Form 3-200-61 Federal Fish and Wildlife Permit Application Form

	Department of the Interior U.S. Fish and Wildlife Service CITES EXPORT PROGRAMS		OMB No. 1018-0093 Expires XX/XX/2017
Return to: Division of Management Authority (DMA) U.S. Fish and Wildlife Service 4401 N. Fairfax Drive, Room 212 Arlington, VA 22203 1-800-358-2104 or 703-358-2104		Type of Activity: American Ginseng Export Program (CITES) STATE OR TRIBE: __________________________ HARVEST YEAR: ____________________________ PREPARED BY: _____________________________

If the information requested has not changed from last year, please indicate “No Change.”
Below, please provide the amount of ginseng harvested.
SOURCE OF GINSENG	HARVESTED (lbs.)	CERTIFIED (lbs.)	ESTIMATED NUMBER OF ROOTS PER POUND
WILD*
WILD SIMULATED (not reported as wild)
ARTIFICIALLY PROPAGATED (as defined under 50 CFR 23.64)
Program administered by (Department or Agency name):
Ginseng certification by (Department or Agency name):
Has the State or State’s enabling legislation, ginseng regulations or ginseng certification form been modified in the last year? If yes, please provide a copy.
Does the State or Tribal agency certify all wild ginseng harvested? If no, when would the agency not certify wild ginseng harvested in the State or on the Tribal lands, and can uncertified ginseng be sold or transported outside the State or Tribe?
Does the State or Tribal agency certify all artificially propagated ginseng harvested? If no, when would the agency not certify artificially propagated ginseng harvested in the State or on the Tribal lands?Can uncertified ginseng be sold or transported outside the State or Tribe?
When does State or Tribal agency certify wild/artificially propagated ginseng (e.g., at time of harvest, at time of sale)?
How does the State or Tribal agency handle wild/artificially propagated ginseng entering the State or Tribe from another State or Tribe? Is this procedure the same for both certified (by another State or Tribe) and uncertified ginseng?

Do all resident and non-resident individuals and companies dealing in (i.e., buying or selling) ginseng in the State or Tribe have to be registered or licensed? If no, please explain.

Can wild and/or artificially propagated ginseng be sold at any time during the year?

How often are dealers required to report the sale, purchase or export of ginseng (e.g., monthly, quarterly)?

Does the State or Tribe track unsold and/or un-exported ginseng from one season or one year to the next? Please explain.

What is the wild ginseng harvest season in the State or Tribe?

Does the State or Tribe have a harvest season for artificially propagated ginseng? If so, what is it?

Within the wild and artificially propagated ginseng reported above, are there other sub-categories of ginseng production that are tracked in the State or Tribe? If so, please describe each sub-category (e.g., woods grown, wild simulated) and, if available, what quantities have been harvested and certified in the last year?

Is there a minimum allowable size/age for the harvest of wild and/or artificially propagated ginseng in the State or Tribe?

Is harvest of wild ginseng allowed on State or Tribal lands?

Does the State or Tribe require ginseng diggers to be licensed?

Does the State or Tribe require ginseng diggers to have written permission from private landowners before harvesting? Do dealers need to supply copies of these written permissions when having ginseng certified?

Please provide the average age of wild-harvested ginseng in the State or Tribal lands?

Please provide an estimate of the average number of roots per pound (dry weight) of wild ginseng harvested in the State or on the Tribal lands for the last harvest season, and describe the methodology used to calculate the estimate.

Does the State or Tribe require or encourage diggers to plant seeds from harvested wild ginseng plants at the site of harvest? If so, please describe any guidelines. Does the State or Tribe allow diggers to plant ginseng seeds from other sources (e.g., commercial sources)?

Based on the best available information, what is the effect of the current harvest level of American ginseng in the State or on Tribal lands on the wild population? (e.g., positive, negative, no impact)

Please provide an assessment of the status of ginseng in the State or on Tribal lands (i.e., stable, increasing, declining). If population levels are increasing or declining, please provide the State or Tribe’s professional assessment of the reason for the change and any steps being taken to address declining populations.

On a separate sheet of paper, please provide a brief description of any research, including ginseng population monitoring, being conducted in your State or Tribe on American ginseng.

Please provide details of any ginseng-related violations found and/or prosecuted in the State or on Tribal lands during the last year.

________________________________________________________________________________________________________________

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?

___ Yes ___ No 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.

Data Sheet for Wild American Ginseng

County	Wild ginseng harvested (lb. dry weight)	Present abundance of wild ginseng* (0,1,2,3)	Current trend in wild ginseng populations** (-2,-1,0,+1)
County	Wild ginseng harvested (lb. dry weight)	Present abundance of wild ginseng* (0,1,2,3)	Current trend in wild ginseng populations** (-2,-1,0,+1)

* Present abundance of ginseng:

0=absent, 1=rare, 3=frequent

** Trend in wild ginseng populations:

-2=extirpated, -1=decreasing, 0=stable, +1=increasing

FEDERAL FISH AND WILDLIFE PERMIT

Paperwork Reduction Act, Privacy Act, and Freedom of Information Act – Notices

In accordance with the Paperwork Reduction Act of 1995 (44 U.S.C. 3501, et seq.) and the Privacy Act of 1974 (5 U.S.C. 552a), please be advised:

