Form 3-177, 3-177a 3-177, 3-177a Declaration for Importation or Exportation of Fish or Wi

USFWS Form 3-177
USFWS
Form 3-177
(Revised
03/10)
(Revised
12/03)
O.M.B.
No. 1018-0012
O.M.B.Date:
No. 1018-0012
Expiration
03/31/2013

1. Date of Import/Export: (mm/dd/yyyy)
___ ___ / ___ ___ / ___ ___ ___ ___

U.S. FISH AND WILDLIFE SERVICE
DECLARATION FOR IMPORTATION
OR EXPORTATION OF
FISH OR WILDLIFE

7. Name of Carrier:
8. Air Waybill or Bill of Lading Number:
Master:
House:

2. Import/Export License Number:
3. Indicate One: † Import
4. Port of Clearance:

†

9. Transportation Code: __________
Export

______________
License #

______________
State or Province

_______ ________

10. Bonded Location for Inspection:
5. Purpose Code: ________
6. Customs Document Number (s)

11. Number of Cartons Containing Wildlife:
12. Markings on Cartons Containing
Wildlife:

13a. (Indicate One) (Complete name/U.S. address/telephone number/e-mail address)
† U.S. Importer
† U.S. Exporter

14a. (Indicate One)
(Complete name/foreign address/telephone number/e-mail address)
† Foreign Importer
† Foreign Exporter
14b. Country Code
____ ____

Type Address Here

Type Address Here

13b. Identifier Number: __________________ ID Type: __________________
15a. Customs Broker, Shipping Agent or Freight Forwarder:
(Complete business name/address/telephone and fax number/e-mail address)

14c. Identifier Number: ____________________ ID Type: ____________________

15b. Identifier Number: __________________ ID Type: ________________

Type Address Here
15c. Contact Name: _______________________________________________
Species
Code
(Official Use
Only)

16a. Scientific Name

17a. Foreign CITES Permit
Number

18a. Description
Code

19a.
Quantity/Unit

20. Country
of Species
Origin Code

16b. Common Name

17b. U.S. CITES
Permit Number

18b. Source
Code

19b. Total
Monetary Value

(ISO Code)

21.
Venomous
Live Wildlife
Indicator ;
(Check if yes)

†
†
†
†
Knowingly making a false statement in a Declaration for Importation or Exportation of Fish or Wildlife
may subject the declarant to the penalty provided by 18 U.S.C. 1001 and 16 U.S.C. 3372(d)

22. I certify under penalty of perjury that the information furnished
is true and correct:

For Official Use Only

_______________________________ ____________

Action/Comments:

Signature

Date

______________________________________________________
Type or Print Name

Wildlife Declared:

Yes

No

Wildlife Inspected:
None / Partial / Full
See Reverse Side of this Form for Privacy Act Notice

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. 1531-1543) 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.
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. 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.
7. 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 clearance 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 Information Collection Clearance Officer, Mail Stop 2042-PDM, U.S. Fish and Wildlife Service,
4401 North Fairfax Drive, Arlington, Virginia 22203.

USFWS Form 3-177
(Revised 03/10)
O.M.B. No. 1018-0012
Expiration Date: 03/31/2013

Page ____ of _____

U.S. FISH AND WILDLIFE SERVICE
DECLARATION FOR IMPORTATION
OR EXPORTATION OF
FISH OR WILDLIFE

13. Name of U.S. Importer or Exporter:
8. Air Waybill or Bill of Lading Number:
Master:

2. Import/Export License Number:
CONTINUATION SHEET

House:
Species
Code
(Official Use
Only)

16a. Scientific Name

17a. Foreign CITES Permit Number

16b. Common Name

17b. U.S. CITES
Permit Number

18a. Description
Code

19a.
Quantity /Unit

18b. Source
Code

19b. Total
Monetary Value

20.
Country of
Species
Origin

21.
Venomous
Live Wildlife
Indicator ;

(ISO Code)

(Check if yes)

†
†
†
†
†
†
†
†
†
Knowingly making a false statement in a Declaration for Importation or Exportation of Fish or
Wildlife may subject the declarant to the penalty provided by 18 U.S.C. 1001 and 16 U.S.C.
3372(d).

