Form 3-200-6 Migratory Bird Import/Export Permit Application Form

Federal Fish and Wildlife Permit Applications and Reports--Migratory Birds and Eagles; 50 CFR 10, 13, 21, 22

3-200-6 Application - Migratory Bird Import_Export Permit Rev 02-2018

Application - Migratory Bird Import/Export Permit (Form 3-200-6) - Government

OMB: 1018-0022

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Department of the Interior
U.S. Fish and Wildlife Service

OMB Control No. 1018-0022
Expires ##/##/####

Federal Fish and Wildlife Permit Application Form
Click here for addresses.

Type of Activity: Migratory Bird Import/Export

Return to: U.S. Fish and Wildlife Service (USFWS)

 New Application
 Requesting Renewal or Amendment of Permit #
__________________
Complete Sections A or B, and C, D, and E of this application. U.S. address may be required in Section C, see instructions for details.
See attached instruction pages for information on how to make your application complete and help avoid unnecessary delays.

A.

Complete if applying as an individual

1.a. Last name

1.b. First name

2. Date of birth (mm/dd/yyyy)

3. Occupation

5.a. Telephone number

5.b. Alternate telephone number

B.

1.c. Middle name or initial

1.d. Suffix

4. Affiliation/ Doing business as (see instructions)
5.c. Fax number

5.d. E-mail address

Complete if applying on behalf of a business, corporation, public agency, Tribe, or institution

1.a. Name of business, agency, Tribe, or institution

1.b. Doing business as (dba)

2. Tax identification no.

3. Description of business, agency, or institution

4.a. Principal officer Last name

4.b. Principal officer First name

5. Principal officer title

4.c. Principal officer Middle name/ initial

4.d. Suffix

6. Primary contact name

7.a. Business telephone number

7.b. Alternate telephone number

C.

7.c. Business fax number

7.d. Business e-mail address

All applicants complete address information

1.a. Physical address (Street address; Apartment #, Suite #, or Room #; no P.O. Boxes)

1.b. City

1.c. State

1.d. Zip code/Postal code:

1.e. County/Province

1.f. Country

2.a. Mailing Address (include if different than physical address; include name of contact person if applicable)

2.b. City

2.c. State

2.d. Zip code/Postal code:

2.e. County/Province

2.f. Country

D.

All applicants MUST complete

1.

Attach check or money order payable to the U.S. FISH AND WILDLIFE SERVICE in the amount of $ 75.00 nonrefundable processing fee.. Federal, Tribal,
State, and local government agencies, and those acting on behalf of such agencies, are exempt from the processing fee – attach documentation of fee exempt status
as outlined in instructions. (50 CFR 13.11(d))
Do you currently have or have you ever had any Federal Fish and Wildlife permits?
Yes  If yes, list the number of the most current permit you have held or that you are applying to renew/re-issue: _________________
No 

2.
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.
______________________________________________________________________________________________________________________
Signature of applicant/Principal Officer (No photocopied or stamped signatures)
Date of signature (mm/dd/yyyy)

Please continue to next page

Form 3-200-6

Rev. 4/2017

Page 1of 6

SECTION E.

MIGRATORY BIRD IMPORT/EXPORT

(Migratory Bird Treaty Act, 50 CFR 21.21)
Note: A Federal Migratory Bird Import/Export permit is required to import or export migratory birds into or out of the United
States (see 50 CFR 10.12 for definition of United States). This application form does not apply to Bald Eagles, Golden
Eagles, or species protected under the Convention on International Trade in Endangered Species, the U.S. Endangered Species
Act, or the Wild Bird Conservation Act. All wildlife shipments must enter and exit the United States through a wildlife port
designated in 50 CFR 14.12 (http://www.fws.gov/le/ports-contact-information.html) unless you have a separate exception to
designated port permit issued by the Office of Law Enforcement under 50 CFR 14. There are a number of exceptions for
import/export permits; for more information, visit https://www.fws.gov/birds/policies-and-regulations/permits/import-andexport.php . You are responsible for reviewing and understanding these regulations before you request and accept a permit.
Check with your State agriculture department for any additional State restrictions on wildlife imports.
Please provide the information requested below on a separate sheet of paper. You should be as thorough and specific as
possible in your responses. Incomplete applications will be returned, delayed, or abandoned. We strongly recommend that
you submit your complete application at least 60 days prior to the date you need your permit, as required by 50 CFR 13.11(c).
Please provide the following information on a separate sheet of paper:
1.

Indicate whether you are requesting a permit to Import, Export, or both.

2.

For each shipment you propose to import or export, provide:
(a) Approximate date(s) of shipment
(b) Country of origin
(c) Common name and scientific name (genus and species)
(d) Type and quantity of specimen (e.g., live, dead, part, nest, or egg) by species
(e) Source (wild-caught or captive-bred)
(f) Band number(s), if applicable

3.

Explain the purpose for the importation or exportation.

4.

