Download:
pdf |
pdfOMB Control No. 1018-0093
Expires xx/xx/xxxx
FWS Form 3-200-47 (Rev. 02/2023)
U.S. Department of the Interior
Import of Birds for Scientific Research or Zoological Breeding and Display (WBCA)
☐New ☐Reissue/Renew ☐Amendment
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.
If you are an individual, who would be named on the face of the permit, you need to complete the Individual Applicant section of this
application.
If you are an individual seeking permits issued to yourself for activities not associated with your business or institution, you need to
complete the Individual Applicant section as an individual permittee.
If you are an individual associated with a business or institution, and the business or institution’s name would appear on the face of the
permit, you need to complete the Business Applicant section of this application.
If you are a business applying on behalf of an individual, you need to complete the Business Applicant section of this application and
include a limited power of attorney from the person for whom you represent.
A person/entity is qualified to obtain a U.S. Fish and Wildlife Service permit or license when they are "subject to the jurisdiction of the
United States", per 16 USC 1532(13). A foreign person/entity with no permanent physical presence in the United States only qualifies
for an import/export license when they physically enter or exit the U.S. with the wildlife items. The foreign entity is required to designate
a U.S. agent for purposes of record keeping.
GENERAL INSTRUCTIONS:
•
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. Items marked with an asterisk (*) are required fields.
•
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.
•
If you choose to mail your submission, mail the original application to the address listed below or, if applicable, on the attached
address list. We encourage electronic filing in the ePermits system.
•
Keep a copy of your completed application.
•
Please plan ahead. Unless otherwise indicated, 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). Longer processing times will be noted on those applications.
•
Applications are processed in the order they are received.
Individual or Business Applicants:
Individual Applicant. Complete if applying as an individual [do not complete this application if applying for Import/Export License (3200-3) or a Designated Port Exception Permit (3-200-2)]:
•
Enter the information requested. Required fields must be completed. This is used to create your profile and consumer information
in the ePermits system. If you do not have an email address, enter not applicable.
•
Doing business as (dba) / Affiliation: The Division of Management Authority (DMA) and the Office of Law Enforcement (OLE) do
not accept doing business as affiliations for individuals seeking permits on behalf of themselves. “Doing business as” affiliations
apply to individuals seeking permits for a business, agency, Tribe, organizational, or institutional affiliation directly related to the
activity requested in the application. For example, a taxidermist is an individual whose business can directly relate to the requested
activity of exporting taxidermy (dba relevant permit); however, said taxidermist should not apply as a business for permits to nonbusiness related travel with their pet exotic parrot (dba is not relevant to the permit; complete the Business Applicant section).
Page 1 of 10
FWS Form 3-200-47 (Rev. 02/2023)
U.S. Department of the Interior
OMB Control No. 1018-0093
Expires xx/xx/xxxx
Business Applicant. Complete if applying as a business, corporation, public agency, Tribe, or institution:
•
Enter the information requested. Required fields must be completed. This is used to create your contact and account information in
the ePermits system. If you do not have an email address, enter not applicable.
•
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.
•
The 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. Each person that is associated with the
business that would need to access the business account needs to create their own contact in the ePermits system.
Application processing fee:
•
An application processing fee is required at the time of application, unless exempted under 50 CFR 13. 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. Checks or money orders must be for the exact
amount for each application submitted. If you are making more than one request, you must submit a separate payment
for each request, otherwise your application will be returned.
•
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.
CERTIFICATION:
•
The individual identified in the Individual Applicant Section, the principal officer named in the Business Applicant Section, 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 THE QUESTIONS ASSOCIATED WITH YOUR APPLICATION
Please continue to next page. DO NOT RETURN THIS PAGE WITH THE APPLICATION
Mail applications to: U.S. Fish and Wildlife Service; Division of Management Authority; Branch of Permits, MS:IA; 5275 Leesburg
Pike; Falls Church, Virginia 22041-3803 or as directed by specific applications.
If you would like expedited mailing, please enclose a self-addressed, pre-paid, computer-generated, courier service airway bill. If
unspecified, all documents will be mailed via the U.S. Postal Service.
Please refer to the fee schedule for the appropriate fees for the activity you are requesting.
If you are making more than one request, you must submit a separate payment
for each request, otherwise your application will be returned.
