Form 3-200-10a Special Purpose - Salvage Permit Application Form

WHAT YOU SHOULD KNOW ABOUT A FEDERAL
SPECIAL PURPOSE SALVAGE PERMIT
A Federal Migratory Bird Special Purpose Salvage permit will authorize you to collect dead migratory birds, nests, eggs and parts
from the wild that you had no part in the killing or death thereof, for wildlife conservation education purposes. You should
review Title 50 Parts 10, 13 and 21.27 of the Code of Federal Regulations (CFR). You are responsible for reviewing and
understanding these regulations before you request and accept a permit. These regulations can be found on our website at:
https://www.fws.gov/birds/policies-and-regulations/permits/permit-policies-and-regulations.php
1. Can I salvage migratory birds for personal use?
No. This permit does not allow anyone to salvage or possess migratory birds for personal use. All migratory birds salvaged
must be transferred to a public scientific or educational institution, zoological park, museum or scientific society as defined in 50
CFR 10 or a Migratory Bird Special Purpose Possession permit issued under 50 CFR 21.27.
2. Do I need to tag the migratory birds I salvage?
Yes. Each migratory bird salvaged must be tagged. Each tag should include the following information:
(a) Date and location specimen salvaged, and
(b) Name of person who salvaged the specimen
(c) The permit number under which the specimen was salvaged must be recorded in the permanent accession record.
3. How long may I retain birds in my possession before transferring them to a designated repository?
All migratory birds salvaged must be deposited with a repository designated on your permit within 6 months of acquisition
and/or by December 31 of that calendar year.
4. Do I need additional authorization to salvage migratory birds on Federal or State lands or private property?
Yes. This permit does not authorize you to salvage specimens on Federal or State lands or other public or private property
without additional prior written authorization, permission, or permits from the appropriate Federal or State agency, landowner, or
custodian.
5. Do I need a State permit to salvage migratory birds?
Your Federal salvage permit is not valid unless you are also in compliance with State requirements. This means that if your
State requires you to have a permit to salvage birds, you must hold a valid State permit in order for your Federal permit to be
valid. It is your responsibility to make sure you comply with State permit requirements.
6. Who are the personnel identified on my permit and what are they authorized to do?
(a) Principal Officer. For permits issued to organizations, a Principal Officer is identified on the permit. The
Principal Officer is the person in charge of the organization and is responsible for the application and any permitted
activities.
(b) Primary Contact. The Primary Contact is the person in the organization who is available to answer questions
about the application or permitted activities. This person may be the same or different than the Principal Officer.
The Primary Contact is not listed on the permit unless the individual is also listed as a subpermittee.
(c) Subpermittee. A subpermittee is an individual authorized to conduct some or all of the permitted activities without
the permittee present. You must identify any subpermittees in your application. Your subpermittees must have
either a copy of your permit that identifies them as a subpermittee, or a copy of your permit and a letter from the
Permittee (Principal Officer) listing activities (including location and duration) they are authorized to conduct. The
permittee is responsible for ensuring subpermittees are trained and adhere to the conditions of your permit.
Subpermittees must be at least 18 years of age. Individuals younger than 18 may assist you, but must have a
permittee or subpermittee present when conducting activities.

7. What is required to transfer my permit to a new location?
Any address change or other circumstances that affect your permit must be reported to your Regional Migratory Bird Permit
Office in writing within 10 days so your permit can be amended. (See 50 CFR 13.23)
8. Will I be required to keep records of my activities?
Yes. You must maintain accurate records, legibly written or reproducible in English, of operations on a calendar-year basis.
Your records should include the species that is salvaged, date salvaged, the city or county and State where the bird was salvaged
and the final disposition of the specimen.
9. Will anyone inspect my records or salvage activities?
By accepting a Federal Special Purpose Salvage permit, you authorize an agent of the Service to enter your premises at any
reasonable hour to inspect the wildlife you hold, your books and records. (See 50 CFR 13.47)
10.Will I be required to submit an annual report of activities?
Yes. The report form can also be found on our website at: http://www.fws.gov/forms/3-202-3.pdf. This report must be
completed and submitted to your issuing office by January 31 of each year.
11. How do I renew my permit?
If you wish to renew your permit, you must submit a renewal application to your Regional Migratory Bird Permit Office at
least 30 days prior to the expiration of your permit and include a copy of your current State permit, if one is required. If we
receive your renewal request at least 30 days prior to the expiration of your permit, your permit will remain valid beyond the
expiration date for the activity authorized on your permit until a decision on your renewal is made. If we receive your renewal
request fewer than 30 days prior to expiration of your permit and we are unable to process your request before the expiration date,
your permit will expire and you will no longer be covered for your activity. If you allow your permit to expire before requesting
renewal, you may be required to submit a new application. (See 50 CFR 13.22 and 13.11(c))
(3-200-10a) Rev. 4/2017

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: SPECIAL PURPOSE - SALVAGE

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

D.
1.

2.
3.