If you are requesting an Import Permit, provide the following information:
(a) Name and address of the person or organization in the foreign country from whom you are importing.
(b) Your Federal and State permit numbers or other authorization to lawfully acquire and possess the birds upon their
arrival in the United States.

5.

If you are requesting an Export Permit, provide the following information:
(a) Name and address of the person or organization in the foreign country to which you are exporting.
(b) The Federal and State permit numbers or other authorization under which the birds were taken and held in the United
States.

6.

If you reside or are located outside of the United States: provide the name of a contact, address, and telephone number
where you can be reached in the United States. If conducting commercial activities, provide the name and address of your
agent that is located in the United States.

7.

Provide the intended U.S. port of entry or exit. If you plan to enter or exit the United States through a port that is not a
wildlife designated port listed in 50 CFR 14.12 (http://www.fws.gov/le/ports-contact-information.html), you will
require a port exception permit from the Office of Law Enforcement. If you already have a valid port exception permit,
provide the permit number.

8. Anyone who will be assisting you with the permitted activities or acting as your agent must either have their own Federal
migratory bird permit for the activity or be identified by you, in writing, as a subpermittee under your permit. They may
also require a State permit. Subpermittees must be at least 18 years old. As the primary permittee, you will be
responsible for ensuring that your subpermittees are properly trained and adhere to the terms of your permit. Provide the
name of anyone besides yourself who will be conducting activities under your permit.

Form 3-200-6

Rev. 4/2017

Page 2 of 6

9.

You must retain records legibly written or reproducible in English relating to the activities conducted under your permit
for at least 5 years after the date of expiration of your permit. Is the physical address you provided in Section C on
page 1 of this application the address where your records will be kept? Indicate “yes” or “no”. If “no,” provide the
physical address.

10.

Any permit issued as a result of this application is not valid unless you also have any required State or tribal permits
associated with the activity. Indicate whether you have obtained all required State or Tribal permits or approvals to
conduct this activity. If “yes,” attach a copy of the approval(s). If “no,” indicate whether your “have applied” or
whether “none is required.” If you “have applied,” send a copy when it is issued.

11. 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?
Indicate “Yes” or “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.

Form 3-200-6

Rev. 4/2017

Page 3 of 6

PERMIT APPLICATION FORM INSTRUCTIONS
The following instructions pertain to an application for a U.S. Fish and Wildlife Service or CITES permit. The General Permit Procedures in ​50
CFR 13​ address the permitting process. For simplicity, all licenses, permits, registrations, and certificates are referred to as a permit.
GENERAL INSTRUCTIONS:
● Complete all blocks/lines/questions in Sections A or B, C, D, and E.
● An incomplete application may cause delays in processing or may be returned to the applicant. Be sure you are filling in
the appropriate application form for the proposed activity.
● Print clearly or type in the information. Illegible applications may cause delays.
● Sign the application. Faxes or copies of the original signature will not be accepted.
● Mail the original application to the address at the top of page one of the application or if applicable on the attached address list.
● Keep a copy of your completed application.
● Please plan ahead. Allow at least 60 days for your application to be processed. Some applications may take longer than 90
days to process. (50 CFR 13.11)
● Applications are processed in the order they are received.
● Additional forms and instructions are available from ​http://permits.fws.gov/​.
COMPLETE ​EITHER ​SECTION A OR SECTION B:

Section A. ​Complete if applying as an individual:
● Enter the complete name of the responsible individual who will be the permittee if a permit is issued. Enter personal information that
identifies the applicant. ​Fax and e-mail are not required if not available.
● If you are applying on behalf of a client, the personal information must pertain to the client, and a document evidencing power
of attorney must be included with the application.
● Affiliation/ Doing business as (dba)​: business, agency, organizational, or institutional affiliation ​directly ​related to the activity
requested in the application (e.g., a taxidermist is an individual whose business can ​directly ​relate to the requested activity). The
Division of Management Authority (DMA) will ​not ​accept ​doing business as ​affiliations for individuals.
Section B. ​Complete if applying as a business, corporation, public agency, Tribe, or institution:
● Enter the complete name of the business, agency, Tribe, or institution that will be the permittee if a permit is issued. Give a
brief description of the type of business the applicant is engaged in. Provide contact phone number(s) of the business.
● Principal Officer ​is the person in charge of the listed business, corporation, public agency, Tribe, or institution. The principal officer is
the person responsible for the application and any permitted activities. Often the principal officer is a Director or President. ​Primary
Contact ​is the person at the business, corporation, public agency, Tribe, or institution who will be available to answer questions about
the application or permitted activities. Often this is the preparer of the application.
ALL APPLICANTS COMPLETE SECTION C:
● For all applications submitted to the Division of Management Authority (DMA) a physical U.S. address is ​required​. Province and
Country blocks are provided for those USFWS programs which use foreign addresses and are not required by DMA.
● Mailing address ​is address where communications from USFWS should be mailed if different than applicant’s physical address.
ALL APPLICANTS COMPLETE SECTION D:
Section D.1 ​Application processing fee:
● An application processing fee is required at the time of application; unless exempted under 50 CFR13.11(d)(3). The application
processing fee is assessed to partially cover the cost of processing a request. ​The fee does not guarantee the issuance of a permit.
Fees will not be refunded for applications that are approved, abandoned, or denied​. We may return fees for withdrawn
applications prior to any significant processing occurring.
● Documentation of fee exempt status is not required for Federal, Tribal, State, or local government agencies; but must be
supplied by those applicants acting on behalf of such agencies​. Those applicants acting on behalf of such agencies must submit a
letter on agency letterhead and signed by the head of the unit of government for which the applicant is acting on behalf, confirming that
the applicant will be carrying out the permitted activity for the agency.
Section D.2 ​Federal Fish and Wildlife permits:
● List the number(s) of your most current FWS or CITES permit or the number of the most recent permit if none are currently valid.
If applying for re-issuance of a CITES permit, the original permit must be returned with this application.
Section D.3 ​CERTIFICATION:
● The individual identified in Section A, the principal officer named in Section B, or person with a valid power of attorney
(documentation must be included in the application) 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.