22. I certify under penalty of perjury that the information furnished is true
and correct:
______________________________________________ ____________
Signature

Date

For Official Use Only

____________________________________________________________
Type or Print Name

See Reverse Side of this Form for Privacy Act Notice

FILING INSTRUCTIONS FOR DECLARATION FOR IMPORTATION OR EXPORTATION OF FISH OR WILDLIFE (USFWS FORM 3-177)
NOTE: Failure to file a declaration for importation or exportation of fish or wildlife when required by the regulations in 50 CFR Part 14 is a violation
of the Endangered Species Act of 1973 as amended (16 U.S.C. 1531 et. seq.). Regulations concerning the importation and exportation of wildlife
may be found in 50 CFR Part 14. Form 3-177 must be filed with the appropriate wildlife inspection office, U.S. Customs and Border Protection
office or regional law enforcement office as required under 50 CFR Part 14. Do not file or forward this form to the Information Collection Clearance
Officer in Arlington, Virginia.
Instructions: We strongly encourage all filers to use the U.S. Fish and Wildlife Service electronic filing system (eDecs) to reduce paper and time.
Filers may access the internet filing system at https://eDecs.fws.gov/. Filers may also access an on-line Adobe Acrobat version of Form 3-177
(http://www.fws.gov/le/pdf/3177_1.pdf) where the form can be filled in on-line and printed. Filers cannot save their completed on-line form unless
they own the Adobe Acrobat software. For filers who choose to file a paper form, you must file the original declaration, and up to 2 copies to be
retained by the Importer/Exporter or Broker. Print or type legibly. All filers are required to provide all relevant information, including supplemental
documentation (as required in 50 CFR 14).
1. Enter the date of import into, or export from, United States jurisdiction (as defined by 50 CFR 14).
2. Enter the USFWS Import/Export License Number as required in 50 CFR 14.
3. Check the appropriate box.
4. Enter the appropriate 2-letter Port code from the list below. If the Port is not listed, use the numeric code for the Region where the port is located.
*When using the numeric code, enter the name of the port. You must include a copy of your USFWS Designated Port Exception Permit in the
document package, if applicable.
Agana, GU .....................................................AG Fairbanks, AK............................................. FB Philadelphia, PA........................................... PA
Alcan, AK...................................................... AL Grand Portage, MN ....................................GP
Phoenix, AZ…………………………..……PX
Anchorage, AK.............................................. AN Highgate Springs, VT................................ .HS Port Huron, MI............................................. PH
Atlanta, GA ....................................................AT Honolulu, HI.............................................. HA Portal, ND..................................................... PL
Baltimore, MD ...............................................BA Houlton, ME.............................................. HO Portland, OR................................................. PT
Blaine, WA.................................................... BL
Houston, TX ..............................................HN
Raymond, MT.............................................. RY
Boston, MA................................................... BO
International Falls, MN............................... IF
Saipan, MP………………………...…..……SP
Brownsville, TX............................................ BV Jackman, ME............................................... JK San Diego/San Ysidro, CA………….......... SY
Buffalo/Niagara Falls, NY …………............ BN Juneau, AK.................................................. JU San Francisco, CA........................................ SF
Calais, ME..................................................... CA Laredo, TX................................................. LR
San Juan, PR.................................................. SJ
Calexico, CA................................................. CX
Las Vegas………………………...……….LV San Luis, AZ………………………….…….SL
Champlain, NY.............................................. CP
Los Angeles, CA........................................ LA Sault Saint Marie, MI................................... SS
Chicago, IL.................................................... CH Louisville, KY…………………...………..LO Seattle, WA................................................... SE
Cleveland, OH................................................ CL Lukeville, AZ............................................. LK Sumas, WA.................................................. SU
Dallas/Fort Worth, TX................................... DF McAllen, TX…………..................………MC Sweetgrass, MT........................................... SW
Del Rio, TX ...................................................DR
Memphis, TN……………….…………….ME Tampa, FL.................................................... TP
Denver, CO.................................................... DN Miami, FL................................................... MI Region 1 - Other ......................................... 01*
Derby Line, VT...............................................DL Minneapolis/St. Paul, MN......................... MP Region 2 - Other ......................................... 02*
Detroit, MI..................................................... DE New Orleans, LA .......................................NO Region 3 - Other ......................................... 03*
Douglas, AZ.................................................. DG
New York, NY........................................... NY Region 4 - Other ......................................... 04*
Dulles, VA……………………………..……DU Newark, NJ............................................... NW Region 5 - Other …..…………................... 05*
Dunseith, ND .................................................DS
Nogales, AZ............................................... NG Region 6 - Other ......................................... 06*
Eastport, ID ....................................................EA Norfolk, VA............................................... NF
Region 7 - Other ......................................... 07*
El Paso, TX.................................................... EL
Pembina, ND.............................................. PB
Region 8 - Other ......................................... 08*
5. Enter the appropriate one-letter Purpose Code from the list below.
Breeding in captivity or artificial
Biomedical research........................................M
propagation ………………………………….B Personal...........................................................P
Educational..................................................... E
Circuses/traveling exhibitions …………....... Q
Botanical gardens........................................... G Scientific......................................................... S
Hunting trophies............................................. H