Page 2 of 10
OMB Control No. 1018-0093
Expires xx/xx/xxxx
FWS Form 3-200-47 (Rev. 02/2023)
U.S. Department of the Interior
INDIVIDUAL APPLICANTS
*First Name
Middle Name
*Last Name
*Email Address
Telephone Number
*Street Address
*City
*State/Province
*Zip or Postal Code
*Country
If you wish to have your permit mailed to a different address, complete the following:
*Street Address
*State/Province
*City
*Zip or Postal Code
*Country
If you would like expedited mailing, please enclose a self-addressed, pre-paid, computer-generated, courier service
airway bill. If unspecified, all documents will be mailed via the U.S. Postal Service.
Have you or your client (if a broker applying on behalf of your client), been assessed a
civil penalty or convicted of any criminal provision of any statute or regulation relating to
the activity for which the application is filed; been convicted, or entered 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; forfeited collateral; OR are currently under
charges for any violation 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” response does not automatically disqualify you from getting a permit.
Page 3 of 10
OMB Control No. 1018-0093
Expires xx/xx/xxxx
FWS Form 3-200-47 (Rev. 02/2023)
U.S. Department of the Interior
Certification Statement
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 and date
Include a check or money order, payable to the U.S. FISH AND WILDLIFE SERVICE, as
a nonrefundable processing fee [50 CFR 13.11(d)(4)] (see instructions above).
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))
*Required fields. Applications without this information are subject to delays or returns.
Page 4 of 10
OMB Control No. 1018-0093
Expires xx/xx/xxxx
FWS Form 3-200-47 (Rev. 02/2023)
U.S. Department of the Interior
BUSINESS APPLICANTS
*Business Name
doing business as (dba)
*Indicate your business type:
__ Business or other for profit
__ Farm
__ Small business
__ Government (Federal/State/Local/Tribal)
__ Not-for-profit institution
Name that will appear on the permit if you are applying on behalf of an individual/business
*Primary Contact Name
*Primary Contact Email Address
*Business Email Address
*Preferred Contact Method (e.g. phone, email)
*Principal Officer Name
*Principal Officer Title
*Principal Officer Email
Tax ID Number
*Business Phone
Alternate Phone
*Street Address
*State/Province
*City
*Zip or Postal Code
*Country
If you wish to have your permit mailed to a different address, complete the following:
*Street Address
*State/Province
*City
*Zip or Postal Code
*Country
If you would like expedited mailing, please enclose a self-addressed, pre-paid, computer-generated, courier service
airway bill. If unspecified, all documents will be mailed via the U.S. Postal Service.
Page 5 of 10
OMB Control No. 1018-0093
Expires xx/xx/xxxx
FWS Form 3-200-47 (Rev. 02/2023)
U.S. Department of the Interior
Have you or your client (if a broker applying on behalf of your client), been assessed a
civil penalty or convicted of any criminal provision of any statute or regulation relating to
the activity for which the application is filed; been convicted, or entered 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; forfeited collateral; OR are currently under
charges for any violation 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” response does not automatically disqualify you from getting a permit.
Certification Statement
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 and date
Include a check or money order, payable to the U.S. FISH AND WILDLIFE SERVICE, as
a nonrefundable processing fee [50 CFR 13.11(d)(4)] (see instructions above).
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))
*Required fields. Applications without this information are subject to delays or returns.
Page 6 of 10
OMB Control No. 1018-0093
Expires xx/xx/xxxx
FWS Form 3-200-47 (Rev. 02/2023)
U.S. Department of the Interior
IMPORT OF BIRDS FOR SCIENTIFIC RESEARCH OR ZOOLOGICAL BREEDING AND DISPLAY (WBCA)
Complete all questions on the application. Mark questions that are not applicable with "N/A". Given the length of many of
the responses, please use a separate sheet of paper. On all attachments or separate sheets you are submitting; please
indicate the number of the application question you are addressing. In addition, if applying to import multiple birds, be sure
to indicate which bird is being addressed in each response.
1. For EACH species/specimen, provide:
a. Scientific name
b. Common Name
(genus, species and, if
applicable,
subspecies)
c. Actual or
Approximate
Hatch date
d. Quantity
e. Sex
(M/F)
f. Removed from the
wild or captive-bred?
2. If the bird(s) is/are still in the wild or was/were taken from the wild, include:
a. The country and specific location where the removal will occur or occurred;
b. Date specimen(s) was/were removed from the wild;
c.
A description of the status of the wild population of the species in the region of removal;
d. A copy of all foreign collecting permits or authorization letters from the proper government authority allowing for
the collection of the bird(s).
e. Provide a description of where the bird(s) is/are currently being held and of the husbandry and care currently
being provided.
