Form 3-200-3a Import/Export License-U.S. Entities

OMB Control No. 1018-0092
Expires:

Department of the Interior
U.S. Fish and Wildlife Service
Federal Fish and Wildlife Permit Application Form

Return to:

Type of Activity: Import/Export License – U.S. Entities*

U.S. Fish and Wildlife Service
Office of Law Enforcement
Send to the appropriate Issuing Office listed
on Page 4 for the State you listed in Block B.

New - $100.00
Renewal of I/E License #LE-________________________ $100.00
Amendment to I/E License #LE-_______________________ $50.00
Name/Address Change ONLY of Permit #LE-___________(no fee)

Complete all sections of this application.
See attached instruction pages for information on how to make your application complete and help avoid unnecessary delays.

A.

All applicants MUST complete

Name of Business (must match Company’s invoice and other permits/shipping documents)
Complete Federal Tax Identification No. or last 4 of SSN

Owner or Principal Officer
Date of Birth (mm/dd/yyyy)

Description of Business

Owner or Principal Officer Last Name Sole Owner? Yes

Owner or Principal Officer First Name

Principal Officer Email Address

URL/Web Address

Principal Officer Title
Principal Officer Telephone Number

Owner or Principal Officer Middle Name

Primary Contact Name
Alternate Telephone Number

Primary Contact Telephone Number

Primary Contact Email Address

B.
All applicants MUST complete
Address (No P.O. Boxes, Retail Postal, or Mail Service Center) (as shown on Company’s invoice and other permits/shipping documents) Where you will
receive all official notices sent from the Service.
City

State

C.

Zip code

County

All applicants MUST complete

1.

Attach check or money order payable to the U.S. FISH AND WILDLIFE SERVICE in the amount listed above. Application fees are nonrefundable.

2.

Do you currently have or have you ever had any Federal Fish and Wildlife license (or other permit)?
Yes
If yes, list the number of the most recent license/permit you have held: ________________________

3.

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.

No

__________________________________________________________________________________________________________________
Signature of Principal Officer (No photocopied or stamped signatures)
Date of Signature (mm/dd/yyyy)
* This application is for U.S. businesses that commercially import (receive into the U.S. from another country) or export (send out from the U.S. to
another country) fish or wildlife (including parts and products). Businesses must be located in the United States to use this form.
Businesses located outside the United States (no U.S. presence at all) that carry their wildlife items into or out of the United States for commercial
purposes should complete 3-200-3b.
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IMPORT/EXPORT LICENSE (U.S. Entities)
APPLICATION CONTINUATION SHEET
SECTION D: ALL APPLICANTS MUST COMPLETE

NOTE: An Import/Export License is required ONLY if you commercially import (receive into the U.S. from
another country) or export (send out from the U.S. to another country). No Import/Export License is required if
your business ships exclusively within the U.S. or its Territories.
1.

Are you the sole owner? Yes

No

(must check one)

2.

Additional Partner(s) or Additional Principal Officer(s) Information (list all – use additional pages as necessary)
Name: _____________________________________________________________________________________
Complete Federal Tax Identification Number or last 4 of SSN:_________________________________________
Date of Birth: _______________________________________________________________________________
Address/City/State/Zip (No P.O. Box, Retail Postal or Mail Service Center):______________________________
___________________________________________________________________________________________
Phone Number: ______________________________________________________________________________
Email address: _______________________________________________________________________________

3.

Are you keeping your business records concerning imports and/or exports of wildlife under this license at
the same location as Block B on page 1 of this application? Yes
No
(must check one)
50 CFR 13.46 and 14.93 describes the required records that are to be maintained for five (5) years from date of expiration of
the I/E License.

If no, provide location of business records (list all – use additional pages as necessary):
Name: _____________________________________________________________________________________
Primary Contact Name: _______________________________________________________________________
Address/City/State/Zip (No P.O. Box, Retail Postal or Mail Service Center):______________________________
___________________________________________________________________________________________
Phone Number: ______________________________________________________________________________
Email address: _______________________________________________________________________________
4.

Are you keeping your wildlife inventories concerning imports and/or exports of wildlife under this license
at the same location as Block B on page 1 of this application? Yes
No
(must check one)
50 CFR 14.93 describes the requirements regarding wildlife inventory.
If no, provide location of wildlife inventories (list all – use additional pages as necessary):
Name: _____________________________________________________________________________________
Primary Contact Name: _______________________________________________________________________
Address/City/State/Zip (No P.O. Box, Retail Postal or Mail Service Center):______________________________
___________________________________________________________________________________________
Phone Number: ______________________________________________________________________________
Email address: _______________________________________________________________________________

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IMPORT/EXPORT LICENSE (U.S. Entities)
APPLICATION CONTINUATION SHEET
5.

General description of the wildlife or wildlife products you wish to import/export. (Choose all that apply)

Perishable
Live (50 CFR 13.41 requires that wildlife possessed under a license must be maintained under humane and
healthful conditions)

Venomous
Dead
Products (Describe: food, sport hunted trophies, jewelry, footwear, carvings, etc.)_______________
___________________________________________________________________________________
Other (Describe)___________________________________________________________________
6.

Type of animal to be used as described in #5 above. (Choose all that apply)

Fish
Coral
Reptiles
Mammals
Birds
Insects/Arachnids
Other______________________________
7.

Amphibians
Molluscs (Shells)

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 (must check one)
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 (list all – use additional pages as necessary).