Commercial …………………........................ T
Reintroduction/introduction into the wild...... Y
Zoos................................................................ Z

6. Enter the U.S. Customs and Border Protection document reference number(s) associated with the import or export, if applicable. For exports,
enter any shipper’s export declaration reference number, if applicable.
7. Enter the name of the carrier used to import or export – (airline, vessel, rail or truck company), or indicate personally owned vehicle.
8. Enter the Master and House Air Waybill number or Bill of Lading, if applicable.
9. Enter the applicable one-letter Transportation Code from the list below. For personal vehicles, also indicate the license plate number and State or
Province.
Air cargo......................................................... A Ocean cargo.................................................... O Rail.................................................................. R
Border crossing on foot.................................. B
Personal accompanying baggage ………....... P Truck (or other commercial vehicle).............. T
Mail................................................................ M
Personal vehicle ………..................................V
10. Enter the customs bonded physical location where the shipment is available for inspection.

Revised: December 2012

Page 1 of 4

FILING INSTRUCTIONS FOR DECLARATION FOR IMPORTATION OR EXPORTATION OF FISH OR WILDLIFE (USFWS FORM 3-177)
11. Indicate the quantity of cartons in the entire shipment that contain wildlife.
12. List any unique markings or codes on cartons that contain wildlife as required in 50 CFR Part 14.
13a. Check the appropriate box to indicate U.S. importer or exporter. Enter the complete name, address (in the United States), e-mail address, if
applicable, and telephone number of the U.S. importer or exporter.
13b. Enter an identifier number and the type of identifier (for example, DUNS number, U.S. Customs and Border Protection account number) for the
U.S. Importer or Exporter, if applicable.
14a. Enter the complete name, address (in the foreign country), and telephone number of the foreign importer or exporter. Enter the e-mail address if
applicable.
14b. Enter the applicable two letter ISO (International Organization for Standardization) country code from the list below.
Afghanistan……………………………….. AF Croatia.......................................................... HR Ireland, Northern…………………….……..GB
Åland Islands............................................... AX Cuba............................................................. CU Isle of Man…………....…………………….IM
Albania......................................................... AL Curacao ………………………………….. CW Israel.............................................................. IL
Algeria......................................................... DZ
Cyprus.......................................................... CY Italy................................................................ IT
Andorra....................................................... AD
Czech Republic............................................ CZ
Ivory Coast………………………………….CI
Angola......................................................... AO
Democratic Republic of Congo………...….CD
Jamaica......................................................... JM
Anguilla........................................................ AI
Denmark...................................................... DK
Japan.............................................................. JP
Antarctica.................................................... AQ
Djibouti......................................................... DJ Jersey ………………………………………JE
Antigua and Barbuda................................... AG Dominica..................................................... DM Jordan............................................................ JO
Argentina..................................................... AR
Dominican Republic.................................... DO Kazakhstan................................................... KZ
Armenia...................................................... AM
Ecuador........................................................ EC
Kenya........................................................... KE
Aruba.......................................................... AW Egypt............................................................ EG Kiribati.......................................................... KI
Australia...................................................... AU
El Salvador................................................... SV Korea, Democratic People’s Republic of
Austria......................................................... AT
England……………………………....…….GB
(North Korea).............................................KP
Azerbaijan.................................................... AZ Equatorial Guinea........................................ GQ Korea, Republic of (South Korea)……..…. KR
Bahamas....................................................... BS
Eritrea........................................................... ER Kuwait........................................................ KW
Bahrain........................................................ BH
Estonia.......................................................... EE Kyrgyzstan................................................... KG
Bangladesh.................................................. BD
Ethiopia........................................................ ET
Lao People’s Democratic Republic……......LA
Barbados...................................................... BB
Falkland Islands (Malvinas)......................... FK Latvia........................................................... LV
Belarus......................................................... BY Faroe Islands................................................ FO
Lebanon ........................................................LB
Belgium........................................................ BE Fiji................................................................. FJ
Lesotho......................................................... LS
