HERBARIUM DEPOSITION FORM

U.S. National Fungus Collections (BPI)
Systematic Mycology and Microbiology Laboratory
USDA-Agricultural Research Service
Room 229, Building 010A
10300 Baltimore Avenue
Beltsville, MD 20705-2350 USA
301-504-6921, FAX 301-504-5810
HerbariumBPI@ars.usda.gov

Data supplied on this form are of scientific importance; they will be entered into the BPI specimen database available on the Internet and used to generate specimen labels.

Scientific name & authority ______________________________________________________
Scientific name of host ______________________________________________________
Substrate/Plant part ______________________________________________________
Country ______________________________________________________
State & county ______________________________________________________
Additional locality data ______________________________________________________
  ______________________________________________________
  ______________________________________________________
Lat./Long., Elev. ______________________________________________________
Habitat ______________________________________________________
Date collected ______________________________________________________
Collector(s) ______________________________________________________
Collection number ______________________________________________________
Determiner ______________________________________________________
Is this a Type specimen? ______________________________________________________
Other herbarium numbers ______________________________________________________
Isolation data ______________________________________________________
Culture/GenBank numbers ______________________________________________________
Literature citation ______________________________________________________
   
Depositor ______________________________________________________
Institution ______________________________________________________
Address ______________________________________________________
  ______________________________________________________
E-mail ______________________________________________________
Date ______________________________________________________