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Office of Law Enforcement Permit Offices
https://www.fws.gov/le/regional-permit-offices.html
Please send your application to the appropriate office.
If you are located in the following states, send your application to the address below:
Alabama, Arkansas, Connecticut, District of Columbia, Delaware, Florida, Georgia, Illinois, Indiana, Iowa,
Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, New
Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Puerto Rico, Rhode Island, South
Carolina, Tennessee, U.S. Virgin Islands, Vermont, Virginia, West Virginia, Wisconsin
U.S. Fish & Wildlife Service
Office of Law Enforcement
1875 Century Boulevard, Suite 380
Atlanta, GA 30345-3324
Phone: (404) 679-7195
Fax: (404) 679-7065
Email: [email protected]
If you are located in the following states, send your application to the address below:
Alaska, Arizona, California, Colorado, Guam, Hawaii, Idaho, Kansas, Montana, Nebraska, Nevada, New
Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Texas, Utah, Washington, Wyoming, the Pacific
Trust Territories
U.S. Fish & Wildlife Service
Office of Law Enforcement
2800 Cottage Way, W-2928
Sacramento, CA 95825-1846
Phone: (916) 414-6660
Fax: (916) 414-6715
Email: [email protected]

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PERMIT APPLICATION FORM INSTRUCTIONS
The following instructions pertain to the Form 3-200-3a that must be completed as an application for a U.S. Fish and Wildlife Service
Import/Export License (U.S. Entities). Reminder: It is a violation to import or export fish and wildlife commercially prior to
obtaining an Import/Export License.
GENERAL INSTRUCTIONS:
 Complete all blocks/lines/questions in Sections A through D.
 An incomplete application may cause delays in processing or may be returned to the applicant.
 Be sure you are completing the appropriate application form for the proposed activity.
o 3-200-3a for U.S. Entities; 3-200-3b for Foreign Entities (U.S. Agent required)
 Print clearly or type in the information. Illegible applications may cause delays.
 Sign the application. Scans, faxes or copies of the original signature will not be accepted.
 No Import/Export License will be issued if any information is missing from the application.
 Mail the original application to the appropriate address on the attached address list.
 Keep a copy of your completed application.
 Allow at least 60 days for your application to be processed. (50 CFR 13.11)
 Applications are processed in the order they are received.
COMPLETE SECTION A:
 Enter the complete name of the business who will be the Licensee if an Import/Export License is issued. If no company name
exists, then use the name (Last, First, Middle) of the owner of the business. Enter personal information that identifies the
applicant.
 We no longer will accept applications signed by anyone other than the sole owner or principal officer.
50 CFR 13.12 clearly states that the applicant must certify they read and are familiar with applicable parts of subchapter B of
Chapter I of title 50, Code of Federal Regulations. No broker, freight forwarder, etc., can certify in the applicant’s place.
This section of the regulations also calls for the signature of the applicant.
 Give a brief description of the type of business in which the applicant is engaged (e.g. Taxidermy, Jewelry, Apparel, etc.).
 Doing business as (dba): dbas are not accepted. The name on the Import/Export License must match the invoice and other
shipping documents that accompany the shipment to or from the United States.
 Principal Officer is the person in charge of the listed business. The principal officer is the person responsible for the
application and any permitted activities. Often the principal officer is a Director or President. Sole Owner should enter
“Owner” under Principal Officer Title. Primary Contact is the person at the business who will answer questions about the
application or business activities and can be the preparer of the application.
COMPLETE SECTION B:
 This is the address where you will receive all official notices sent from the Service, which must match the invoice and other
shipping documents that accompany the shipment to or from the United States.
COMPLETE SECTION C:
Application processing fee:
 An application processing fee is required at the time of application. The fee does not guarantee the issuance of an I/E
license. Fees will not be refunded for applications that are approved, abandoned, or denied. We may return fees for
withdrawn applications if no significant processing has occurred.
Federal Fish and Wildlife license/permits:
 List the number of your most recent Import/Export License even if it is no longer valid.
CERTIFICATION:
 The individual identified in Section A as sole owner or principal officer must sign and date the application. This
signature binds the applicant to the statement of certification. This means that you certify that you have read and understand
the regulations that apply to the permit. You also certify that everything 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 the application.
COMPLETE SECTION D:
 All questions must be answered. Provide additional pages as necessary. You must provide (in writing) a revised list of
additional partner(s) or principal officer(s) within 10 days of any changes.
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APPLICATION FOR A 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.ecfr.gov/ and https://www.fws.gov/le/laws-regulations.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. Response is not required unless a currently valid Office of Management and Budget (OMB) control number is
displayed on the form.

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.
b.
c.
d.
e.

f.
g.
h.
i.
j.

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.
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.
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.
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.
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.
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.
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.
Routine disclosure to a congressional office in response to an inquiry to the office by the individual to whom the record pertains.
Routine disclosure to the Government Accountability Office or Congress when the information is required for the evaluation of the permit
programs.
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. 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 an Import/Export license application is 1.25 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, U.S. Fish and Wildlife Service, MS BPHC, 5275 Leesburg Pike, Falls Church, VA
22041–3803 (mail). Please include “1018-0092” in the subject line of your comments.
Freedom of Information Act – Notice
For organizations, businesses, or individuals operating as a business (i.e., licensees 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)].

3-200-3a Revised December 2016

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