Form 3-2341 Application for Electronic Federal Duck Stamp Pilot Prog

OMB Control No. 1018-XXXX
Expiration Date: XX/XX/XXXX

APPLICATION FOR PARTICIPATION IN THE
ELECTRONIC FEDERAL DUCK STAMP PILOT PROGRAM

SELECTION FACTOR 1. The responsiveness of the applicant to the eligibility
requirements of the act. (Scored: Satisfactory/Unsatisfactory)

1A.

The Applicant agrees to comply with all terms and conditions in the application
package including compliance with all applicable laws under the terms and
conditions specified in the draft Memorandum of Understanding.
____________Yes

1B.

__________No

The State must currently sell State hunting, fishing, and other associated
licenses and products through an established electronic system, including point
of sale, or internet, or telephonic systems.
Please provide information verifying the current systems the State utilizes.

1C.

The State must issue these electronic licenses through a State automated
licensing system authorized under State law;
Please provide the appropriate reference to the applicable state laws, or
regulations or policies that authorize the use of these electronic systems.

1D.

The State must agree to terms established by the Director, Fish and Wildlife
Service for this pilot program to issue Federal Migratory Bird Hunting and
Conservation electronic stamps.
Have you included your transmittal letter attesting to the State’s unconditional
concurrence with the terms and conditions of the MOU?
_______________Yes
__________________No

FWS Form 3-2341
04/07

OMB Control No. 1018-XXXX
Expiration Date: XX/XX/XXXX

1E.

For a State to include the Federal Migratory Bird Hunting and Conservation
Stamp in its portfolio, the electronic version of the actual stamp must contain a
unique identifier for the individual to whom it is issued.
Please provide an example and explanation of the codes your State
proposes to use to create and endorse this unique identifier.

1F.

For the State to include the Federal Migratory Bird Hunting and Conservation
Stamp in its portfolio, the electronic version of the actual stamp must have the
ability to be printed on paper; as “Fed Duck Stamp”.
Please enclose a mock up copy of the printed version of your state’s proposed
electronic stamp.
Please describe the format of the electronic stamp that the State will issue
under the pilot program, including identifying features of the licensee to be
specified on the stamp.

1G.

For the State to include the Federal Migratory Bird Hunting and Conservation
Stamp in its portfolio, the electronic version of the actual stamp must be
compatible with the hunting licensing system of that State.
Is the electronic version compatible with the system of your state?
____________Yes

______No

SELECTION FACTOR 2: State’s responsiveness to the pilot program application
requirements - narrative response (satisfactory/ unsatisfactory)
The law states that the Director may NOT approve a State application unless the
application contains the following information:

FWS Form 3-2341
04/07

OMB Control No. 1018-XXXX
Expiration Date: XX/XX/XXXX

2A.

Please describe any fees the State will charge for issuance of an electronic
stamp;

2B.

Please describe the process the State will use to account for and transfer the
amounts collected by the State to the fulfillment center as required under the
program;

The contractor available for fulfillment services is Amplex Corporation. Please examine
the requirement of the contractor (Exhibit A) in answering the following question.
2C.

Please describe how and when the State will transmit electronic stamp customer
data to the fulfillment center;

2D.

Please describe how the actual stamps will be delivered; this information should
include your choice of utilizing a consignment agreement with Amplex or direct
information transfer to Amplex Corporation.

2E.

Please supply a copy of the policies and procedures the State will use to issue
duplicate electronic stamps.

FWS Form 3-2341
04/07

OMB Control No. 1018-XXXX
Expiration Date: XX/XX/XXXX

2F.

Please supply a copy of other policies, procedures, and information that relate to
this program; i.e. , Are there separate policies in other permit language that may
influence this program?

SELECTION FACTOR 3 - Stamp Requirements- the Director will require an electronic
stamp issued by a State under the pilot program have specific characteristics.
3A.

Please provide information to show that the Federal Duck Stamp issued by your
State will have the same format as any other license, validation, or privilege the
State issues under the automated licensing system of the State.

3B.

Please demonstrate what specific identifying features of the licensee will appear
on the “point of sale”, telephonic or web receipt that are adequate to enable
Federal, State, and other law enforcement officers to identify the holder. Provide
physical copies or examples where possible.

3C.

Provide information and demonstrate how you will communicate to the purchaser
and law enforcement officials in your State:

.

That any electronic stamp issued by a State under the pilot program will,
during the effective period of the electronic stamp:
1.
2.

bestow upon the licensee the same privileges as are bestowed by an
actual stamp;
be nationally recognized as a valid Federal migratory bird hunting and
conservation stamp; and

FWS Form 3-2341
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OMB Control No. 1018-XXXX
Expiration Date: XX/XX/XXXX

3.

authorize the purchaser to hunt migratory waterfowl in any other State, in
accordance with the laws of said State governing that hunting.

SELECTION FACTOR 4 - Guaranteed delivery of the physical stamp to the customer
and improved customer service and convenience.
4A.

An electronic stamp issued by a State under the pilot program will be valid for a
period of time, not to exceed 45 days. What action will you take to guarantee
timely information transfer to the fulfillment center which will allow them to meet
the time constraints in filling the order?