3. If the bird(s) was/were captive-bred, include:
a. Specimen report; or
b. A signed statement from the breeder containing the scientific and common name certifying that the bird(s)
was/were hatched and bred by the breeder, including the name and address of the breeder, hatch date, and the
identity and location of the parental birds;
c.
Documentation showing how the bird(s) was/were acquired including the history of transactions (e.g., chain of
ownership), if applicable and
d. Documentation on the parental stock of the requested bird(s) including from where the parental stock was
originally sourced and any other information detailing their acquisition. In some instances, we may request
documentation going back more than two generations.
Page 7 of 10
FWS Form 3-200-47 (Rev. 02/2023)
U.S. Department of the Interior
OMB Control No. 1018-0093
Expires xx/xx/xxxx
4. Complete name and address of overseas person or business shipping the bird(s) to you:
Name:
Address:
City/Province:
State, County, Postal Code:
5. List all facilities that will be receiving birds from this shipment, either immediately after importation, or within the next
year. If you are unsure, of which facilities may be receiving birds (e.g., final decisions on placement have not been
made), please indicate likely candidates and the mechanism that will be used to determine recipient facilities.
6. For each facility listed in question 5, provide:
a. Detailed description and photographs (no blueprints, please) of current facilities, including the total number of
enclosures to house incoming birds, the dimensions of each enclosure for the birds intended for import, and the
number of birds to be housed in each;
b. A description of husbandry practices; and
c.
Qualifications of the personnel, within each facility receiving birds, who will be overseeing/caring for the bird(s)
(e.g., resume or brief curricula vitae (CV)).
7. If the purpose is for scientific research, include:
a. Research proposal including formal research protocol with timetable;
b. If research includes the production of progeny, include a full justification for the breeding;
c.
The relationship of such research to the conservation of the species in the wild;
d. A discussion of possible alternatives and efforts to obtain birds from other sources within the United States;
e. The disposition of the imported birds and any progeny upon completion of the research project and
f.
Qualifications of the personnel (within each facility receiving birds) conducting the research, collecting samples,
and caring for the bird(s) (brief curricula vitae are acceptable).
8. If the purpose is for zoological breeding and display, provide the following for each facility receiving birds:
a. A history of the zoological facility's breeding programs with the same or similar species, including:
i.
Participation in any cooperative breeding programs and/or efforts to collaborate with other managed zoological
breeding programs;
ii.
Breeding and inventory records for the last two years, including hatching, survival, and mortality records;
iii. Plans for developing or maintaining a self-sustaining population of the exotic bird species in captivity;
iv. Causes of any previous mortalities and corrections to prevent future mortalities.
b. The relationship of the zoological breeding and display program to the conservation of the species in the wild;
c.
The education program, including display graphics and other educational activities, provided to the public on the
ecology and/or conservation status of the species;
d. The number of visitors the facility receives annually;
e. A discussion of possible alternatives and efforts to obtain birds from other sources within the U.S.; and
f.
Plans for disposition of the birds and any progeny.
Page 8 of 10
FWS Form 3-200-47 (Rev. 02/2023)
U.S. Department of the Interior
OMB Control No. 1018-0093
Expires xx/xx/xxxx
9. The transport conditions for live animals must comply with the CITES Guidelines for Transport of Live Animals, FWS
regulations at 50 CFR 14, Subpart J. and in the case of air transport, with the International Air Transport Association
(IATA) live animal regulations (contact airline for information). As such, describe:
a. The type, size, and construction of any shipping container; and
b. The arrangements for watering or otherwise caring for the wildlife during transport.
All international shipment(s) must be through a designated port. A list of designated ports (where a wildlife inspector
is posted) is available. If you wish to use a port not listed, please contact the Office of Law Enforcement for a Designated
Port Exemption Permit (Form 3-200-2).
Page 9 of 10
OMB Control No. 1018-0093
Expires xx/xx/xxxx
FWS Form 3-200-47 (Rev. 02/2023)
U.S. Department of the Interior
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
We estimate public reporting for this collection of information to average:
Original submission - electronically and paper-based: 1 hour and 30 minutes
Amended submission - electronically and paper-based: 1 hour and 15 minutes
These estimates include 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.
Questions regarding permits from Management Authority should be sent to managementauthority@fws.gov.
Page 10 of 10
File Type | application/pdf |
Author | Harlow, Caroline I |
File Modified | 2023-02-24 |
File Created | 2023-01-24 |