Belize........................................................... BZ
Finland........................................................... FI Liberia.......................................................... LR
Benin............................................................. BJ France........................................................... FR Libyan Arab Jamahiriya............................... LY
Bermuda...................................................... BM French Guiana.............................................. GF Liechtenstein………………………………LI
Bhutan.......................................................... BT French Polynesia (Tahiti)............................. PF
Lithuania....................................................... LT
Bolivia......................................................... BO
French Southern Territories …………….….TF Luxembourg................................................. LU
Bonaire, Saint Eustatius and Saba……….. BQ Gabon.......................................................... GA
Macao………............................................. MO
Bosnia and Herzegovina............................. BA
Gambia........................................................ GM Macedonia...……...…................................. MK
Botswana.................................................... BW
Georgia......................................................... GE Madagascar……..………........................... MG
Bouvet Island............................................... BV Germany....................................................... DE Malawi....................................................... MW
Brazil........................................................... BR
Ghana........................................................... GH Malaysia...................................................... MY
British Indian Ocean Territory …………..... IO Gibraltar........................................................ GI
Maldives..................................................... MV
British Virgin Islands.................................. VG
Great Britain................................................ GB
Mali............................................................. ML
Brunei Darussalam...................................... BN
Greece.......................................................... GR Malta........................................................... MT
Bulgaria....................................................... BG
Greenland..................................................... GL Marshall Islands.......................................... MH
Burkina Faso................................................ BF
Grenada....................................................... GD
Martinique................................................... MQ
Burundi......................................................... BI
Guadeloupe.................................................. GP
Mauritania................................................... MR
Cambodia……………................................ KH
Guatemala.................................................... GT
Mauritius..................................................... MU
Cameroon.................................................... CM Guernsey ………………………………….GG
Mayotte........................................................ YT
Canada......................................................... CA
Guinea......................................................... GN
Mexico........................................................ MX
Cape Verde.................................................. CV
Guinea-Bissau............................................. GW Micronesia, Federated States of ………..... FM
Cayman Islands........................................... KY
Guyana......................................................... GY Moldova, Republic of................................. MD
Central African Republic............................. CF
Haiti............................................................. HT
Monaco....................................................... MC
Chad............................................................. TD Heard and McDonald Islands ………….... HM
Mongolia..................................................... MN
Chile............................................................. CL High Seas…………………………………...ZZ Montenegro……………………………… ME
China, People’s Republic of........................ CN Holy See (Vatican City State)………….….VA
Montserrat................................................... MS
Christmas Island.......................................... CX
Honduras..................................................... HN
Morocco...................................................... MA
Cocos (Keeling) Islands............................... CC Hong Kong.................................................. HK
Mozambique................................................ MZ
Colombia..................................................... CO
Hungary....................................................... HU Myanmar.................................................... MM
Comoros..................................................... KM
Iceland........................................................... IS
Namibia....................................................... NA
Congo.......................................................... CG
India.............................................................. IN
Nauru........................................................... NR
Congo, Democratic Republic of.................. CD Indonesia....................................................... ID
Nepal............................................................ NP
Cook Islands................................................ CK
Iran, Islamic Republic of............................... IR Netherlands.................................................. NL
Costa Rica.................................................... CR Iraq................................................................ IQ
Netherlands Antilles.................................... AN
Cote d’Ivoire (Ivory Coast)…....................... CI Ireland............................................................ IE Neutral Zone………………...……………..NT

