted in thisagreement; b. The performance of wildlife damage management actions by APHIS -WS under this agreement is contingent upon a determination by APHIS -WS that such actions are in compliance with the National Environmental Policy Act, Endangered Species Act, and any other applicable environmental statutes. APHIS -WS will not make a final decision to conduct requested wildlife damage management actions until it has made the determination of such compliance; c. To provide personnel and other resources necessary to implement the approved WDM program Work and Financial Plan; d. To bill the Cooperator for costs incurred in performing WDM activities in Eagle County Regional Airport, CO as authorized in the approved annual Work and Financial Plan as may be amended; e. Authorized auditing representatives of the Cooperatorshall be accorded reasonable opportunity to inspect the accounts and records of WS pertaining to such claims for reimbursement to the extent permitted by Federal laws and regulations. ARTICLE 6 - APPROPRIATIONS For costs borne by APHIS -WS, this agreement is contingent upon the passage of the Agriculture, Rural Development, and Related Agencies Appropriation Act for the current fiscal year from which expenditures may be legally met and shall not obligate APHIS upon failure of Congress to so appropriate. This Agreement also may be reduced or terminated if Congress provides APHIS funds only for a finite period under a Continuing Resolution. ARTICLE 7 - ASSURANCES Nothing in this agreement shall prevent any other State, agency, organization or individual from entering into separate agreements with APHIS -WS or the Cooperator for the purpose of managing wildlife damage. ARTICLE 8 — CONGRESSIONAL RESTRICTIONS Pursuant to Section 22, Title 41, United States Code, no member of or delegate to Congress shall be admitted to any share or part of this agreement or to any benefit to arise therefrom. ARTICLE 9 — APPLICABLE REGULATIONS All WDM activities will be conducted in accordance with applicable Federal, State, and local laws and regulations. This agreement is not a procurement contract (31 U.S.C. 6303), nor is it considered a grant (31 U.S.C. 6304). In this agreement, APHIS provides goods or services on a cost recovery basis to nonfederal recipients. 3 APHIS Agreement No: 13 - 73 - 6538 - Account Code: AP.RA.RX08.73.0097 ARTICLE 10 — AGREEMENT EFFECTIVE DATE This agreement shall become effective on final signature and shall continue through March 1, 2018. This agreement may be amended at any time by mutual agreement of the parties in writing. It may be terminated by either party upon 60 days written notice to the other party Further, that in the event the Cooperator does not for any reason reimburse expended funds, WS is relieved of the obligation to continue any operations under this agreement. AUTHORIZATION: COUNTY OF EAGLE, STATE OF COLORADO, By and Through Its BOARD OF , 1 NTY COMMISSIONERS il 1 , Y, Jon Stave hairman Date UNITED STATES DEPARTMENT OF AGRICULTURE ANIMAL AND PLANT HEALTH INSPECTION SERVICE WILDLIFE SERVICES if i 2 -t4 -13 Sta • ► " ire r tor, Co ora• • • Date £ , 1 a 3 /u /13 Dire- or, We :1 -rn Reg n Date 4 According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0579-0335. The time OMB Approved required to complete this information collection is estimated to average .059 hours per response, including the time for reviewing instructions, 0579 -0335 searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. UNITED STATES DEPARTMENT OF AGRICULTURE ANIMAL AND PLANT HEALTH INSPECTION SERVICE 1 2 03 / 01 / 2013 WILDLIFE SERVICES Work Initiation MM DD YYYY WORK INITIATION DOCUMENT FOR WILDLIFE DAMAGE MANAGEMENT Document Number 3. TYPE OF WORK INITIATION DOCUMENT (mark all that apply): r . z a- Airport District 0 ® Private Property ❑ Temporary ❑ Non - Private Property Assign to These Special Groups F. ert b. U c % ❑ Adjacent Landowner ❑ Addendum to a ❑ Amendment to Existing c. Work Initiation Doc. Work Initiation Doc- d 4. Cooperators Name Eagle County Regional Airport Last First Middle 5 Cooperators Address 219 Eldon Road Gypsum Street City N Where will work be performed? On airport property o (give address or directions, if different from above) r— co nT 6. BusinesstFa fRanch/or Common Name Eagle County Regional Airport 7. CO 81637 State ZIP Code 8- Owners or Representative's Name 9- 970 -328 - 2680 (If different from Cooperators) Cooperator Telephone Number 10 Owners or Representative's Address (if different from Cooperator's) Street City State ZIP code 11. WS Employee and Work Location 12- Land Class Information: 13. Adjoining Property Work 14. Species Information: Information: Land Class Acres Information Document Number(s): Kendra Cross 1 1 1 Coyotes WS Employee Name 0 2. 2. 2 Wyoming Ground Squirrels U w Jefferson 3 3. a co County 4. 4- 4. Co Total Acres ❑ 15. If box is checked, attachment State lists additional species. 16- In consideration of the benefits to be derived from the proper management of damage caused by those species listed in Section 3 Item 14- (and Item 15 -, if applicable), I, the undersigned cooperator or cooperators representative, do hereby give my consent and concurrence to the Animal and Plant Health Inspection Service (APHIS) (to include its officials, ' employees, and agents) to use, upon lands owned, leased, or otherwise controlled by me, and identified by this Work Initiation Document, the following methods and devices: z O P. COMPONENTS: 1 Pneumatics 2, Shooting 3. Harassment 4 Aluminum Phosphide 5. Zinc Phosphide _ 6. Trapping (raptor,cage traps) co ❑ If box is marked, an attachment lists additional methods or devices - 17- I, the cooperator or cooperators representative, have been informed of the methods and the manner in which the control materials and devices listed in Section 4 vdll w be used, and of the possible hazards associated with their use 1 understand that APHIS, (to include its officers, employees and