Form 3-200-13 Migratory Bird Depredation Permit Application Form

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

3-200-13 Application - Migratory Bird Depredation Rev 02-2018

Application - Migratory Bird Depredation Permit (Form 3-200-13) - Individuals

OMB: 1018-0022

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WHAT YOU SHOULD KNOW ABOUT A FEDERAL
DEPREDATION PERMIT
A federal depredation permit authorizes you to capture or kill birds to reduce damage caused by birds or to protect other interests such as
human health and safety or personal property. A depredation permit is intended to provide short-term relief for bird damage until long-term,
non-lethal measures can be implemented to eliminate or significantly reduce the problem.
You should review Title 50 parts 10, 13 and 21.41 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 are on our website at:
https://www.fws.gov/birds/policies-and-regulations/permits/permit-policies-and-regulations.php.

1. What is Depredation?
Depredation is damage or loss caused by birds. Depredation includes agricultural damage, private property damage, threats to human
health and safety, and threats to recovery of protected wildlife.

2. What is a Migratory Bird?
Almost all birds, including their nests and eggs native to the United States are protected under the Migratory Bird Treaty Act (MBTA).
Protection is not limited to only individual birds or species that migrate. In this fact sheet, “bird” refers to any bird species protected by the
MBTA. A list of protected species is published in the Code of Federal Regulations at 50 CFR 10.13. You can view the list at:
https://www.fws.gov/birds/management/managed-species/migratory-bird-treaty-act-protected-species.php. Nonnative species such as European
starlings, rock (feral) pigeons, house sparrows, and mute swans as well as upland gamebirds such as grouse, turkey and quail are NOT protected
under the MBTA. (See 70FR12710 for a complete list)

3. What activities can I do without a depredation permit?
You do not need a federal depredation permit to simply harass or scare birds (except eagles and federally listed threatened or endangered
species), provided (a) birds are not killed or injured and (b) birds sitting on active nests (nests with eggs or chicks present) are not disturbed to the
point that it causes the eggs to not hatch or the chicks to die or become injured.

4.

Do I need a federal permit to destroy bird nest?
A permit is not needed to destroy inactive bird nests, provided the nest is destroyed and not kept. An inactive bird nest is one without eggs
or chicks present. The Nest Destruction Migratory Bird Permit Memorandum (MBPM-2; April 15, 2003) provides additional guidance on nest
destruction (http://www.fws.gov/policy/m0208.pdf).
A permit is required to destroy an active bird nest (one with eggs or chicks present). A different permit is required to disturb or destroy nests
of Bald Eagles or Golden Eagles and birds listed as federally threatened or endangered. A list of threatened or endangered species can be found at:
https://www.fws.gov/endangered/

5.

What is a federal depredation order or control order?
Depredation and control orders allow the take of specific species of birds for specific purposes without a depredation permit. Make sure you
read the depredation or control order very closely before taking birds under it because each has very specific restrictions and conditions that
apply. Although a permit is not required, you must report any take conducted under a depredation or control order to be in compliance with the
Order and so the Service can monitor potential population impacts. The depredation and control orders in place are listed in the following table.
Regulation
50 CFR 21.43

Species
Blackbirds, Cowbirds,
Grackles, Crows, Magpies

Interest Harmed
Ornamental shade trees,
agricultural crops, livestock,
wildlife, when concentrated in
such numbers and manner that
they are a health hazard or other
nuisance

States
All

50 CFR 21.44

Horned Larks, Goldencrowned, White-crowned
and other Crowned
Sparrows, House finches

Agriculture, horticulture

CA

50 CFR 21.45
50 CFR 21.46
50 CFR 21.49

Purple gallinules
Scrub Jay, Steller’s Jay
Resident Canada Geese

50 CFR 21.50

Resident Canada Geese
(nests and eggs)

Rice
Nut Crops
Public safety at airports and
military airfields
People, property, agricultural
crops, or other interests

LA
OR, WA
Lower 48 States
(implemented by States and Tribes)
See registration website
(https://epermits.fws.gov/eRCGR/)

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50 CFR 21.51

Resident Canada Geese

Agriculture

Atlantic, Central, and Mississippi
Flyway portions of AL, AR, CO,
CT, DE, FL, GA, IL, IN, IA, KS,
KY, LA, ME, MN, MS, MO, MT,
NE, NH, NM, NJ, NY, NC, ND,
OH, OK, PA, RI, SC, SD, TN, TX,
VT, VA, WV, WI, WY
(implemented by States and Tribes)

50 CFR 21.52

Resident Canada Geese

Human health

50 CFR 21.53

Purple swamphens

(Invasive)

50 CFR 21.54

Muscovy Duck

(Invasive)

50. CFR 21.55

Barn Owl, Cattle Egret

(Invasive)

Lower 48 States (implemented by
States and Tribes)
All States, Puerto Rico, U.S. Virgin
Islands.
All States except TX Counties:
Hidalgo, Starr, and Sapata
Hawaii and the Pacific Islands

6.

