Form 3 200 46 PDF Details

In order to ensure your nonprofit organization is in compliance with Form 3 200 46 regulations, it is important to understand what the form entails. This article will provide an overview of the information requested on Form 3 200 46, as well as offer some tips for completing the form. By understanding what is required on Form 3 200 46, you can be sure that your nonprofit is meeting all necessary reporting requirements.

QuestionAnswer
Form NameForm 3 200 46
Form Length7 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 45 sec
Other nameswildlife d complete, permit complete export online, permit d export, s permit export

Form Preview Example

Form 3-200-46

OMB Control No. 1018-0093

 

Expires 08/31/2020

Department of Interior

U.S. Fish and Wildlife Service

Federal Fish and Wildlife Permit Application Form

U.S. Fish and Wildlife Service Division of Management Authority Branch of Permits, MS: IA 5275 Leesburg Pike

Falls Church, VA 22041-3803

1-800-358-2104 or 703-358-2104

Type of Activity

IMPORT/EXPORT/RE-EXPORT OF PERSONAL PETS under the Convention on International Trade in Endangered Species (CITES) and/or the U.S. Endangered Species Act (ESA)

Complete Sections A or B, and C, D, and E of this application. U.S. address may be required in Section C, see instructions for details.

Instructions on how to make your application complete and help avoid unnecessary delays are attached.

Section A: Complete if applying as an individual

1.a. Last Name

 

1.b.

First Name

1.c. Middle Name/Initial

1.d. Suffix

 

 

 

 

 

 

2. Date of Birth (mm/dd/yyyy)

3. Telephone Number

3.a.

Alternate Telephone Number

4. E-mail address

 

 

 

 

 

 

 

Section B: Complete if applying on behalf of a business, corporation, public agency, Tribe, or institution

1.a. Name of business, agency, Tribe, or institution

 

1.b. Doing business as (DBA)

 

 

 

 

 

 

 

 

 

 

2.

Tax identification no.

 

 

 

3. Description of business, agency, Tribe, or institution

 

 

 

 

 

 

 

 

4.a. Principal officer Last name

4.b. Principal officer First Name

 

4.c. Principal officer Middle name/initial

 

4.d. Suffix

 

 

 

 

 

 

 

 

5.

Principal officer title

 

6. Primary contact name

 

 

 

 

 

 

 

 

 

 

 

7.a. Business telephone number

7.b. Alternate telephone number

 

7.c. Business fax number

7.d. Business e-mail address

 

 

 

 

 

 

 

 

Section C: All applicants complete address information

1.a. Physical address (Street address; Apartment #, Suite #, or Room #; no P.O. Boxes)

1.b. City

1.c. State

1.d. Zip code/Postal code

1.e. County/Province

1.f. Country

 

 

 

 

 

2.a. Mailing address (include if different than physical address; include name of contact person if applicable)

 

 

 

 

 

 

 

2.b. City

2.c. State

2.d. Zip code/Postal code

2.e. County/Province

2.f.Country

 

 

 

 

 

Section D: All applicants MUST complete

1.Attach the nonrefundable application processing fee in the form of a check or money order payable to the U.S. FISH AND WILDLIFE SERVICE in the amount of $50. Federal, Tribal, State, and local government agencies, and those acting on behalf of such agencies, are exempt from the processing fee – attach documentation of fee exempt status as outlined in instructions [50 CFR 13.11(d)].

2.Certification: I hereby certify that I have read and am familiar with the regulations contained in Title 50 Part 13 of the Code of Federal Regulations and the other applicable parts in subchapter B of Chapter I of Title 50, and I certify that the information submitted in this application for a permit is complete and accurate to the best of my knowledge and belief. I understand that any false statement herein may subject me to the criminal penalties of 18 U.S.C. 1001.

Signature of applicant/Principal Officer for permit (No photocopied or stamped signatures) Date of signature (mm/dd/yyyy)

Please continue to next page

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Form 3-200-46

OMB Control No. 1018-0093

 

Expires 08/31/2020

E.IMPORT/EXPORT/REEXPORT OF PERSONAL PETS (CITES and/or Wild Bird Conservation Act) Note: This form is for the one-time import, export, or re-export of pets.