1. The gathering of information on fish and wildlife is authorized by:

(Authorizing statutes can be found at: http://www.gpoaccess.gov/cfr/index.html and http://www.fws.gov/permits/ltr/ltr.html

a. Bald and Golden Eagle Protection Act (16 U.S.C. 668), 50 CFR 22;

b. Endangered Species Act of 1973 (16 U.S.C. 1531-1544), 50CFR 17;

c. Migratory Bird Treaty Act (16 U.S.C. 703-712), 50 CFR 21;

d. Marine Mammal Protection Act of 1972 (16 U.S.C. 1361, et. seq.), 50 CFR 18;

e. Wild Bird Conservation Act (16 U.S.C. 4901-4916), 50 CFR 15;

f. Lacey Act: Injurious Wildlife (18 U.S.C. 42), 50 CFR 16;

g. Convention on International Trade in Endangered Species of Wild Fauna and Flora (TIAS 8249), http://www.cites.org/, 50 CFR 23;

h. General Provisions, 50 CFR 10;

i. General Permit Procedures, 50 CFR 13; and

j. Wildlife Provisions (Import/export/transport), 50 CFR 14.

2. 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. We may not conduct or sponsor and you are not required to respond to a collection of information unless it displays a currently valid OMB control number.

3. Certain applications for permits authorized under the Endangered Species Act of 1973 (16 U.S.C. 1539) and the Marine Mammal Protection Act of 1972 (16

U.S.C. 1374) will be published in the Federal Register as required by the two laws.

4. Disclosures outside the Department of the Interior may be made without the consent of an individual under the routine uses listed below, if the disclosure is

compatible with the purposes for which the record was collected. (Ref. 68 FR 52611, September 4, 2003)

a. Routine disclosure to subject matter experts, and Federal, Tribal, State, local, and foreign agencies, for the purpose of obtaining advice relevant to making a

decision on an application for a permit or when necessary to accomplish a FWS function related to this system of records.

b. Routine disclosure to the public as a result of publishing Federal Register notices announcing the receipt of permit applications for public comment or

notice of the decision on a permit application.

c. Routine disclosure to Federal, Tribal, State, local, or foreign wildlife and plant agencies for the exchange of information on permits granted or denied to

assure compliance with all applicable permitting requirements.

d. Routine disclosure to Captive-bred Wildlife registrants under the Endangered Species Act for the exchange of authorized species, and to share information

on the captive breeding of these species.

e. Routine disclosure to Federal, Tribal, State, and local authorities who need to know who is permitted to receive and rehabilitate sick, orphaned, and injured

birds under the Migratory Bird Treaty Act and the Bald and Golden Eagle Protection Act; federally permitted rehabilitators; individuals seeking a permitted

rehabilitator with whom to place a bird in need of care; and licensed veterinarians who receive, treat, or diagnose sick, orphaned, and injured birds.

f. Routine disclosure to the Department of Justice, or a court, adjudicative, or other administrative body or to a party in litigation before a court or adjudicative

or administrative body, under certain circumstances.

g. Routine disclosure to the appropriate Federal, Tribal, State, local, or foreign governmental agency responsible for investigating, prosecuting, enforcing, or

implementing statutes, rules, or licenses, when we become aware of a violation or potential violation of such statutes, rules, or licenses, or when we need to

monitor activities associated with a permit or regulated use.

h. Routine disclosure to a congressional office in response to an inquiry to the office by the individual to whom the record pertains.

i. Routine disclosure to the Government Accountability Office or Congress when the information is required for the evaluation of the permit programs.

j. Routine disclosure to provide addresses obtained from the Internal Revenue Service to debt collection agencies for purposes of locating a debtor to

collect or compromise a Federal claim against the debtor or to consumer reporting agencies to prepare a commercial credit report for use by the FWS.

5. For individuals, personal information such as home address and telephone number, financial data, and personal identifiers (social security number, birth date,

etc.) will be removed prior to any release of the application.

6. The public reporting burden on the applicant for information collection varies depending on the activity for which a permit is requested. The relevant burden

for a/an American Ginseng Export Program application varies from 2 to 85 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 Clearance Officer, U.S. Fish and Wildlife Service, Mail Stop 2042-PDM, U.S. Department of the Interior, 1849 C Street,

NW, Washington D.C. 20240.

Freedom of Information Act – Notice

For organizations, businesses, or individuals operating as a business (i.e., permittees not covered by the Privacy Act), we request that you identify any

information that should be considered privileged and confidential business information to allow the Service to meet its responsibilities under FOIA. Confidential

business information must be clearly marked "Business Confidential" at the top of the letter or page and each succeeding page and must be accompanied by a

non-confidential summary of the confidential information. The non-confidential summary and remaining documents may be made available to the public under

FOIA [43 CFR 2.13(c)(4), 43 CFR 2.15(d)(1)(i)].

DO NOT RETURN THIS PAGE WITH THE APPLICATION

Form 3-200-61 Rev. 02/2014 Page 4 of 5