What can I do with a depredation permit?
A depredation permit is intended to provide short-term relief for bird damage until long-term nonlethal measures can be implemented to
eliminate or significantly reduce the problem. A depredation permit authorizes “take” of birds protected under MBTA. Take includes killing
birds, trapping birds, egg addling (oiling), and destruction of active nests. Capture or killing of birds cannot be the primary methods used to
address depredation and will ONLY be authorized in conjunction with ongoing nonlethal measures.

7.

What are nonlethal measures?
Nonlethal measures are methods that prevent or minimize bird damage without take (take includes killing or trapping birds). Methods
include harassment (e.g., loud noises, pyrotechnics, propane cannons, scarecrows, dogs, trained raptors), habitat management (e.g., grass
management, vegetative barriers, fencing and netting), cultural practices (e.g., seasonal timing, landscape placement), and policies (e.g., no feeding
policies). Wildlife Services, part of the USDA, can provide information and expertise about preventing depredation and nonlethal methods. Visit
their website: www.aphis.usda.gov/aphis/ourfocus/wildlifedamage.

8.

Who can apply for a depredation permit?
The entity who is (a) experiencing the damage, (b) responsible for compliance with the permit, AND (c) has authority to implement
nonlethal measures should apply for the permit. Applicants are most commonly the landowner, occasionally a land manager or resource manager.
Private landowners, managers of public lands, State, Tribal, and local governments, and other entities, such as homeowners associations, with
legal jurisdiction for the property involved may apply for depredation permits.

Pest control and other contractors may assist permittees in completing an application as well as conducting the work as a subpermittee,
but may not apply for the depredation permit.

9.

What is a Form 37 and what is the role of Wildlife Services?
Wildlife Services is part of the U.S. Department of Agriculture (USDA) and provides expertise to help resolve wildlife conflicts. They
can assess your particular situation and provide recommendations of short-term measures to provide relief from bird damage and long-term
measures to help eliminate or significantly reduce the problem. Wildlife Services also provides a “Form 37 Permit Review Form”. This form
is required as part of your Depredation Permit application. You must call Wildlife Services (866-487-3297) to obtain a Form 37.

10. What information do I need to include with my application:
Your federal depredation permit application will consist of two forms:
(1) The Service application form 3-200-13, including Section E questions 1-15 along with a completed take table; and
(2) A current “Form 37 Permit Review Form”.
Your application will be considered incomplete and returned if you provide incomplete answers, do not answer all of the questions or
provide the information on each of these pages or do not include a current WS-37..

11. What is the application fee for a depredation permit?
The permit application processing fee is $100 for most permittees. The fee is $50 for homeowners experiencing damage to their personal
residence or property. The application fees are processing fees and nonrefundable, whether or not a permit is issued (50 CFR 13.11(d) (1)).
Government agencies (Federal, State, Tribal, and municipal governments) are exempt from the fee. Persons acting on behalf of a
government agency are fee exempt provided documentation of this status is submitted with the application. Please clearly state in your application
if you consider yourself fee exempt.

12. Will my permit be restricted to certain methods and species and numbers of birds?
Yes. Your permit will list the species and numbers of birds you are authorized to take and the method(s) you are authorized to use. You
must describe the species and numbers you are requesting to take and the method(s) you propose to use on your application. The take of some
species of birds may be further restricted due to their conservation status.
3-200-13 Rev. 10/2017

13. May I request to take Bald Eagles or Golden Eagles?
No. Bald Eagles and Golden Eagles receive additional protection under the Bald and Golden Eagle Protection Act. Please use the eagle
depredation permit application to apply to take (this includes disturbance, harassment, and/or trap-relocate) Bald Eagles or Golden Eagles
(http://www.fws.gov/forms/3- 200-16.pdf).

14. Do I have to use nontoxic ammunition when using a firearm to take birds?
Yes. We require the use of non-toxic ammunition when using firearms. You may request the use of lead shot and provide a
justification in the methods section of your application.