Revised: December 2012

Page 2 of 4

FILING INSTRUCTIONS FOR DECLARATION FOR IMPORTATION OR EXPORTATION OF FISH OR WILDLIFE (USFWS FORM 3-177)
New Caledonia............................................ NC
New Zealand……………………………….NZ
Nicaragua…………………………………..NI
Niger……………………………………….NE
Nigeria……………………………………..NG
Niue………………………………..……...NU
Norfolk Island…………………..…………NF
Norway........................................................ NO
Oman.......................................................... OM
Pakistan........................................................ PK
Palau............................................................ PW
Palestinian Territory, Occupied………….....PS
Panama......................................................... PA
Papua New Guinea....................................... PG
Paraguay....................................................... PY
Peru............................................................... PE
Philippines..........................................,......... PH
Pitcairn ………............................................ PN
Poland........................................................... PL
Portugal.................................................,...... PT
Qatar............................................................ QA
Reunion........................................................ RE
Romania....................................................... RO
Russian Federation...................................... RU
Rwanda....................................................... RW
Saint Barthelemy……………….…,……… BL
Saint Helena, Ascension and
Tristan Da Cunha…………....………….. SH
Saint Kitts and Nevis................................... KN
Saint Lucia................................................... LC
Saint Martin……………………….………MF
Saint Pierre and Miquelon........................... PM

Saint Vincent and the Grenadines..…...…....VC
Samoa…………..………………….....……WS
San Marino.................................................. SM
Sao Tome and Principe................................. ST
Saudi Arabia................................................. SA
Scotland……………………...…………….GB
Senegal......................................................... SN
Serbia …………………..………...……..…RS
Seychelles..................................................... SC
Sierra Leone.................................................. SL
Singapore...................................................... SG
Sint Maarten………………………….……SX
Slovakia........................................................ SK
Slovenia......................................................... SI
Solomon Islands........................................... SB
Somalia......................................................... SO
South Africa................................................. ZA
South Georgia and
South Sandwich Islands…………...…... GS
Spain............................................................. ES
Sri Lanka...................................................... LK
Sudan............................................................ SD
Suriname……………………………………SR
Svalbard and Jan Mayen …………………... SJ
Swaziland...................................................... SZ
Sweden.......................................................... SE
Switzerland.................................................. CH
Syrian Arab Republic................................... SY
Taiwan (Province of China)........................ TW
Tajikistan....................................................... TJ
Tanzania, United Republic of....................... TZ

Thailand....................................................... TH
Timor-Leste………………...………………TL
Togo…………………………………...…...TG
Tokelau…………………………...………..TK
Tonga…………………...………………….TO
Trinidad and Tobago.................................... TT
Tunisia......................................................... TN
Turkey………………………………...……TR
Turkmenistan………………………..……..TM
Turks and Caicos Islands............................. TC
Tuvalu.......................................................... TV
Uganda......................................................... UG
Ukraine........................................................ UA
United Arab Emirates.................................. AE
United Kingdom…….................................. GB
United States of America............................. US
Unknown..................................................... XX
Uruguay....................................................... UY
Uzbekistan................................................... UZ
Vanuatu....................................................... VU
Vatican City................................................. VA
Venezuela..................................................... VE
Viet Nam..................................................... VN
Virgin Islands, British………………...…...VG
Wales……………………………....…........GB
Wallis and Futuna Islands........................... WF
Western Sahara............................................ EH
Western Samoa............................................ WS
Yemen.......................................................... YE
Zambia......................................................... ZM
Zimbabwe................................................... ZW