•If you are a U.S. resident and intend to travel with your pet in and out of the United States several times over the next few years, use form 3-200-64 to apply for a U.S. CITES Certificate of Ownership.

•This form may also be used by non-U.S. residents, with pet birds intending to travel to the United States under a foreign CITES Certificate of Ownership, applying for a matching 3-year WBCA permit.

•Please review our webpage “Personal Pets” for important guidance and reminders Personal Pets Information.

Complete all questions on the application. Mark questions that are not applicable with "N/A". If needed, use separate sheets of paper. On all attachments or separate sheets you submit, indicate the application question number you are addressing. For each individual animal listed provide documentation. Be sure to indicate which animal is being addressed in each response.

1.Name and address where you wish the permit to be mailed, if different from page 1 (All permits will be mailed via the U.S. Postal Service, unless you identify an alternative means below). If you wish expedited delivery, please provide a self-addressed, pre-paid, computer-generated courier service airway bill.

2.Who should we contact if we have questions about the application? (Include name, phone number, and e- mail):

3.Disqualification factor. A conviction, or entry of a plea of guilty or nolo contendere, for a felony violation of the Lacey Act, the Migratory Bird Treaty Act, or the Bald and Golden Eagle Protection Act disqualifies any such person from receiving or exercising the privileges of a permit, unless such disqualification has been expressly waived by the Service Director in response to a written petition. (50 CFR 13.21(c)) Have you or any of the owners of the business, if applying as a business, been convicted, or entered a plea of guilty or nolo contendere, forfeited collateral, or are currently under charges for any violations of the laws mentioned above?

No

 

Yes

 

 

 

If you answered “Yes” provide: a) the individual’s name; b) date of charge; c) charge(s); d) location of incident;

e) court, and f) action taken for each violation. Please be aware that a “Yes” answer does not automatically disqualify you from getting a permit.

4.Are you requesting authorization to: (please check one)

Import your pets into the United States? (Only two (2) birds allowed per person for import).

___ Export your pet from the United States?

Re-Export your pet from the United States (see question 9)?

5.What is your expected date of import/export: _______________________________________

(Note: please allow 60 days, for the processing of this application.)

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Form 3-200-46

OMB Control No. 1018-0093

 

Expires 08/31/2020

6.Please provide your foreign address, including country for imports, or for exports/re-exports provide a U.S. address:

Name:

Street Address:

City:

State/Province:

Country, Postal Code:

7. For EACH pet to be imported or exported provide the following: If needed, use separate sheets of paper.

Scientific name

Common

Hatch date

Sex

Permanent

Household

Source

Country where

(genus, species, and, if

Name

mm/dd/yyyy

 

marking1

name

(wild/

the animal was

applicable,

 

 

 

 

 

captive-

acquired

subspecies)

 

 

 

 

 

born)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8. What is the current location of your pet(s)?

Origin Of Your Pet: On a separate sheet of paper answer question 9 if your pet was wild-caught; question 10 if your pet was captive-born; and question 11 if you do not know the origin of your pet.

9.For animals that were wild caught:

a.If your pet was removed from the wild within the United States, provide:

i.Evidence that it was legally acquired (State authorization);

ii.The purpose for which the bird was removed from the wild; and

iii.The date the bird was removed from the wild.

iv.Documentation demonstrating the history of transactions [e.g., chain of ownership of pet(s)].

b.If your pet was removed from the wild outside the United States, provide:

i.Country of origin;

ii.Evidence that it was legally imported into the U.S. (you may refer to question 13);

iii.The purpose for which the bird was removed from the wild;

iv.The date the bird was removed from the wild; and

v.The date you acquired the bird.

vi.Documentation demonstrating the history of transactions [e.g., chain of ownership of pet(s)].

1(e.g., tattoo number, band number, microchip number, type, and location on animal, prominent scars)

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Form 3-200-46

OMB Control No. 1018-0093

 

Expires 08/31/2020

10.For animals that were captive-born:

Provide a dated and signed statement from the breeder that includes the following:

i.Scientific and common names of bird;

ii.Birth/hatch date, band/tag number or identifying markings, and sex of the animal;

iii.Name and address of the facility where the animal was bred and born;

iv.Location of parental stock; and

v.A statement that the animal was bred at the above facility.

vi.In addition, provide documentation demonstrating the history of transactions [e.g., chain of ownership of pet(s)].

