Download:
pdf |
pdfFEDERAL FISH AND WILDLIFE PERMIT APPLICATION FORM
Notice of Transfer or Sale of Migratory Waterfowl
(Migratory Bird Treaty Act, 50 CFR 21.25)
U.S. Fish and Wildlife Service
Division of Migratory Bird Management
FWS Form 3-186 (Rev. 01/2020)
U.S. Department of the Interior
OMB Control No. 1018-0022
Expires ##/##/####
BEFORE FILLING OUT THIS FORM, please read the form instructions (below), and access the
Return Addresses (to obtain the email/postal mail addresses where this form can be returned).
SENDER (Permittee)
RECIPIENT
Permit Number:_____________
Name:
Name:
Address:
Address:
City:
Zip Code:
State:
City
Phone Number:
Phone Number:
E-mail Address:
E-mail Address:
DATE OF SHIPMENT:
Zip Code:
State:
METHOD OF MARKING (excluding eggs):
BIRDS AND/OR EGGS TRANSFERRED
Number of
Species
Males
Females Eggs
Species
Number of
Males
Females
Eggs
I certify that the information submitted above is true and correct to the best of my knowledge. I understand that making a false
statement may subject me to the criminal penalties of 18 U.S.C. 1001.
_______________________________________ _______________
____________
Permittee’s Signature
Date
Instructions for Completing Form 3-186
If you are...
selling, trading, or giving
away migratory waterfowl
directly to the recipient,
1.
2.
3.
4.
5.
conducting your
transaction by mail,
________________________________
Date
Recipient’s Signature
1.
2.
3.
4.
then you need to do the following:
You (the seller) must complete all sections of the form and sign the certification, even if you
are giving the birds or eggs as a gift.
Make sure that the recipient of the birds or eggs (whether buying them or receiving them as a
gift) signs the certification.
Give the recipient the original copy of the completed form.
Retain one copy as your record of the transaction.
Mail one copy to the Regional FWS Migratory Bird Permit Office responsible for your State
before the end of the month in which you transfer the birds or eggs.
You (the seller) must complete all sections of the form and sign the certification, even if you
are giving the birds or eggs as a gift.
Send the completed form to the recipient of the birds or eggs (whether buying them or
receiving them as a gift) on the date the birds are shipped.
a. Have the recipient sign the certification.
b. Have the recipient keep the original copy and return a copy to you.
Retain one copy as your record of the transaction.
Mail one copy to the Regional FWS Migratory Bird Permit Office responsible for your State
before the end of the month in which you transfer the birds or eggs.
USFWS Use Only
Date Received
______/_____/_____
Initials:
Page 1 of 2
FWS Form 3-186 (Rev. 07/2019)
U.S. Department of the Interior
OMB Control No. 1018-0022
Expires ##/##/####
NOTICES
PRIVACY ACT STATEMENT
Authority: The information requested is authorized by the Migratory Bird Treaty Act (MBTA) (16 U.S.C. 703 et seq.)
and Parts 13 and 21 of Title 50 of the Code of Federal Regulations.
Purpose: To collect the contact information of participating parties in the transfer or sale of migratory waterfowl and to
monitor the take and disposition of migratory birds.
Routine Uses: The information will be used by the Regional FWS Migratory Bird Permit Office to verify that the transfer
or sale of migratory waterfowl is in compliance with the individual’s Federal Waterfowl and Disposal permit. More
information about the routine uses may be found in the Systems of Records Notice, FWS-21 Permits System.
Disclosure: Providing the information is required as a condition of maintaining a Federal permit under the MBTA.
Failure to disclose the requested information may be sufficient cause for revocation of the permit. If the information
indicates a violation of a statute, regulation, rule, order or license, whether civil, criminal, or regulatory in nature, the
information may be transferred to the appropriate Federal, State, local or foreign agency charged with investigating or
prosecuting such violations.
PAPERWORK REDUCTION ACT STATEMENT
In accordance with the Paperwork Reduction Act (44 U.S.C. 3501), the U.S. Fish and Wildlife Service collects
information necessary to used to monitor take and disposition of migratory birds under the applicable laws governing the
requested activity, for which a permit is requested, and 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 process applications for permits authorized under the above laws. Failure
to provide all requested information may be sufficient cause for the U.S. Fish and Wildlife Service to deny the request. A
ccording 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. 1018-0022.
ESTIMATED BURDEN STATEMENT
We estimate public reporting for this collection of information averages 12 minutes (electronically) to 15 minutes (paperbased), 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: PRB (JAO/3W), Falls
Church, VA 22041-3803, or via email at Info_Coll@fws.gov. Please do not send your completed form to this address.
Page 2 of 2
File Type | application/pdf |
File Title | U.S. Fish and Wildlife Service Form 3-186 |
Subject | Notice of Transfer or Sale of Migratory Waterfowl Report Form |
Author | U.S. Fish and Wildife Service |
File Modified | 2023-02-27 |
File Created | 2014-07-09 |