15. How do I dispose of dead birds?
Typically, dead birds must be (a) turned over to USDA for official purposes, (b) donated to a public educational or scientific institution,
or (c) completely destroyed by burial or incineration. Alternative disposal methods may be requested with appropriate justification.

16. Do I need any additional permits or other authorizations to conduct depredation activities?
Some States require a permit in addition to the Federal depredation permit. Additionally, you must comply with local ordinances, such as
discharging firearms. This permit does not authorize you to use Federal, State or Tribal lands or other public or private property without
appropriate authorization. It is your responsibility to make sure you comply with these requirements.

17. Where do I submit my depredation permit application?
Submit your application to the Service Regional Migratory Bird Permit Office that is responsible for the State in which the permitted
activity will take place. A list of permit offices, their area of responsibility, and contact information is included in the application package.

18. 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.

19. Will I be required to keep records of my depredation activities? Will they be inspected?
Yes. You must maintain accurate records, legibly written or reproducible in English, of operations on a calendar-year basis of the information
required by your permit. By accepting a Federal Depredation permit, you authorize an agent of the Service to enter your premises at any reasonable
hour to inspect the wildlife you hold, your books or records. (50 CFR 13.47)

20. Will I be required to submit an annual report of my depredation activities?
Yes. You will receive an annual report form from your Regional Migratory Bird Permit Office. The report form can also be found on our
website at: http://www.fws.gov/forms/3-202-9.pdf. This report must be completed and submitted to your issuing office by the date specified in
your permit even if no take activity occurred.

21. How long is a depredation permit valid? Can it be renewed?
Depredation permits may be valid for up to 1 year. Permits may be restricted to less than 1 year depending on the species involved and the
nature of the damage being experienced.
Depredation permits may be renewed. 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, along
with a new Permit Review form from Wildlife Services. 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 not able to process your request before the
expiration date, your permit will expire and you will no longer be authorized to conduct your activity. If you allow your permit to expire before
requesting renewal, you may be required to submit a new application. (See 50 CFR 13.11(c) and 13.22))

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

OMB Control No. 1018-0022
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Federal Fish and Wildlife Permit Application Form
Click here for addresses.

Type of Activity: Depredation

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

D.

2.d. Zip code/Postal code:

2.e. County/Province

2.f. Country

All applicants MUST complete

1.Attach check or money order payable to the U.S. FISH AND WILDLIFE SERVICE in the amount of $100.00 ($50.00 Homeowner) 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))
2.
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 
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

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SECTION E. MIGRATORY BIRD DEPREDATION
(Migratory Bird Treaty Act, 50 CFR 21.41)
A Federal Migratory Bird Depredation Permit is required to capture or kill migratory birds to reduce depredation or to protect other interests
such as human health and safety or personal property. You should apply for a depredation permit only after deterrents such as hazing and
habitat modification prove unsuccessful. If a permit is issued, you will be expected to continue nonlethal measures in conjunction with any
killing or trapping authorized.
Please read “What You Should Know About a Federal Migratory Bird Depredation Permit” before you sign and submit your application. You
should review Title 50 Parts 10, 13, and 21.41 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/policiesand-regulations/permits/need-a-permit.php .
Resident Canada goose nests and eggs: If you are only destroying or addling resident Canada goose eggs and your state is one that accepts
Federal registration, you may register for free online at https://epermits.fws.gov/eRCGR in lieu of obtaining a depredation permit. The States that
accept Federal registration are listed in the “State Agency Contacts and Information” link on the registration website.
Please provide the information requested below on a separate sheet of paper with your responses numbered according to the questions. You must
answer all of the questions even if the same information is included in your Form 37 (see question 9 below). You should be as thorough and
specific as possible in your responses. We may request additional information as appropriate to the activities you are requesting (50 CFR
13.21(d)). Incomplete applications will be returned. Failure to respond in the time required may delay processing of your application and may
be considered abandoned.
Processing time depends on the complexity of the request and completeness of the application. In general, applicants may expect a response within
90 days of our receipt o a complete application.

1.

Complete and submit the Take Request Table.

2.

Describe your requested method(s) of take and your experience with the method(s).

3.
Provide the exact location of the property or properties where the control activity would be conducted (State, county, physical address of
the specific site and the latitude/longitude in decimal degrees if available).
4.