agents) wilt exercise reasonable z precautions to safeguard all persons to prevent injury to animal life other than those listed in Section 3, Item 14. and Item 15., if applicable); p P J ry (and pp � ); guard against the mishandling p of control devices and materials; and exercise due caution and proper judgment in all wildlife damage management operations. I understand that APHIS, WS, will maintain w restricted use pesticide application records on applications made under the Work Initiation Document, and that APHIS, WS, WIII provide copies of the records or record m information promptly upon the property owners or cooperator's request. I understand that APHIS may collect Global Positioning System (GPS) coordinates at the project site as part of component or activity tracking or as wildlife disease monitoring or research data. 18. In consideration of these understandings and of the benefits to be derived, I, the cooperator or cooperator's representative, agree to: take reasonable precautions to w prevent injury to livestock and other domestic animals; assume responsibility for injury to my property under my control, when said injury is not the result of negligence on z the part of APHIS; assist in maintaining such waming signs as APHIS may place for the purpose of notifying persons entering onto such lands of the possible hazards j associated with wildlife damage management measures in use thereon; and to give adequate waming of these possible hazards to r 9 9 9 eq 9 Po persons I authorize to enter onto such w lands. Further, in recognition of the benefits to be derived from the use of specified methods and devices authorized by this Work Initiation Document, I, the cooperator or co cooperators representative, agree not to concurrently use or allow to be used upon lands covered by this Work Initiation Document, any toxic material that rrught _ reasonably be expected to take a species listed above in Section 3, Item 14. (and Item 15., if applicable) unless such use of said toxicant is agreed to by APHIS in writing_ SPECIAL CONSIDERATIONS: SIG. • ! RE AND TITLE (La .. er, essee, or Administrator) TELEPHONE NUMBER ADDRESS DATE (11-0'r - yo K gib P g(pb6 t O �I(413l I �/ SIGNA D TITLE (APHIS Representative} TELEPHONE NUMBER ADDRESS DATE 303-236-5815 12345 W. Alameda Pkwy. Ste 204 1/25/2013 Lakewood, CO 80228 WS FORM 12A MAR 2010 Instructions for Completing WS Forml2A Work Initiation Document for Wildlife Damage Management Section 1 — Basic Work Initiation Information Item 1. Work Initiation Document Number - Record the assigned number for this document. 2. Date - Enter the date the form is completed. 3. Type of Document - Record the type of Work Initiation Document by marking the appropriate box(es). Hint: A Work Initiation Document may have more than one characteristic. Example: A Work Initiation Document can be a Temporary and Urban Document. Assign to Special Groups: If this Work Initiation Document is to be tracked by special groups which are serviced, list them in this item. Section 2 — Items in this Section capture data about the Cooperator 4. Enter name of cooperator as it appears on the cooperative service agreement, cooperative service field agreement, Memorandum of Agreement or Understanding, or as it appears in the cooperator's business references. 5. Enter the cooperator's address and alternate address or location if the primary address is different from the site where the work will be done. 6. Enter the name of the cooperator's business, farm, or ranch, if applicable. 7. Enter the State abbreviation and the ZIP Code. 8. Enter the name of the owner or cooperator's representative if it is different from the cooperator name, the area code, and telephone number of the owner. 9. Enter the Cooperator's telephone number, including the area code. 10. Enter the property owner's address (or property owner's representative's work address if this is a non - private agreement), including the ZIP Code even if it is the same as item 6. NOTE: If the cooperator's address in Item 5 is also the address of the owner, you need not complete this item. Section 3 — Information about the WS employee conducting activities, the property being worked on, and the species being addressed is captured in this Section 11. Employee Name, County and State - In this subsection, record the name of the WS employee, and the State and county for the site where the work is being performed. 12. Land Class - Record the land class being worked on, and enter the number of acres for that land class. Record the total acres by summing all entries in the "Acres" column. 13. Adjoining Property - If the Work Initiation Document allows you to work on an adjoining property as part of the project, you must have additional Work Initiation Documents signed by those adjoining land owners /managers. The Work Initiation Document numbers for those properties go in this subsection. 14. Species /Codes - List the names of the species that will be targeted during the damage management activities. Official MIS abbreviations for the names of the species may be used. 15. Additional Species - If more species are targeted than can be entered in this block, mark this box and attach the WS Form 12A Addendum listing them. Section 4 — Component Use Information 16. Components - List the type of components that will be used in the wildlife damage management activity. If more components are to be used than can be entered in the available space, mark this box in this Section and attach the WS Form 12A Addendum listing them. Section 5 — Work Initiation Considerations — WS Responsibilities 17. Allow the cooperator to read this section, or alternately, read it to the cooperator before signatures are affixed. Section 6 — Work Initiation Considerations — Cooperator Responsibilities 18. Allow cooperator to read this section, or alternately, read it to the cooperator before signatures are affixed. Section 7 — Special Considerations 19. Special Considerations - If any special considerations are agreed to for this project, enter them in this Section. Section 8 — Signatures /Dates 20. Obtain the signature and address of the landowner, lessee, administrator, or representative of the project land(s). Enter a date when the document was signed. 