Form 3-200-44A Annual Report - Registered Agent/Tannery Inventory

OMB No. 1018-0093

Expires 05/31/2017

Registered Agent/Tannery Bi-Annual Inventory Report

Permit number________________ Name__________________________________ Time-period _________________________ Signature _________________________

Address (If location/address has changed, indicate new location and date of change): _______________________________________________________________________

This information details activities of a registered agent or registered tannery. This form may be copied. Please include the following information for EACH ITEM:

Animal Species 1	Amount and Description of Item (only one item per line)	Weight of Walrus Ivory *2	US FWS Tag#3	Received from: Name and Address	Date	Transferred to, Returned to, or Sold to (applicable only to Registered Agents): Name and Address	Date
Example: Walrus	1 Tusk	5 lbs.	#8787	John Littlesmith 16 Main St., Anchorage, AK 99999	1/1/2007	Jane Featherstone 20 Main St., Anchorage, AK 99999	5/1/2007

SUBMIT REPORT: Biannually (twice a year) on or before the 10th day of January and July, the permittee must submit this form containing records of each transaction by either e-mail to: [email protected] OR by mail to: Regional Investigative Analyst, U.S. Fish and Wildlife Service, Office of Law Enforcement, 1011 East Tudor Road, Mail Stop 151, Anchorage, AK 99503-6199. If no transactions have occurred, a negative report is required.

FEDERAL FISH AND WILDLIFE PERMIT

Paperwork Reduction Act – Notice

In accordance with the Paperwork Reduction Act of 1995 (44 U.S.C. 3501, et seq.), please be advised:

1. The gathering of information on fish and wildlife is authorized by:

(Authorizing statutes can be found at: http://www.gpoaccess.gov/cfr/index.html and http://www.fws.gov/permits/ltr/ltr.html

a. Bald and Golden Eagle Protection Act (16 U.S.C. 668), 50 CFR 22;

b. Endangered Species Act of 1973 (16 U.S.C. 1531-1544), 50CFR 17;

c. Migratory Bird Treaty Act (16 U.S.C. 703-712), 50 CFR 21;

d. Marine Mammal Protection Act of 1972 (16 U.S.C. 1361, et. seq.), 50 CFR 18;

e. Wild Bird Conservation Act (16 U.S.C. 4901-4916), 50 CFR 15;

f. Lacey Act: Injurious Wildlife (18 U.S.C. 42), 50 CFR 16;

g. Convention on International Trade in Endangered Species of Wild Fauna and Flora (TIAS 8249), http://www.cites.org/, 50 CFR 23;

h. General Provisions, 50 CFR 10;

i. General Permit Procedures, 50 CFR 13; and

j. Wildlife Provisions (Import/export/transport), 50 CFR 14.

3. The relevant burden for the report conditioned by an issued Registration of Agent/Tannery is 1 hour. This burden estimate includes time for reviewing instructions, gathering and maintaining data and completing and reviewing the report. 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.

DO NOT RETURN THIS PAGE WITH THE APPLICATION

1 Animal Species: Polar bear, Walrus, Alaskan sea otter

22 Applicable only to Registered Agents in Alaska. Provide weight of walrus ivory in pounds.

33 U.S. Fish & Wildlife Service Tag number assigned by Service personnel or Service’s authorized representative.

3-200-44a Rev. 02/2014 Page 2 of 2