Provide the information below for each species. Including photographs or other documentation can assist us in reviewing your request.
(a) A detailed description of the specific migratory bird damage or injury you are experiencing. Include details such as types of crops
destroyed or property damage incurred. Include any human health and safety hazards involved.
(b) How long it has been occurring (the number of days, months, or years).
(c) What times or seasons of the year does it occur?
(d) How large is the area affected (e.g., 1-acre pond; 50-acre vineyard)?

5.
Describe the extent of the damage and estimate the economic loss suffered as a result, such as percentage of acres of crop and dollar loss,
cost to replace damaged property, or cost of injuries. Attach copies of any receipts, invoices, contracts, or other available documentation to support
your estimate.
6.
Describe deterrents you have used to discourage depredating migratory birds and the results of the following nonlethal measures.
Photographs or other documentation of the situation can assist us in reviewing your request.
(a) Hazing or harassment techniques (e.g. horns, pyrotechnics, propane cannons, silhouettes, etc.), including how long (e.g. number of
weeks, months, year(s)) and how often you have conducted these deterrents.
(b) Habitat management measures (e.g. vegetative barriers, longer grass management, fencing, netting, etc.) you have taken to discourage
migratory birds from using the area.
(c) Cultural practices (e.g. crop selection and rotation, predator protection practices, no feeding policies) you have established to discourage
migratory birds from using the area.
7.
A depredation permit is not considered a long-term solution for most situations. What long-term measures do you plan to take to eliminate
or significantly reduce the continued need for killing or removal of birds, or destroying eggs/nests?
8.
If this is a renewal application, submit a completed annual report form. The Annual Report form can be found online at:
https://www.fws.gov/forms/3-202-9.pdf
9.
Your application for a depredation permit must include a recommendation from the U.S. Department of Agriculture, Animal and Plant
Health Inspection Service, Wildlife Services, for addressing your depredation problem. Contact Wildlife Services at (866) 487-3297. If Wildlife
Services recommends that a permit be issued to capture or kill birds, they will complete a Wildlife Services Permit Review Form (Form 37). Attach a
copy of the completed Wildlife Services Permit Review Form (Form 37). Your application will be considered incomplete if you fail to include a
current Form 37 with your application.

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Please note: The information contained on the Form 37 has similar information that is requested below. You must also complete each section
below that is applicable to your situation.

11. If you are applying on behalf of an airport for a permit to control birds in flight zones, indicate whether you are operating under a Federal
Aviation Administration-approved Wildlife Hazard Management Plan.
12. 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.
13. You must retain records, legibly written or reproducible in English, relating to the activities conducted under your permit for at least 5
years from 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

No

If “no,” provide the physical address.

14. 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

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

Have applied (Send copy when issued.)

None required

15. 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 (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)

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Instructions: Complete the following table for each species of migratory bird(s) you request to take under a Depredation Permit. If you propose multiple methods of take for one species, use a
separate line for each method; in such a case, the “estimated total number of birds involved in the damage or safety concern” for each line should be the same, as in the example below.
Estimated
PROPOSED METHOD OF TAKE
total
Proposed disposition
number of
Species
(bury; incinerate; release; food bank; falconer
birds
(Common name)
(specify name/State/permit number); institution;
causing
other (specify)
damage or
safety
concern
Number of nests (not
individual eggs) you
Number of birds you propose to:
propose to:
Kill
EXAMPLE: Canada goose
Canada goose

3-200-13 Rev. 10/2017

50
50

10
0

Trap &
Relocate
0
0

Other (specify quantity &
method)
0
0

Addle
(oil/shake)
0
25

Destroy
0
0

Bury
Other – leave

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MIGRATORY BIRD DEPREDATION PERMIT APPLICATION - TAKE REQUEST TABLE
Estimated
PROPOSED METHOD OF TAKE
total
number of
Species
birds
(Common name)
causing
damage or
safety
concern
Number of birds you propose to:

Kill

3-200-13 Rev. 10/2017

Trap &
Relocate

Other (specify quantity &
method)

Supplemental Page Number:
Proposed disposition
(bury; incinerate; release; food bank; falconer
(specify name/State/permit number); institution;
other (specify)

Number of nests
(not individual
eggs) you propose
to:
Addle
(oil/shake)

Destroy

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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. 10/2017

Page 6 of 8

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 3-200-13 is 1.5 hours for individuals to 3 hours for businesses and state/local/tribal governments. The burden
for recordkeeping is 15 minutes for individuals and 30 minutes for businesses and state/local/tribal governments. This includes 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 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. 10/2017

Page 7 of 8

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 Created2017-04-10

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