11.If you do not know the origin of your pet, provide a signed and dated statement with a complete description of the circumstances under which you acquired the pet, including when, where, from whom, and any other pertinent information. Include pet store receipts or other information that would assist in determining the source of your pet.

12.For the EXPORT of an APPENDIX I bird, provide a copy of the foreign CITES import permit or evidence that one will be issued.2

13.For RE-EXPORT (bird was previously imported into the United States), provide evidence that the bird was legally imported, including:

a.Copies of canceled CITES export permits or re-export certificates issued by the appropriate CITES office in the country from which the bird was imported, and a copy of the cleared Declaration for Importation (Form 3-177).

b.If you did not make the original import, provide copies of the importer’s documents outlined above and any invoice or other documents that show you purchased or otherwise obtained the bird from the original importer. If you did not obtain the wildlife from the original importer, include documentation demonstrating the history of transactions.

c.For birds previously imported, provide a copy of your Wild Bird Conservation Act (WBCA) import authorization (non-native birds) or Migratory Bird Treaty Act authorization (native birds).

14.For pets that are pre-Convention (i.e., the pet was born or removed from the wild before the species was listed under CITES), provide documents, signed statements, or other evidence that the specimen was

obtained prior to the date CITES applied to it (i.e., bill of sale, signed breeder’s records, or signed affidavit attesting to age of animal). [If you are not sure of the listing date for the species, consult the CITES

website for CITES listed species or contact the Division of Management Authority.]

15.FOR IMPORT OF BIRDS ONLY:

a.Provide documentation that shows you have continually resided outside of the United States for at least one (1) year (from 1 year ago and the most recent month)just prior to submission of this application. (e.g., employment records, utility bills, etc.).

2If you are not sure which Appendix your pet is listed under, contact the Division of Management Authority at 800/358-2104.

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OMB Control No. 1018-0093

 

Expires 08/31/2020

b.Provide your primary addresses where you resided for the last full year consecutively.

__________________________________________

From _________To_______

__________________________________________

From _________To_______

__________________________________________

From _________To_______

c.Have you imported any non-native birds in the last 12 months? Yes ___ No ___ If yes, how many? ____________

16.If you are applying for a three-year WBCA import permit (i.e., you are a non-US resident traveling through the United States), you must provide a copy of your valid foreign CITES Certificate of Ownership (Pet Passport).

17.For the EXPORT of a migratory bird (listed in 50 CFR 10.13), provide Federal and State permit or license numbers that authorize possession and acquisition, where such document is required.

18.Transport conditions must comply with the CITES Guidelines for Transport of Live Animals or, in the case of air transport, with the International Air Transport Association (IATA) (http://iata.org) live animal regulations (contact airlines for additional information). Please provide a description of the shipping conditions including:

a.The type, size, and construction of any shipping container; and

b.The arrangements for watering or otherwise caring for your pet during transport.

19.When travelling with your pet, there may be animal health requirements specific for that destination. As soon as you know your travel details, contact your local veterinarian to assist with the pet travel process. Factors to consider may include meeting time frames for obtaining a health certificate, updating vaccinations, diagnostic testing, or administration of medications/ treatments. Please contact: https://www.aphis.usda.gov/aphis/pet-travel

20.Be aware that certain States require pet possession certificates. Contact your State Conservation Agency for pertinent requirements, and submit copies of applicable documentation with your application.

21.CERTIFICATION STATEMENT (All applicants must complete with an original signature)

I understand that the purpose for the pet(s) identified in this application is to import, export, or re-export my personally owned pet(s) and I have no intention of selling the pet(s) or using the pet(s) for any commercial activity.