4B.

Please outline how your plan to resolve customer complaints regarding late,
incorrect orders or missing stamp deliveries.

SELECTION FACTOR 5 – State’s agreement to the terms and conditions outlined in the
Memorandum of Understanding governing the pilot program.
5A.

The State agrees to comply with all of the terms and conditions specified in the
Memorandum of Understanding, including its exhibits.
Yes_____________________

5B.

No________________________

Do you, the State; agree to operate at the current Service approved handling
rates (Exhibit B) during the term of the pilot until such time as a new handling

FWS Form 3-2341
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OMB Control No. 1018-XXXX
Expiration Date: XX/XX/XXXX

rate schedule is approved by the Director justifying cost recovery. (A selected
State may request a handling rate increase at any time after the selection of the
State is made by the Service.)
Yes________________________
5C.

No _______________________

If the State wishes to operate their own fulfillment operations, does the State
agree to accept the operating terms of the optional fulfillment opportunity as
outlined by Amplex on their consignment web-site? (www.duckstamp.com)
Yes_________________________ No_________________________

5D.

Does the State agree to implement an equal opportunity program and comply
with the terms of the equal opportunity and handicapped access requirements of
the draft Memorandum of Understanding?
Yes__________________ No ______________________________

5E.

Does the State agree to meet the public liability and property insurance
requirements of the draft Memorandum of Understanding?
Yes_____________________ No ______________________________

5F.

Does the State agree to the use of Electronic Funds Transfer (Exhibit C) in
transmitting funds to the State selected fulfillment center?
Yes ____________________________ No ______________________

SELECTION FACTOR 6 – Experience and financial capability. Narrative/Statistical –
(Satisfactory/Unsatisfactory)
Congress has not appropriated funds to the Service to support this Pilot Program. The
selected States understand, and concur that there will be no funding provided by the
Service to either launch or manage this program.
The Service believes that past experience provides a reasonable indication of how we
may expect the electronic Duck Stamp sales to perform. Please provide example(s) of
your State’s experience in the operation and management of electronic licensing
systems including any information you might have on customer satisfaction. Also,
please provide information on the number of transactions for each individual system
(web, phone or point-of-sale) for the years the system has been in operation, up to 6
years. This will assist us in determining a base line and measure for future performance
with this method of sales.

FWS Form 3-2341
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OMB Control No. 1018-XXXX
Expiration Date: XX/XX/XXXX

6A.

Provide complete contact information, including, name, mailing and FedEx
address, phone, fax, cell, and e-mail, for personnel who will be involved in the
state’s management and operation of the system:
Information Technology Contact:
Financial Contact:
Project Management Contact:
Stamp/Licensing Program Contact:

6B.

Demonstrate that your organization and supporting partners have a history of
meeting financial obligations.

6C.

Demonstrate your understanding of the financial obligations of the pilot program
by providing the following:

6D.

1.

Provide your estimate of the start-up costs of this pilot including the
purchase of additional equipment and technology.

2.

Explain fully the methodology and the assumptions used to develop the
estimate. The information provided must be of sufficient detail to allow a
reviewer to fully understand how you arrived at these estimates.

If you intend to assess a handling fee to cover costs or other forms of overhead
you must CLEARLY describe what this fee is comprised of (salaries, human
resources, accounting, marketing, etc.).

FWS Form 3-2341
04/07

OMB Control No. 1018-XXXX
Expiration Date: XX/XX/XXXX

Additional Instructions for statistical and financial information:
1.

Provide a clear and concise narrative explanation of the method(s) used to
prepare the estimates and the assumptions on which you base your cost and
sales projections. Information must be sufficiently detailed to allow the reviewer
to understand the basis for the estimates and decide whether or not the
projections are realistic.

2.

Failure to provide all of the information requested may result in a non-responsive
score on the evaluation.

3.

Pilot program labor costs should be supported by a schedule identifying the
estimated number of full- and part time employees involved. Provide the
estimated number of hours each part-time employee will work per year or during
the time the program is operational.

In accordance with the Privacy Act (5 U.S.C. 552a) and the Paperwork Reduction Act (44 U.S.C. 3501),
please note the following information. This information collection is authorized by the Electronic Duck
Stamp Act of 2005 (Pub. L. 109-266). We will use information that you provide to select participants for
the 3-year pilot program and to issue actual duck stamps to purchasers. It is our policy not to use your
name for any other purpose. We will maintain this information in accordance with the Privacy Act, but
may release the information under a Freedom of Information Act request (5 U.S.C. 552). Your response
is voluntary. OMB has assigned OMB Control No. 1018-XXXX, which expires XX/XX/XXXX.
Response is not required unless a currently valid OMB control number is displayed. The relevant burden
for completing this form is 40 hours. This burden estimate includes time for reviewing instructions,
gathering and maintaining data, and completing and reviewing the form. You may direct comments
regarding the burden estimate or any other aspect of the form to the Service Information Collection
Clearance Officer, Fish and Wildlife Service, Mail Stop 222, Arlington Square, U.S. Department of the
Interior, 1849 C Street, NW., Washington D.C. 20240.

FWS Form 3-2341
04/07