2.c. State

2.d. Zip code/Postal code:

2.e. County/Province

2.f. Country

All applicants MUST complete

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 
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 3-200-10a

Rev. 4/2017

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OMB Control No. 1018-0022
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SECTION E.
SPECIAL PURPOSE – SALVAGE
(Migratory Bird Treaty Act, 50 CFR 21.27)
Note: A Federal Special Purpose Salvage Permit is required to salvage migratory birds that you find dead and had no part in
killing. The permit authorizes temporary possession of the dead specimens for transport to a designated public, scientific, or
educational institution. Possession for personal use is prohibited. You must be at least 18 years old to apply. Please read “What
You Should Know About a Migratory Bird Special Purpose Salvage Permit” and the pertinent regulations before you sign and
submit your application.
Please provide the following information in the space provided or numbered according to the questions 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.
1.

Describe the project or activity for which you require this permit, including the location or area where you propose to salvage.

2.

Identify the public, scientific, or educational institution where the migratory birds salvaged under this permit will be
deposited. If the specimens will be deposited with an institution other than your own, attach a letter, on the institution’s
letterhead, from the Director or Principal Officer of the institution where the salvaged materials will be deposited. The letter
must confirm the institution’s need for the specimens, that they want you to salvage for them, and describe how they will be
used.

3.

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.

4.

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?
Yes

5.

If “no,” provide the physical address.

Any permit issued as a result of this application is not valid unless you also have any required State or tribal
permits or approvals associated with the activity. Have you obtained all required State or tribal permits or approvals
to conduct this activity?
Yes

6.

No

If “yes,” attach a copy of the approval(s).

Have applied (Send copy when issued)

None required

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

Form 3-200-10a

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OMB Control No. 1018-0022
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guilty or nolo contendere, forfeited collateral, or are currently under charges for any violations of the laws mentioned above?
Yes

No (you 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).

Form 3-200-10a

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 S
​ ECTION 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.

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APPLICATION FOR A FEDERAL FISH AND WILDLIFE PERMIT
NOTICES
PRIVACY ACT STATEMENT
Authority: The information requested is authorized by the following: the Bald and Golden Eagle Protection Act (16 U.S.C. 668), 50 CFR 22; the
Endangered Species Act (16 U.S.C. 1531-1544), 50 CFR 17; the Migratory Bird Treaty Act (16 U.S.C. 703-712), 50 CFR 21; the Wild Bird
Conservation Act (16 U.S.C. 4901-4916), 50 CFR 15; the 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), 50 CFR 23; General Provisions, 50 CFR 10; General Permit Procedures, 50
CFR 13; and Wildlife Provisions (Import/export/transport), 50 CFR 14.
Purpose: The collection of contact information is to verify the individual has an eligible permit to conduct activities that affect protected species.
The information the individual provides helps the FWS monitor and report on protected species and assess the impact of permitted activities on the
conservation and management of species and their habitats.
Routine Uses: The collected information may be used to verify an applicant’s eligibility for a permit to conduct activities with protected wildlife;
to provide the public and the permittees with permit related information; to monitor activities under a permit; to analyze data and produce reports
to monitor the use of protected wildlife; to assess the impact of permitted activities on the conservation and management of protected species and
their habitats; and to evaluate the effectiveness of the permit programs. More information about routine uses can be found in the System of
Records Notice, Permits System, FWS-21.
Disclosure: The information requested in this form is voluntary. However, submission of requested information is required to process
applications for permits authorized under the listed authorities. Failure to provide the requested information may be sufficient cause for the U.S.
Fish & Wildlife Service to deny the request.

PAPERWORK REDUCTION ACT STATEMENT
In accordance with the Paperwork Reduction Act (44 U.S.C. 3501), the U.S. Fish and Wildlife Service collects information necessary to monitor
take and disposition of migratory birds, under the applicable laws governing the requested activity, for which a permit is requested, and to respond
to requests made under the Freedom of Information Act and the Privacy Act of 1974. 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. According to the Paperwork
Reduction Act of 1995, an agency may not conduct or sponsor and a person is not required to respond to a collection of information unless it
displays a currently valid OMB control number. OMB has approved this collection of information and assigned Control No. 1018-0022.

ESTIMATED BURDEN STATEMENT
Public reporting for FWS Form 3-200-10a is 1 hour for the application and 30 minutes for recordkeeping, including time for reviewing instructions,
gathering and maintaining data and completing and reviewing the form. Direct comments regarding the burden estimate or any other aspect of the
form to the Service Information Clearance Officer, Fish and Wildlife Service, U.S. Department of the Interior, 5275 Leesburg Pike, MS: BPHC,
Falls Church, VA 22041-3803. Please do not send your completed form to this address.

FREEDOM OF INFORMATION ACT STATEMENT
For organizations, businesses, or individuals operating as a business (i.e., permittees not covered by the Privacy Act), we request you identify any
information that should be considered privileged and confidential information to allow the Service to meet its responsibilities under the Freedom of
Information Act (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

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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]