Applicant’s signature: _______________________________________ Date: _________________

22.All international shipment(s) of wildlife must be declared to the U.S. Fish and Wildlife Service at the time of export/import. A list of designated ports (where a wildlife inspector is posted) is available from the list of designated ports. If you wish to use a port not listed, additional authorization to use a non-designated port will be required. If you wish to use several different non-designated ports, you may be required to contact the Office of Law Enforcement for additional authorization.

Enter the U.S. port(s) through which the [export/re-export/import] is anticipated to occur:

_____________________________________________________________.

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Form 3-200-46

OMB Control No. 1018-0093

 

Expires 08/31/2020

APPLICATION FORM INSTRUCTIONS

The following instructions pertain to U.S. Fish and Wildlife Service (FWS) permit applications. The General Permit Procedures in 50 CFR 13 address the permitting process. For simplicity, all licenses, permits, registrations, and certificates are referred to as a permit.

GENERAL INSTRUCTIONS:

•Complete all relevant questions in Sections A or B, C, D, and E.

•An incomplete application may cause delays in processing or may be returned to the applicant. Be sure you are filling in the appropriate application form for the proposed activity.

•Print clearly or type in the information. Illegible applications may cause delays.

•Sign the application. Faxes or copies of the original signature will not be accepted.

•Mail the original application to the address at the top of page one of the application or, if applicable, on the attached address list.

•Keep a copy of your completed application.

•Please plan ahead. Allow at least 60 days for your application to be processed, however, some applications may take longer than 90 days to process (50 CFR 13.11).

•Applications are processed in the order they are received.

SECTION A OR SECTION B:

Section A. Complete if applying as an individual [do not complete if importing/exporting under an Import/Export License.]:

•Enter the complete name of the responsible individual who will be the permittee if a permit is issued. Enter personal information that identifies the applicant. Fax and e-mail, while helpful in processing, are not required.

•If you are applying on behalf of a client, the personal information must pertain to the client, and a document evidencing power of attorney must be included with the application.

•Affiliation/ Doing business as (dba): business, agency, Tribe, organizational, or institutional affiliation directly related to the activity requested in the application (e.g., a taxidermist is an individual whose business can directly relate to the requested activity). The Division of Management Authority (DMA) and the Office of Law Enforcement (OLE) do not accept doing business as affiliations for individuals (complete Section B).

Section B. Complete if applying as a business, corporation, public agency, Tribe, or institution:

•Enter the complete name of the business, agency, or institution that will be the permittee if a permit is issued. Give a brief description of the type of business the applicant is engaged in. Provide contact phone number(s) of the business. If you are applying on behalf of a client, a document evidencing power of attorney must be included with the application.

•Principal Officer is the person in charge of the listed business, corporation, public agency, Tribe, or institution. The principal officer is the person responsible for the application and any permitted activities. Often the principal officer is a Director or President. Primary Contact is the person at the business, corporation, public agency, or institution who will be available to answer questions about the application or permitted activities. Often this is the preparer of the application.

ALL APPLICANTS COMPLETE SECTION C:

•For all applications submitted to the Division of Management Authority (DMA), a physical U.S. address is required.

•Mailing address is the address to which communications from USFWS should be mailed if different from applicant’s physical address.

ALL APPLICANTS COMPLETE SECTION D:

Section D.1 Application processing fee:

•An application processing fee is required at the time of application, unless exempted under 50 CFR13. The application processing fee is assessed to partially cover the cost of processing a request. The fee does not guarantee the issuance of a permit, nor will fees be refunded for applications for which processing has begun.

•Documentation of fee exempt status is not required for applications submitted by Federal, Tribal, State, or local government agencies; but must be supplied by those applicants acting on behalf of such agencies. Such applications must include a letter on agency letterhead and signed by the head of the unit of government for which the applicant is acting on behalf, confirming that the applicant will be carrying out the permitted activity for the agency.

Section D.2 CERTIFICATION:

•The individual identified in Section A, the principal officer named in Section B, or person with a valid power of attorney (documentation must be included in the application) must sign and date the application. This signature legally binds the applicant to the statement of certification. You are certifying that you have read and understand the regulations that apply to the permit. You are also certifying that all information included in the application is true to the best of your knowledge. Be sure to read the statement and re- read the application and your answers before signing.

