Form 3-2338 Application Cover Sheet

This space for agency use

OMB No. 1018-0123
Expiration Date: XX/XX/XXXX

APPLICATION COVER

1. PROGRAM

PAGE
(See instructions on page 3)
2. APPLICANT ORGANIZATION
a.
b.

Organization Name:
Number and Street:
City and State:
Country and Postal Code/Zip code +4:

c. DUNS Number:
d. EIN (if applicable):
e. Grant Administrator Name:
Grant Administrator Email:
Grant Administrator Telephone:
3. PROJECT TITLE

4. FINANCIAL INFORMATION
a.

Amount Requested from USFWS

USD

b.

Applicant Contribution

USD

c.

Secured Partner Contributions

USD

d.

Pending Partner Contributions

USD

e.

Total Project Cost

USD

5. PROJECT INFORMATION
a.

Project location (region or protected area and country)

b.

Project coordinates (latitude and longitude)

c.

Proposed period of project activity

6. PROJECT PERSONNEL
a.

Project Manager:

b.

Alternate Contact:

Title:

Title:

Organization:

Organization:

Telephone:

Telephone:

Email:

Email:

Number and Street:
City and State:
Country and Postal code:
7. ADDITIONAL INFORMATION
a.

Does your organization have active registration in the System for Award
Management (SAM)?

b.

Is your organization required to submit an A-133 audit report?

c.

Will your project involve financial or in-kind support to security forces?

d.

Do you have secured or pending funds from other US Government
agencies?

e.

Are you submitting this same project proposal to other USFWS programs?

f.

Does your organization have a NICRA?

YES

NO

FWS FORM 3-2338
REV XX/XX

OMB No. 1018-0123
Expiration Date: XX/XX/XXXX

8. PERMISSION TO SHARE THIS APPLICATION WITH THIRD PARTIES
The U.S. Fish and Wildlife Service is interested in engaging partners for international wildlife conservation. To
achieve this goal we may share your proposal with qualified organizations or individuals that have the potential to
enhance the proposed conservation effort. If you prefer that your proposal not be shared, please check this box
9. CERTIFICATION
I certify that I have examined
this application and
accompanying
documentation, and to the
best of my knowledge and
belief the information
contained herein are true,
correct, and complete.

SIGNATURE OF AUTHORIZED REPRESENTATIVE

DATE REQUEST
SUBMITTED

TYPED OR PRINTED NAME AND TITLE

NOTICE
In accordance with the Paperwork Reduction Act (44 U.S.C. 3501), please be advised that:
1.

The gathering of information from potential grant recipients is authorized under Section 8 of the Endangered Species Act of 1973, as amended (16

U.S.C. 1531-43); the African Elephant Conservation Act (16 U.S.C. 4201-4203, 4211-4214, 4221-4225, 4241-4246); the Rhinoceros and Tiger Conservation Act
(16 U.S.C. 5301-5306); the Asian Elephant Conservation Act (16 U.S.C. 4261-4266); the Great Ape Conservation Act (16 U.S.C. 6301-6305); and the Marine
Turtle Conservation Act (P.L. 108-266).
2.

The submission of requested information is required for all entities competing for financial assistance awards under the Wildlife Without Borders

Programs and the Multinational Species Conservation Funds.
3.

You are not required to respond to a collection of information unless it displays a currently valid OMB control number.

4.

This information collection has been approved by OMB and assigned clearance number 1018-0123.

5.

The requested information may be subject to disclosure under provisions of the Freedom of Information Act (5 U.S.C. 552).

The public reporting burden for the information collected on this form is 1 hour. This burden estimate includes time for reviewing instructions, gathering data, and
completing and reviewing form. The public reporting burden for completing a full proposal is 21 hours, which amounts to a total estimated time of 22 hours to
fully respond to this information collection.

FWS FORM 3-2338
REV XX/XX

OMB No. 1018-0123
Expiration Date: XX/XX/XXXX

4d

INSTRUCTIONS
1

been signed with a donor organization.

Select program name from the drop down box or, if completing a

5a

Conservation Fund; Asian Elephant Conservation Fund; Great Ape

5b

site or project headquarters.

and Tiger Conservation Fund; Wildlife Without Borders programs:
Critically Endangered Animals.
2a

Legal name of the organization or individual submitting the application.

2c

U.S. Government-wide policy requires all applicant organizations and
individuals, both domestic and non-domestic, to apply for, and include
a Dun & Bradstreet Data Universal Number System (DUNS) number

5c
6a

or

to

your

6b

7a

2d

information.
7b

7c

2e

and/or use force.
7d

contributions but should be noted and explained in detail in the body of
your proposal.

who will receive all grant-related documentation from FWS. The Grant
address you provide must accept delivery of express/courier mail

7e

proposal.

your in-country courier service will deliver express/courier mail to your

3

Project title should reflect the nature of the work to be performed, and
include specifics on the location and country where the work will take

If ‘Yes,’ in the body of your application please list any other US Fish &
Wildlife Service grant programs to which you are submitting this project

(DHL/FedEx/Airborne Express). Do not provide a P.O. Box unless
P.O. Box.

Funds provided by another U.S. Federal Government agency or another
US Fish & Wildlife Service award cannot be reported as matching

In the event an award is granted, the Grant Administrator is the person
Administrator may also serve as the Project Manager. The mailing

“Security forces” for this purpose are defined as: park rangers, police,
customs officials, or anyone with authority to detain, confiscate, arrest,

Employer Identification Number or Tax Identification Number.

not required to provide a Taxpayer Identification Number.

An A-133 audit report is only necessary if your organization has expended
more than $500,000 of Federal assistance in the past year.

Required for all U.S.-based organizations. If you are located outside
the United States and do not pay employees within the U.S., you are

All applicants must have “Active” status in the System for Awards
Management (SAM) to receive funding. See the NOFA for more

system. An application will not be considered eligible for funding until
the applicant provides a valid DUNS number

The Alternate Contact Person should be available in the absence of
the Project Manager and should be familiar with project activities.

updating changes to their address or business name with Dun &
an award is made must match the information in Dun & Bradstreet’s

The Project Manager is the primary person responsible for overseeing
other questions related to the proposal.

Applicants who already have a DUNS number are responsible for
Bradstreet directly. The organizational address to be used in the event

Enter the month and year of the start and end of the project.

project activities, and can be contacted for technical, biological, or

on their application. Applicants without a DUNS number should go to
country-specific D&B website to request a new DUNS number.

Enter the latitude and longitude of the project site in decimal degrees.
If there are multiple project sites, identify coordinates for the primary

Conservation Fund; Marine Turtle Conservation Fund; Rhinoceros
Africa, Western Hemisphere, Eurasia, Amphibians in Decline, and

List either the protected area or region, and the country in which the
project will take place.

printed form, write the name of the grant program under which you are
submitting your application. The programs are: African Elephant

http://fedgov.dnb.com/webform/pages/CCRSearch.jsp

Enter the total of all pending contributions from other partners, in U.S.
dollars. Pending funds are those for which an agreement has not yet

7f

If ‘No,’ you may request a maximum of 10% indirect cost rate, and include
a statement in your budget justification. For more information on
Negotiated Indirect Cost Rate Agreements, see the NOFA.

place.
4a

Enter the amount requested from the US Fish & Wildlife Service, in
U.S. dollars.

4b

Enter the amount your organization will contribute to the project, in
U.S. dollars. These funds may also be referred to as matching funds.

4c

Enter the total of all secured contributions from other partners, in U.S.
dollars. Secured funds are those for which an agreement has been
signed and the funds have been committed.

FWS FORM 3-2338
REV XX/XX