Usfws Form 3 177 PDF Details

Are you familiar with the United States Fish and Wildlife Service (USFWS) Form 3 177? If not, no worries - this blog post seeks to provide a comprehensive overview of the USFWS form 3177: what it is, how it's used, where to find it, and who must fill out the form. Read on for all the details! Intended primarily for wildlife professionals or those involved in licensing activities related to domestic animals and aquatic life forms, this information will help ensure you understand everything about this important federal government document.

QuestionAnswer
Form NameUsfws Form 3 177
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesfish and wildlife form 3 177, usfws declaration form 3 177, form 3177, 3 177 fish wildlife

Form Preview Example

__ __
14c. Identifier Number: _________________ ID Type: ________________
15b. Identifier Number: _________________ ID Type: ________________
15c. Contact Name: ______________________________________________
14b. Country Code
14a. (Indicate One) (Complete name/foreign address/telephone number/e-mail address)
_____ Foreign Importer
_____ Foreign Exporter
10. Bonded Location for Inspection:
11. Number of Cartons Containing Wildlife:
12. Markings on Cartons Containing Wildlife:
Address Here

USFWS Form 3-177 (Rev. 10/2017)

OMB Control No. 1018-0012

Expires 09/30/2019

1.Date of Import/Export: (mm/dd/yyyy)

2.Import/Export License Number:

3. Indicate One: _____ Import

_____ Export

4.Port of Clearance: ______________________

5.Purpose Code: __________

6.Customs Document Number (s)

U.S. FISH AND WILDLIFE SERVICE DECLARATION FOR IMPORTATION OR EXPORTATION OF

FISH OR WILDLIFE

7.Name of Carrier:

8.Air Waybill or Bill of Lading Number: Master: ______________________________

House: ________________________________________

9. Transportation Code: ______________

_________________

_____________________

License #

State or Province

13a. (Indicate One) (Complete name/U.S. address/telephone number/e-mail

address)

Address Here

_____

U.S. Importer

 

_____

U.S. Exporter

 

13b. Identifier Number: _________________ ID Type: ________________

15a. Customs Broker, Shipping Agent or Freight Forwarder:

(Complete business name/address/telephone and fax number/e-mail address)

Species

Code

(Official Use

Only)

16a. Scientific Name

------------------------------------------------------------

16b. Common Name

17a. Foreign CITES Permit

Number

-----------------------------------------

17b. U.S. CITES

Permit Number

18a Description

Code

---------------------

18b Source

Code

19a

Quantity/Unit

-------------------

19b. Total

Monetary Value

20.Country of Species

Origin Code

(ISO Code)

44284428

21.

Venomous

Live Wildlife

Indicator

(Check if yes)

Knowingly making a false statement in a Declaration for Importation or Exportation of Fish or Wildlife may subject the declarant to the penalty provided by 18 U.S.C. 1001 and 16 U.S.C. 3372(d)

For Official Use Only

Action/Comments:

Wildlife Declared: ___Yes ___ No

Wildlife Inspected:

None/ Partial / Full

22.I certify under penalty of perjury that the information furnished is true and correct:

_________________________________ _________________

SignatureDate

________________________________________________________________________

Type or Print Name

See Reverse Side of this Form for Required Notices

NOTICES

PRIVACY ACT STATEMENT

Authority: The information requested is authorized by the Endangered Species Act (ESA)(16 U.S.C. 1531-1544), Title 50, Parts 14, 15, 16, 17, 18, 21, 22 and the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) [TIAS 8249, 27

U.S.T. 1087], 50 CFR 23.

Purpose: The ESA makes it unlawful to import or export fish, wildlife, or plants without filing a declaration or report deemed necessary for enforcing

the ACT or upholding CITES (see 16 U.S.C. 1538 (e)).

Routine Uses: The collected information is used to provide information about imports or exports, including products and parts, to facilitate en- forcement of the Act and other wildlife laws and regulations including the provisions of CITES. The information enables the Service to enforce any

regulations that pertain to the wildlife contained in a shipment. We also use the information as an enforcement tool and management aid to monitor the international wildlife market and detect trends and changes to the trade of fish, wildlife, and wildlife products. More information about routine

uses can be found in the Systems of Records Notice, Permits System, FWS-20.

Disclosure: The information requested in this form is voluntary. However, submission of the requested information is required to enforce any regu- lations that pertain to the wildlife contained in the shipment. Failure to provide the requested information may be sufficient cause for the U.S. Fish &

Wildlife Service to deny the import or export of wildlife.