14c. Enter an identifier number and the type of identifier (for example, DUNS number, U.S. Customs and Border Protection account number) for the
foreign Importer or Exporter, if applicable.
15a. Enter the business name of the appropriate agent, if applicable.
15b. Enter an identifier number and the type of identifier (for example, DUNS number, U.S. Customs and Border Protection account number) for the
U.S. Customs Broker, Shipping Agent or Freight Forwarder, if applicable.
15c. Enter the contact information for the appropriate agent, including name, telephone and fax numbers, and e-mail address, if applicable
16a. List the scientific name for each species. This is a Latin name including genus and species (and sub-species, when required to determine if the
fish or wildlife is protected at the subspecies level). Use multiple species lines if a species is associated with multiple permits or certificates,
descriptions, sources, or countries of species origin.
16b. List the common name in English for each species in 16a.
17a. List the foreign CITES permit or certificate number for each species in 16a, if applicable. List one permit or certificate number per block. Use
multiple species lines if a species is listed on more than one CITES permit or certificate.
17b. List the U.S. CITES permit or certificate number for each species in 16a, if applicable. List one permit or certificate number per block. Use
multiple species lines if a species is listed on more than one CITES permit or certificate.
18a. Enter the applicable description code for each species in 16a from the list below.
Baleen…………………………………………………….….………..…BAL* Coral rock (live rock)…………………………………………………… COR
Bark (raw, dried, powdered, unprocessed).…………………….…..…...BAR*
Culture of an artificially propagated plant …...........................................CUL*
Bone piece (not manufactured).................................................................BOP*
Cutting (plant, including division) .............................................................CUT
Bone product or carving.............................................................................BOC
Dead animal (whole animal)....................................................................BOD*
Bone (including jaw, but not skull) ….....................................................BON*
Dead specimen (live specimen that died during shipment) …...................DEA
Bulb, corm or tuber …................................................................................BUL Derivative (except those included elsewhere) .………………..…..……DER*
Calipee (turtle cartilage for soup)….........................................................CAL*
Dried plant ................................................................................................DPL*
Carapace (raw or unworked) …….....………..………………..……...... CAP* Ear (except when part of whole trophy)…………................…...……..EAR*
Carving (other than bone, horn, or ivory) ................................................CAR* Egg (dead or blown, excluding caviar) ………...………………….......EGG*
Caviar (unfertilized dead processed eggs of sturgeon or paddlefish) …..CAV* Egg (live) ................................................................................................EGL*
Chip (timber)………..………………………………..….………..….....CHP*
Eggshell (raw or worked)…………………………………....…………ESH
Claw (including talon)..............................................................................CLA*
Extract………………..............................................................................EXT*
Cloth..........................................................................................................CLO* Feather …................................................................................................FEA*
Coral (raw or unworked, excluding live or coral rock) ...........................COR*
Fiber (plant fiber, tennis racket string)………………….…………..….FIB*
Coral product ..............................................................................................CPR Fin (fresh, frozen, or dried fin or part)…….……..…………………..…FIN*

Revised: December 2012

Page 3 of 4

FILING INSTRUCTIONS FOR DECLARATION FOR IMPORTATION OR EXPORTATION OF FISH OR WILDLIFE (USFWS FORM 3-177)
Description codes (continued)
Fingerling (juvenile fish of one or two years age for the
aquarium trade, hatchery, or release operation).....................FIG*
Flower……………………………………………………………....…FLO*
Flower pot (made of tree fern or other plant fiber)…………..........…..FPT*
Foot......................................................................................................FOO*
Frog leg...............................................................................................LEG*
Fruit ....................................................................................................FRU*
Gall bladder........................................................................................GAB*
Gall .……............................................................................................GAL*
Garment (excluding shoe or trim) .....................................................GAR*
Genitalia (castrate and dried penis)…….…...………………..….…..GEN*
Graft rootstock ....................................................................................GRS*
Hair......................................................................................................HAI*
Hair product (including paint brush)……….…………......................HAP
Horn carving (including horn or antler product)............................... HOC
Horn piece (not manufactured)………………..……….……........... HOP*
Horn (substantially whole, including antler)…….………................ HOR*
Ivory carving …...................................................................................IVC
Ivory jewelry....................................................................................... IJW
Ivory piano key (# of keys)…………….............................................KEY
Ivory piece (not manufactured, includes scraps)..................................IVP*
Jewelry (other than ivory)………. .....................................................JWL
Leather product (small manufactured, including belt, handbag,
wallet, watch band) …............................................LPS*
Leather product (large manufactured, including briefcase,
furniture, suitcase) ………………….......................LPL*
Leaves……………............................................................................. LVS*
Live rock (coral rock)…...…………….………..…..…...……….….ROC
Live specimen.………………………..……………...........................LIV*
Log (all wood in the rough, whether or not stripped of bark
or sapwood, or roughly squared, for processing into
sawn wood, pulpwood or veneer)………...………...………...LOG*
Meat ...................................................................................................MEA*
Medicinal part or product...................................................................MED*
Musk ..................................................................................................MUS*
Nest (including product).....…………………………………………NES
Oil........................................................................................................ OIL*
Piano with ivory keys (# of pianos)………… .....................................PIV
Plate of fur skins (include rugs if made from several skins)..............PLA*
* CITES recognized description code