ALL APPLICANTS COMPLETE SECTION E.

Rev. 4/2017

Page 4 of 6

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/birds/policies-and-regulations/permits/permit-policies-andregulations.php)

a.
b.
c.
d.
e.
f.
g.
h.
i.
j.

2.

3.

Bald and Golden Eagle Protection Act (16 U.S.C. 668), 50 CFR 22;
Endangered Species Act of 1973 (16 U.S.C. 1531-1544), 50 CFR 17;
Migratory Bird Treaty Act (16 U.S.C. 703-712), 50 CFR 21;
Marine Mammal Protection Act of 1972 (16 U.S.C. 1361, ​et. seq​.), 50 CFR 18;
Wild Bird Conservation Act (16 U.S.C. 4901-4916), 50 CFR 15;
Lacey Act: Injurious Wildlife (18 U.S.C. 42), 50 CFR 16;
Convention on International Trade in Endangered Species of Wild Fauna and Flora (TIAS 8249), ​http://www.cites.org/ ,​ 50 CFR 23;
General Provisions, 50 CFR 10;
General Permit Procedures, 50 CFR 13; and
Wildlife Provisions (Import/export/transport), 50 CFR 14.

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.
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 F
​ ederal 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.

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 an 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.

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.
i.

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

j.

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 Rehabilitation permit application is 7 hours for the application and 5 hours for recordkeeping. This burden estimate
includes time for reviewing instructions, gathering and maintaining data and completing and reviewing the form. You may direct comments regarding
the b​ urden estimate or any other aspect of the form to the Service Information Clearance Officer, U.S. Fish and Wildlife Service, 5275 Leesburg Pike, MS:
BPHC, Falls Church, VA 22041-3803.
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 2.26 – 2.33].

Rev. 4/2017

Page 5 of 6

Migratory Bird Regional Permit
Offices
FWS
REGION

Region 1

Region 2

Region 3

Region 4

Region 5

Region 6

AREA OF
RESPONSIBILITY
Hawaii, Idaho, Oregon,
Washington
Arizona, New
Mexico, Oklahoma,
Texas

Iowa, Illinois, Indiana,
Minnesota, Missouri,
Michigan, Ohio,
Wisconsin

Alabama, Arkansas, Florida,
Georgia, Kentucky, Louisiana,
Mississippi, North Carolina,
South Carolina, Tennessee,
Virgin Islands, Puerto Rico
Connecticut, District of
Columbia, Delaware,
Maine, Maryland,
Massachusetts, New
Hampshire, New Jersey,
New York, Pennsylvania,
Rhode Island, Virginia,
Vermont, West Virginia
Colorado, Kansas, Montana,
North Dakota, Nebraska,
South Dakota, Utah,
Wyoming

Region 7

Alaska

Region 8

California, Nevada

MAILING
ADDRESS

CONTACT
INFORMATION

911 N.E. 11th Avenue
Portland, OR 97232-4181

Tel. (503) 872-2715
Email [email protected]

P.O. Box 709
Albuquerque, NM 87103

Tel. (505) 248-7882
Email [email protected]

5600 American Blvd. West
Suite 990
Bloomington, MN
55437-1458

Tel. (612) 713-5436
Email [email protected]

1875 Century Blvd., NE
Atlanta, GA 30345

Tel. (404) 679-7070
Email [email protected]

300 Westgate Center Drive
Hadley, MA 01035-0779

Tel. (413) 253-8643
Email [email protected]

P.O. Box 25486
DFC(60154)
Denver, CO 80225-0486

Tel. (303) 236-8171
Email [email protected]

1011 E. Tudor Road
(MS-201)
Anchorage, AK
99503

Tel. (907) 786-3693
Email [email protected]

2800 Cottage Way
Room W-2606
Sacramento, CA 95825

Tel. (916) 978-6183
[email protected]


File Typeapplication/pdf
AuthorThompson, Jerry E
File Modified2018-02-02
File Created2017-04-05

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