Form 3-200-10e Special Purpose - Migratory Game Bird Propagation Permit

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

3-200-10e Application - Special Purpose - Migratory Game Bird Prop Rev 02-2018

Application - Special Purpose - Migratory Game Bird Propagation (Form 3-200-10e) - Individuals

OMB: 1018-0022

Document [pdf]
Download: pdf | pdf
WHAT YOU SHOULD KNOW ABOUT A
FEDERAL SPECIAL PURPOSE GAME BIRD PERMIT
A Federal Migratory Bird Special Purpose Game Bird permit will authorize you to acquire, purchase, possess, transfer, sell, donate,
or otherwise dispose of to another person, migratory game birds (excluding waterfowl) that are captive-reared and properly marked,
including their eggs. (A Migratory Bird Waterfowl Sale and Disposal permit is required to sell, donate, or otherwise dispose of to
another person, any species of captive-reared and properly marked waterfowl or their eggs.) 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
Below is a review of several sections pertinent to a Federal Migratory Bird Special Purpose Game Bird permit.
1. Do I need a permit to acquire, purchase, possess, transfer, sell, donate, release to the wild, or otherwise dispose of migratory
game birds?
Yes. Anyone who wishes to conduct these activities with migratory game birds other than waterfowl must first obtain a
Federal Migratory Bird Special Purpose Game Bird permit.
2. Can I take migratory game birds from the wild?
No. You may not take migratory game birds or their eggs from the wild. Anyone who transfers migratory game birds to
you must have a valid Special Purpose Game Bird permit.
3. What documentation is required when I transfer game birds to another person?
The person you sell to or buy from must also have a Special Purpose Game Bird permit. Each time you transfer game
birds to another person, you will be required to complete a Form 3-186a, Migratory Bird Acquisition and Disposition Report.
These forms are available on our website at: http://www.fws.gov/forms/3-186a.pdf. You will give the original of the form to the
person acquiring the birds or eggs, retain one copy in your files as a record of your operations, and mail one copy to your Regional
Migratory Bird Permit Office within 5 days following the acquisition or disposition of any migratory game bird.
4. What species of migratory game birds can I propagate with a Migratory Bird Special Purpose Game Bird permit?
The following species are eligible for propagation with this permit:
Family

Common Name

Scolopacidae

Common snipe and American woodcock

Columbidae

Band-tailed pigeon, Bridled quail-dove, Common ground-dove, Inca dove, Key
West quail dove, Mourning dove, Plain pigeon, Red-billed pigeon, Ruddy grounddove, Ruddy quail-dove, Scaly-naped pigeon, White-crowned pigeon, White-tipped
dove, White-winged dove, Zenaida dove

Gruidae

Sandhill crane (except Mississippi subspecies)

Rallidae

Clapper rail, King rail, Virginia rail, Sora, Purple gallinule, American coot
and Common moorhen

5. Do I need to mark migratory game birds that I propagate?
All live migratory game birds (including offspring) possessed in captivity under authority of a valid Migratory Bird
Special Purpose Game Bird permit must, prior to 6 weeks of age, be physically marked using one of the following methods:
(a) Removing the hind toe from the right foot.
(b) Pinioning of a wing by removing the metacarpal bones of one wing or a portion of the metacarpal bones thereby
rendering the bird permanently incapable of flight.
(c) Banding one metatarsus with a seamless metal band.
(d) Tattooing a readily discernible number or letter or combination thereof on the web of one foot.

6. Do I need a State permit to possess and sell migratory game birds?
Your Migratory Bird Special Purpose Game Bird permit is not valid unless you also are in compliance with State
requirements. This means that if your State requires you to have a permit to sell or transfer migratory game 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.
7. Will anyone inspect my records or propagation activities?
By accepting a Migratory Bird Special Purpose Game Bird permit, you authorize an agent of the U.S. Fish and Wildlife
Service to enter your premises at any reasonable hour to inspect the wildlife you hold, your books and records. (See 50 CFR
13.47)
8. 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)
9. 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 calendaryear basis. Your records should reflect the species of game bird you possess during the reporting year, total number at the start of
the year, method of marking, number raised, sold or traded, and the total number at the end of each year.
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/3-202-6.pdf. This report must be
completed and submitted to your regional permit 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 license, 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))
(3-200-10e) 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 Game Bird

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 3-200-10e

Rev. 4/2017

Page 1 of 6

OMB Control No. 1018-0022
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SECTION E.

SPECIAL PURPOSE - MIGRATORY GAME BIRD PROPAGATION
(Migratory Bird Treaty Act, 50 CFR 21.27)

Note: A Federal Special Purpose - Migratory Game Bird Propagation Permit is required to possess, propagate, purchase, sell,
and barter captive-reared, properly marked migratory game birds, other than waterfowl. Migratory game birds are listed in the
regulations at 50 CFR 20.11. All migratory game birds held or transferred under this permit must be marked in accordance
with 50 CFR 21.13(b). Please read “What You Should Know About A Migratory Bird Special Purpose Game Bird Permit” and
the pertinent regulations before you sign and submit your application.
Please provide the following information in the space provided or on a separate sheet of paper numbered according to the
questions below. You should be as thorough and specific as possible in your responses. Incomplete applications will be
returned, delayed or abandoned.
1.

List the common and scientific name of each species of migratory game birds, other than waterfowl, you plan to acquire.

2.

Are your facilities located at the mailing or physical address you provided on page 1, section C.1., of this application?
Yes

No If “no,” provide the location (street address or legal description).

3.

Describe the facilities where the game birds will be held. Attach diagrams and photographs of your enclosures,
including dimensions (length, width, and height).

4.

Which of the following methods will you use to mark progeny?
Remove hind toe of right foot
Pinion one wing
Band one leg with a seamless leg band
Tattoo web of one foot

Form 3-200-10e

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OMB Control No. 1018-0022
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5.

Provide the name, address and Federal permit number of the person from whom you will acquire the birds.

6.

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. Is the physical address you provided in Section C on page 1 of this application the address where your records
will be kept?
Yes

7.

No 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
associated with the activity. Have you obtained all required State or tribal permits or approvals to conduct this activity?
Yes If “yes,” provide a copy of the approval(s).

8.

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 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 3-200-10e

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;
​ .), 50 CFR 18;
Marine Mammal Protection Act of 1972 (16 U.S.C. 1361, e​ t. seq
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 ​Federal Register a​ s 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.

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.

b.

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.

c.
d.
e.

f.

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 Special Purpose - Game Bird Propagation permit application is 1 hours for the application and 30 minutes 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 ​burden 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 Created2017-04-07

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