Plywood (material consisting of 3 or more sheets of wood
glued and pressed one on another and generally
disposed so that the grains are at an angle)………….........PLY*
Powder ………………………………………..………………….....POW*
Root (dead) ………………................................................................ROO*
Rug (made from one skin only)………………................................. RUG
Sawn wood (sawn lengthwise or produced by profile-chipping;
normally exceeds 6mm in thickness)…..……..............SAW*
Scale (turtle, other reptile, fish, pangolin)………………….…......... SCA*
Seedling ..............................................................................................SDL
Seed .....................................................................................................SEE*
Shell product (from mollusc or turtle)………..…………….……..... SPR
Shell (mollusc, raw or unworked) ……………………………...........SHE*
Shoe (including boot) ...…..................................................................SHO
Side (including flanks except tinga frames)…..…………..……...... SID*
Skeleton (substantially whole)…………............................................ SKE*
Skin piece (raw or tanned, including scraps)............................……...SKP*
Skin (substantially whole, raw or tanned, including tinga frames)...... SKI*
Skull (except when part of whole trophy) ..........................................SKU*
Soup.....................................................................................................SOU*
Specimen (scientific or museum, including blood,
tissue, histological preparation) ……………………….... SPE*
Stem (plant)……..................................................................................STE*
Swim bladder (hydrostatic organ including isinglass,
sturgeon glue)…………...…...………………..……..SWI*
Tail ......................................................................................................TAI*
Teeth (excluding tusk) .……………...................................................TEE*
Timber (raw except log and sawn wood) ………….……………….. TIM*
Trim (shoe, garment, or decorative)………….................................... TRI
Trophy (all the parts of one animal, if they are exported
together; e.g. horns, skull, cape, backskin, tail
and feet constitute one trophy)..............................................TRO*
Tusk (substantially whole, worked or not)………………................. TUS*
Unspecified ........................................................................................UNS
Veneer (thin layers of wood of uniform thickness, usually
less than 6mm)...................................................................... VEN*
Wax (including ambergris)............................................................... WAX*
Wing………………………………………………………………...WNG
Wood product (including furniture, rainsticks)……………………..WPR

18b. Enter the appropriate one-letter wildlife source code for each species in 16a from the list below.
Plants that are artificially propagated, parts and derivatives ……..........A Confiscated or seized specimens. ..............................................................I
Animals bred in captivity (from parents that mated in captivity)…....…C Pre-convention specimens........................................................................ P
CITES Appendix I animals or plants commercially bred or
Specimens originating from a ranching operation………………........... R
propagated in CITES registered facilities……….……………...D Source unknown (lack of information must be justified) ………........... U
Animals born in captivity (from parents that mated in the wild) or
Specimens taken from the wild................................................................W
animals that do not qualify as captive-bred under CITES….......F
19a. Enter the quantity of items containing wildlife, and unit of measure for each species in 16a from the list below. Multiply pairs by two.
Number (individual units)…………........... NO
Meters.......................................................... MT Grams.......................................................... GM
Centimeters................................................. CM
Square meters……...…............................... M2
Milligrams…………………………… ….MG
Square centimeters…………………………C2
Cubic meters................................................ M3 Kilograms.................................................... KG
Cubic centimeters…………........................ C3
Liters…………............................................ LT
Milliliters…………..................................... ML
19b. Indicate the total value of items containing wildlife in U.S. dollars (rounded to the nearest dollar) for each species in 16a.
20. Enter the two-letter ISO (International Organization for Standardization) code for the country where the animal was taken from the wild or where
the animal was born.
21. Indicate whether each species of live wildlife identified in 16a is venomous.
22. Sign and date the form. Type or print your name below your signature.
If additional space is needed, please use the continuation form (USFWS Form 3-177a).
Knowingly making a false statement may subject the declarant to the penalty provided by 18 U.S.C. 1001 and 16 U.S.C. 3372(d).

Revised: December 2012

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