PAPERWORK REDUCTION ACT STATEMENT

In accordance with the Paperwork Reduction Act (44 U.S.C. 3501), the U.S. Fish and Wildlife Service collects required information about imports or exports, including products and parts, to facilitate enforcement of the Act and other wildlife laws and regulations including the provisions of the Convention on International Trade in Endangered Species of Wild Fauna and Flora. Information collected is also used to respond to requests made under the Freedom of Information Act and the Privacy Act of 1974. Information requested in this form is purely voluntary. However, submission

of requested information is required in order to enforce any regulations that pertain to the wildlife contained in the shipment. Failure to provide all requested information may be sufficient cause for the U.S. Fish and Wildlife Service to deny the import or export of wildlife. According to the Paper-

work 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 currently valid OMB control number. OMB has approved this collection of information and assigned Control No. 1018-0012.

ESTIMATED BURDEN STATEMENT

We estimate the public burden to complete this form to be 15 minutes by hand, or 10 minutes electronically, including time for reviewing instruc-

tions, gathering and maintaining data and completing and reviewing the form. Direct comments regarding the burden estimate or any other aspect of the form to the Service Information Clearance Officer, Fish and Wildlife Service, U.S. Department of the Interior, 5275 Leesburg Pike, MS: BPHC,

Falls Church, VA 22041-3803. Please do not send your completed form to this address.

USFWS Form 3-177 (Rev. 10/2017)

U.S. FISH AND WILDLIFE SERVICE

OMB Control No. 1018-0012

DECLARATION FOR IMPORTATION

Expires 09/30/2019

OR EXPORTATION OF

 

 

FISH OR WILDLIFE

 

CONTINUATION SHEET

 

 

Page ____ of ____

13. Name of U.S. Importer or Exporter:

8.Air Waybill or Bill of Lading Number: Master: ______________________________

House: ________________________________________

Species

Code

(Official Use

Only)

16a. Scientific Name

------------------------------------------------------------

16b. Common Name

17a. Foreign CITES Permit

Number

-----------------------------------------

17b. U.S. CITES

Permit Number

18a Description

Code

---------------------

18b Source

Code

19a

Quantity/Unit

-------------------

19b. Total

Monetary Value

20.Country of Species

Origin Code

(ISO Code)

44284428

21.

Venomous

Live Wildlife

Indicator

(Check if yes)

Knowingly making a false statement in a Declaration for Importation or Exportation of Fish or Wildlife may subject the declarant to the penalty provided by 18 U.S.C. 1001 and 16 U.S.C. 3372(d)

For Official Use Only

22.I certify under penalty of perjury that the information furnished is true and correct:

_________________________________________ _________________

SignatureDate

___________________________________________________________________________________

Type or Print Name

See Reverse Side of this Form for Required Notices

How to Edit Usfws Form 3 177 Online for Free

3 177 fish can be completed in no time. Just make use of FormsPal PDF tool to perform the job right away. The tool is consistently updated by our staff, getting awesome functions and becoming even more convenient. Starting is easy! Everything you need to do is adhere to the following easy steps below:

Step 1: Click on the "Get Form" button above on this page to get into our editor.

Step 2: When you access the file editor, you will see the document all set to be completed. Other than filling out various blank fields, you can also do other things with the form, namely adding custom textual content, modifying the original text, adding images, affixing your signature to the form, and more.

To be able to finalize this PDF form, ensure that you provide the required information in each and every blank field:

1. For starters, when completing the 3 177 fish, start with the section with the following blank fields:

Step number 1 for completing usfws declaration form 3 177

2. When this part is filled out, go to type in the suitable information in these - b Common Name, b US CITES Permit Number, b Source, b Total, Code, Monetary Value, ISO Code, Indicator Check if yes, Knowingly making a false statement, I certify under penalty of, For Official Use Only, Wildlife Declared Yes No, Wildlife Inspected None Partial, Signature, and Date.

Wildlife Declared Yes No, Code, and b Source of usfws declaration form 3 177

3. In this particular step, check out USFWS Form Rev OMB Control No, US FISH AND WILDLIFE SERVICE, Page of, Name of US Importer or Exporter, OR EXPORTATION OF, FISH OR WILDLIFE, CONTINUATION SHEET, Air Waybill or Bill of Lading, Species Code, Official Use, Only, a Scientific Name, a Foreign CITES Permit, a Description, and Number. All these need to be filled out with utmost precision.

How to complete usfws declaration form 3 177 stage 3

4. This next section requires some additional information. Ensure you complete all the necessary fields - Knowingly making a false statement, and I certify under penalty of - to proceed further in your process!

Filling out segment 4 in usfws declaration form 3 177

5. The pdf must be finalized by dealing with this segment. Here you can find an extensive set of blank fields that need specific details to allow your document usage to be complete: Knowingly making a false statement, I certify under penalty of, For Official Use Only, Signature Date, Type or Print Name, and See Reverse Side of this Form for.

Part number 5 in filling out usfws declaration form 3 177

As for See Reverse Side of this Form for and Signature Date, make certain you do everything properly in this section. The two of these could be the key fields in this page.

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