Form 3-200-10d Special Purpose - Possession of Dead Migratory Birds for

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

3-200-10d Application - Spec Purp - Poss of Dead Mig Birds for Educ Purp Rev 02-2018

Application - Special Purpose - Possession of Dead Migratory Birds for Educational Purposes (Form 3-200-10d) - Private Sector

OMB: 1018-0022

Document [pdf]
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WHAT YOU SHOULD KNOW ABOUT A FEDERAL MIGRATORY BIRD
SPECIAL PURPOSE PERMIT – POSSESSION OF DEAD MIGRATORY BIRDS
FOR EDUCATIONAL PURPOSES

A Federal Migratory Bird Special Purpose Possession - Education (Dead) permit will authorize you to possess migratory
birds parts, nests and nonviable eggs for educational purposes. You should review Title 50 Parts 10, 13 and 21.27 of the
Code of Federal Regulations (CFR) with your application. 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/need-a-permit.php

1. What experience must I have to qualify for a Migratory Bird Special Purpose Possession – Education permit for
dead migratory bird specimens?
You must be at least 18 years of age and have experience in providing education programs.
2. Is the Migratory Bird Special Purpose Possession – Education (Dead) Permit to be used for a specific type of
education?
Yes. The intent of this permit is wildlife conservation education. Conservation, biology, and/or ecology must
be a primary component of all educational programs conducted using migratory birds. Other topics such as history of
falconry and cultural significance of birds may also be included in the program.
3. Can I use migratory birds for commercial purposes?
No. Migratory birds possessed or transported for educational purposes may not be displayed in any manner which
implies personal use. You may not use migratory birds to promote or endorse any product, merchandise, goods, services,
business or organization except your own educational activities. Educational programs are not considered commercial
activities.
4. What is the educational program requirement for specimens authorized under this permit?
A minimum of 12 programs that are open to the public must be presented each year. If specimens are only on static
display for educational purposes, birds must be on public exhibit for a minimum of 400 hours per year. The authority to
possess migratory birds will be subject to re-evaluation if this requirement is not met.
5. How can I acquire or dispose of migratory bird specimens under a Migratory Bird Special Purpose Possession –
Education (Dead) permit?
Dead migratory bird(s), parts, nests or nonviable eggs may be acquired from persons authorized by permit or
regulation to possess and transfer such items. You may request salvage authority if you wish to acquire specimens from the
wild. Salvaged specimens are intended for use under your education permit. Any specimen not used within a calendar year
as described in Number 4 above must be destroyed, donated, or transferred to persons authorized by permit or the
regulations to possess migratory birds.
6. Can I move birds authorized under this permit to a new location?
Yes. Any change in physical location or other circumstances that affect your permit conditions (e.g. change in
principal officer or physical location as listed on the permit) must be reported to your Regional Migratory Bird Office in
writing within 10 days so your permit can be amended. (50 CFR 13.23)
7. Do I need a State permit to possess migratory bird specimens?
Your Federal permit is not valid unless you also are in compliance with State requirements. This means that if your
State requires a permit to possess migratory bird specimens for educational or exhibit purposes or to salvage migratory
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.
8. Will I be required to keep records of my activities?
Yes. You must maintain accurate records of operations on a calendar-year basis. Your records should reflect each
specimen that is held, the number of presentations given with each and the disposition, if applicable. Such records shall
be legibly written or reproducible in English and shall be maintained for five years from the date of expiration of the

permit. (50 CFR 13.46)
9. Will anyone inspect my records or bird specimens held for educational purposes?
By accepting a Federal Migratory Bird Special Purpose Possession – Education (Dead) permit, you authorize an
agent of the U.S. Fish and Wildlife Service to enter your premises at any reasonable hour to inspect any bird specimens in
your possession, your books or records. (50 CFR 13.47)
10. Will I be required to submit an annual report of activities?
Yes. Report forms can be found on our website at: http://www.fws.gov/forms/3-202-5.pdf or you can request one
from your Regional Migratory Bird Permit Office. 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 expired 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))

Form 3-200-10d

Rev. 10/2017

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 – Possession of Dead Migratory
Birds for Educational Purposes

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 3-200-10d

Rev. 10/2017

Page 1of 5

SECTION E.

SPECIAL PURPOSE - POSSESSION OF DEAD MIGRATORY BIRDS
FOR EDUCATIONAL PURPOSES
(Migratory Bird Treaty Act, 50 CFR 21.27)

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

Note: A Federal Special Purpose - Possession of Dead Migratory Birds for Educational Purposes permit is required
to possess and transport dead migratory birds (parts, nests, and nonviable eggs) for the sole purpose of providing
public education about the biology, ecology, and conservation needs of migratory birds. Possession for personal use
is prohibited. A minimum of 12 educational programs or 400 display hours is required per year. You must be at
least 18 years old to apply. A special purpose possession permit may be valid for up to 3 years.
Please provide the following information 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.

2.
3.

4.
5.
6.

7.
8.

9.

(a) List the specimens needed, including species and type of specimen (carcass, mount, feathers, nest, egg, etc.).
(b) If you have already located a specimen or specimens to use in your program, list the species and type(s) of
specimen(s) and the source’s name, address, and Federal permit number.
(c) Do you want authorization to salvage dead migratory birds, feathers, parts, nests, and non-viable eggs found in
the wild? Y/N
Describe in detail your experience in providing education programs, including duration of your education
experience and any experience in conservation education.
Describe the educational message will you deliver and the type of audience.
(a) Provide a detailed outline of your program and attach any brochures or other materials prepared for
distribution.
(b) Explain why these specimens are necessary for your program, and describe how they will be used and
displayed during the presentation to meet this need.
Where will specimens be stored when not being used for programs?
Attach letters from schools or other organizations that have expressed interest in scheduling your educational
programs.
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
You must retain records relating to the activities conducted under your permit for at least 5 years after the date of
expiration of your permit. Indicate whether the physical address you provided in Section C on page 1 of this
application is the same address where your records will be kept. If not, 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. Indicate whether you 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.
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

Form 3-200-10d

Rev. 10/2017

✔ 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.

Page 2 of 5

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. Form 3-200-10d

Rev. 10/2017

Page 3 of 5

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 3-200-10d is 2 hours 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].

Form 3-200-10d

Rev. 10/2017

Page 4 of 5

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 Created2017-03-27

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