21. The WS employee completing the form signs and enters the official title, telephone number, address, and date. Provide a copy to the cooperator after signature; keep one copy for your files, provide one copy to the State Office, and provide copies to other WS personnel /offices, as appropriate. The Privacy Act Notice required to be given to the cooperator is on the back of the Cooperator Copy of this form. Privacy Act Notice Title 5, United States Code, Section 552a(e)(3) requires that each agency that maintains a system of records provide each individual from whom the agency solicits information with the following information. Authority for Requesting Information Title 7, United States Code, Section 426 -426c, and Title 16 United States Code, Section 667, authorizes officers, agents, and employees of USDA, APHIS, Wildlife Services, to conduct a program of wildlife service's and to enter into agreements with States, local jurisdictions, individuals, and public and private agencies, organizations, and institutions for the purpose of conducting such services. Nature of Your Disclosure of Information Disclosure of information solicited by USDA, APHIS, and Wildlife Services, is voluntary. Principal Purpose for Which the Information is Solicited Information is solicited from you for the purpose of executing and implementing agreements for control of wildlife damage. Routine Uses Which May be Made of the Information The routine uses which may be made of the information are: Routine use 1 permits disclosure to cooperative State government officials, employees, or contractors, as necessary to carry out the program; and other parties engaged to assist in administering the program. Such contractors and other parties will be bound by the nondisclosure provisions of the Privacy Act. This routine use assists the agency in carrying out the program, and thus is compatible with the purpose for which the records are created and maintained; Routine use 2 permits disclosure to the appropriate agency, whether Federal, State, local, or foreign, charged with the responsibility of investigating or prosecuting a violation of law or of enforcing, implementing, or complying with a statute, rule, regulation, or order issued pursuant thereto, of any record within this system when information available indicates a violation or potential violation of law, whether civil, criminal, or regulatory in nature, and either arising by general statute or particular program statute, or by rule, regulation, or court order issued pursuant thereto; Routine use 3 permits disclosure to the Department of Justice when the agency, or any component thereof, or any employee of the agency in his/her official capacity, or any employee of the agency in his /her individual capacity where the Department of Justice has agreed to represent the employee, or the United States, in litigation, where the agency determines that litigation is likely to affect the agency or any of its components, is a party to litigation or has an interest in such litigation, and the use of such records by the Department of Justice is deemed by the agency to be relevant and necessary to the litigation; provided, however, that in each case, the agency determines that disclosure of the records to the Department of Justice is a use of the information contained in the records that is compatible p e with the purpose for which the records were collected; Routine use 4 pen disclosure for use in a proceeding before a court or adjudicative body before which the agency is authorized to appear, when the agency, or any component thereof, or any employee of the agency in his /her official capacity, or any employee of the agency in his /her individual capacity where the agency has agreed to represent the employee, or the United States, where the agency determines that litigation is likely to affect the agency or any of its components, is a party to litigation or has an interest in such litigation, and the agency determines that use of such records is relevant and necessary to the litigation; provided, however, that in each case, the agency determines that disclosure of the records to the court is a use of the information contained in the records that is compatible with the purpose for which the records were collected; Routine use 5 permits disclosure to appropriate agencies, entities, and persons when the agency suspects or has confirmed that the security or confidentiality of information in the system of records has been compromised; the agency has determined that as a result of the suspected or confirmed compromise there is a risk of harm to economic or property interests, a risk of identity theft or fraud, or a risk of harm to the security or integrity of this system or other systems or programs (whether maintained by the agency or another agency or entity) that rely upon the compromised information; and the disclosure made to such agencies, entities, and persons is reasonably necessary to assist in connection with the agency's efforts to respond to the suspected or confirmed compromise and prevent, minimize, or remedy such harm. Routine use 6 permits disclosure to USDA employees or contractors, partner agency employees or contractors, or private industry employees to identify patterns, trends, or anomalies indicative of fraud, waste, or abuse. Routine use 7 permits disclosure to the National Archives and Records Administration or to the General Services Administration for records management inspections conducted under 44 U.S.C. §§ 2904 and 2906. Effects of Failure to Furnish Information Failure to provide the solicited information will not subject you to penalties or adverse consequences.