Declaration for Importation or Exportation of Fish or Wildlife-Indiv (Hard Copy)

NOTICE
In accordance with the Privacy Act (5 U.S.C. 522a) and the Paperwork Reduction Act (44 U.S.C. 3501), please be advised that:
1.

The gathering of information on the importation and exportation of wildlife (any wild animal, including without limitation any wild mammal,
bird, reptile, amphibian, fish, mollusk, crustacean, arthropod, coelenterate, or other invertebrate, whether or not bred, hatched, or born in
captivity, and including any part, product, egg, or offspring thereof) is authorized by the Endangered Species Act of 1973 (16 U.S.C. 15311543) and Title 50, Parts 14 and 17, of the Code of Federal Regulations.

2.

The disclosure of the requested information is required to provide information about imports or exports, including products and parts, to
facilitate enforcement of the Act and other wildlife laws and regulations including the provisions of the Convention on International Trade in
Endangered Species of Wild Fauna and Flora (CITES).

3.

Failure to provide all of the requested information is sufficient cause for the U.S. Fish and Wildlife Service to deny you permission to
import or export wildlife.

4.

In the event there is indicated a violation of a statute, regulation, rule, order, permit, or license, whether civil, criminal, or regulatory in nature,
the requested information may be transferred to the appropriate Federal, State, local, or foreign agency charged with investigating or
prosecuting such violations.

5.

In the event of litigation involving records or the subject matter of the records, the requested information may be transferred to the U.S.
Department of Justice.

6.

7.

The requested information may be subject to disclosure under provisions of the Freedom of Information Act (5 U.S.C. 552). The U.S. Fish
and Wildlife Service will retain information from Form 3-177 for a minimum of 5 years. We will maintain the information in accordance
with a Privacy Act System of Records: Interior-FWS 20, - Investigative Case File (48 FR 54719).
You are not required to respond to a collection of information unless it displays a currently valid OMB control number.

8.

This information collection has been approved by OMB and assigned control number 1018-0012.

We estimate that it will take you about 15 minutes by hand or 10 minutes electronically to complete this form. Comments on this form should be
mailed to the Service Information Collection Clearance Officer, U.S. Fish and Wildlife Service, MS 2042-PDM, 4401 North Fairfax Drive, Arlington,
VA 22203 (mail); or [email protected] (email). Please include “1018-0012” in the subject line of your comments.