ALL APPLICANTS COMPLETE SECTION E

Please continue to next page. DO NOT RETURN THIS PAGE WITH THE APPLICATION

Rev. 8/2017

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Form 3-200-46

OMB Control No. 1018-0093

 

Expires 08/31/2020

NOTICES

Privacy Act Statement

Authority: The information requested is authorized by the following: the Bald and Golden Eagle Protection Act (16 U.S.C. 668), 50 CFR 22; the Endangered Species Act (16 U.S.C. 1531-1544), 50 CFR 17; the Migratory Bird Treaty Act (16 U.S.C. 703-712), 50 CFR 21; the Marine Mammal Protection Act (16 U.S.C. 1361, et seq.), 50 CFR 18; the Wild Bird Conservation Act (16 U.S.C. 4901-4916), 50 CFR 15; the Lacey Act: Injurious Wildlife (18 U.S.C. 42), 50 CFR 16; Convention on International Trade in Endangered Species of Wild Fauna and Flora (TIAS 8249), 50 CFR 23; General Provisions, 50 CFR 10; General Permit Procedures, 50 CFR 13; and Wildlife Provisions (Import/export/transport), 50 CFR 14.

Purpose: The collection of contact information is to verify the individual has an eligible permit to conduct activities which affect protected species. This helps FWS monitor and report on protected species and assess the impact of permitted activities on the conservation and management of species and their habitats.

Routine Uses: The collected information may be used to verify an applicant’s eligibility for a permit to conduct activities with protected wildlife; to provide the public and the permittees with permit related information; to monitor activities under a permit; to analyze data and produce reports to monitor the use of protected wildlife; to assess the impact of permitted activities on the conservation and management of protected species and their habitats; and to evaluate the effectiveness of the permit programs. More information about routine uses can be found in the System of Records Notice, Permits System, FWS-21.

Disclosure: The information requested in this form is voluntary. However, submission of requested information is required to process applications for permits authorized under the listed authorities. Failure to provide the requested information may be sufficient cause for the U.S. Fish & Wildlife Service to deny the request.

PAPERWORK REDUCTION ACT STATEMENT

We are collecting this information subject to the Paperwork Reduction Act (44 U.S.C. 3501) in order provide the U.S. Fish and Wildlife Service the information necessary, under the applicable laws governing the requested activity, for which a permit is requested. Information requested in this form is purely voluntary. However, submission of requested information is required in order to process applications for permits authorized under the applicable laws. Failure to provide all requested information may be sufficient cause for the U.S. Fish and Wildlife Service to deny the request. 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 currently valid OMB control number. OMB has approved this collection of information and assigned Control No. 1018-0093.

ESTIMATED BURDEN STATEMENT

Public reporting for this collection of information varies depending on the activity for which a permit is requested. The relevant burden for FWS Form 3-200-46 is 30 minutes including time for reviewing instructions, 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 application to this address.

Rev. 8/2017

Page 7 of 7

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The right way to fill in permit wildlife d stage 1

2. When this segment is completed, you have to include the essential specifics in Signature of applicantPrincipal, Rev, Page of, and Please continue to next page so you can go further.

Page of, Please continue to next page, and Signature of applicantPrincipal of permit wildlife d

3. Completing mailed via the US Postal Service, Who should we contact if we have, mail, Disqualification factor A, Lacey Act the Migratory Bird, and No Yes If you answered Yes provide is essential for the next step, make sure to fill them out in their entirety. Don't miss any details!

Part no. 3 in filling out permit wildlife d

4. This next section requires some additional information. Ensure you complete all the necessary fields - Are you requesting authorization, Import your pets into the United, ReExport your pet from the United, What is your expected date of, Note please allow days for the, Rev, and Page of - to proceed further in your process!

Stage # 4 in filling out permit wildlife d

5. While you come close to the completion of the document, you'll find several more requirements that need to be met. Notably, address, Name, Street Address, City, StateProvince, Country Postal Code, For EACH pet to be imported or, Scientific name, Common, genus species and if, Name, Hatch date mmddyyyy, Sex Permanent marking, Household, and name must be filled out.

How you can prepare permit wildlife d step 5

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