Form 3-200-10b Rehabilitation Permit Application Form

WHAT YOU SHOULD KNOW ABOUT A FEDERAL
MIGRATORY BIRD REHABILITATION PERMIT

A Federal Migratory Bird Rehabilitation permit will authorize you to take, transport and temporarily
possess sick, injured, and orphaned migratory birds protected under the Migratory Bird Treaty Act
(MBTA) for rehabilitation purposes. You should review Title 50 parts 10, 13 & 21.31 of the Code of
Federal Regulations (CFR). These regulations can be found on our website at:
https://www.fws.gov/birds/policies-and-regulations/permits/permit-policies-and-regulations.php
You are responsible for reviewing and understanding these regulations before you request and
accept a permit. Below is a review of several sections pertinent to a Federal Migratory Bird
Rehabilitation permit. The list of migratory birds (50 CFR 10.13) can be found at
https://www.fws.gov/birds/management/managed-species/migratory-bird-treaty-act-protectedspecies.php.
1.

What are the age and experience requirements necessary to qualify for a rehabilitation permit?
You must be at least 18 years of age with a minimum of 100 hours of hands-on experience, gained
over the course of at least 1 whole year, rehabilitating each type of migratory bird you intend to
rehabilitate (e.g., waterbirds, songbirds, raptors). Up to 20 hours of the 100-hour time requirement may
be fulfilled by participation in migratory bird rehabilitation seminars and courses.
What are the caging requirements?
Facilities must be adequate for each species you plan to rehabilitate. You will be required to submit
photographs and diagrams of your enclosures with your application. Criteria used for evaluating and/or
inspecting your facilities will be based on the National Wildlife Rehabilitators Association (NWRA) and
International Wildlife Rehabilitation Council’s (IWRC) Minimum Standards for Rehabilitation (2000).
You may obtain a copy of this publication by calling NWRA at 320-259-4086 or IWRC at 510-383-9090.
You can also visit their web sites at: www.nwrawildlife.org or http://theiwrc.org/.
2.

3.

May I share rehabilitation facilities with someone else?
No. We will issue only one permit per address. The permitted individual or principal officer is
legally responsible for the activities and all the birds at the facility and anyone who is a subpermittee
named in writing to the Regional Migratory Bird Permit Office.
4.

Can I rehabilitate migratory birds at more than one location?
Yes. If permitted activities will take place at additional locations other than your primary facility,
the facilities at that location must be listed on the permit.
5.

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) Primary Caretaker. A Primary Caretaker can be identified for an organization if the principal
officer does not meet the experience requirements for this permit. This individual is listed on the
permit. The Primary Caretaker or subpermittee must be present when authorized activities are
conducted.
(d) 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)
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. If subpermittees maintain birds or records off-site, their physical location must be
listed on your permit. Subpermittees must be at least 18 years of age. Individuals younger than
18 must have a permittee or subpermittee present when conducting activities.
Do individuals transporting birds to rehabilitation need a permit?
The Good Samaritan provision (50 CFR 21.31(a)) allows any person who finds a sick, injured, or
orphaned migratory bird to take possession of the bird in order to immediately transport it to a permitted
rehabilitator. However, any individual(s) regularly transporting birds directly to your facility or from
your facility directly to another facility must either be listed under your permit as a subpermittee or
possess their own rehabilitation permit.

6.

Do I need to report suspected criminal activity involving a migratory bird that I receive for
rehabilitation?
Yes. You must notify your U.S. Fish and Wildlife Service’s Office of Law Enforcement if you
receive a live or dead migratory bird whose injuries appear to be caused by poisoning, gunshot,
electrocution or other criminal activity. Contact information for Office of Law Enforcement is at the end
of your permit or can be obtained at https://www.fws.gov/le/regional-law-enforcement-offices.html or by
calling your Regional Migratory Bird Permit Office.
7.

8.

How long can I keep a migratory bird in captivity for rehabilitation?
Birds may not be held for more than 180 days unless approved by the Regional Migratory Bird
Permit Office. If a bird needs greater than 180-days for care or placement, you may request an extension
from the Regional Migratory Bird Permit Office at least 30-days prior to the end of the 180-day period.
You must release all releasable recuperated birds to the wild in appropriate habitat as soon as seasonal
conditions allow. You must place non-releasable birds as soon as possible. Repeat extensions may not be
provided for placement reasons.
9.

When must I euthanize a migratory bird?
You must euthanize any bird that has sustained injuries requiring amputation of a leg, a foot, or a
wing at the elbow (humero-ulnar joint) or above, and/or is completely blind. You must not sustain the
life of any migratory bird that cannot after medical management feed itself, perch upright, or ambulate
without inflicting additional injuries to itself. You must obtain permission before euthanizing any Bald
Eagle, Golden Eagle or Threatened or Endangered species unless Service personnel are not available and
humane considerations warrant prompt euthanasia.

10. Can I accept migratory birds that are injured in the process of being removed from inside
buildings?
Yes. The public does not require a Federal permit to humanely remove a trapped bird from the
interior of a residence or a commercial or government building if the bird poses a health threat, is
attacking people, threatens commercial interests such as damage to merchandise, or may injure itself. The
property owner must transfer any bird that is injured or orphaned during the removal to a federally
permitted rehabilitator. If an active nest with eggs or nestlings is present, the property owner must seek
the assistance of a federally permitted rehabilitator in removing the eggs or nestlings and caring for them.
A request for a contribution to help cover the cost of care incurred by you is encouraged. (See 50 CFR
21.12(d))
11. Can I allow the public to view migratory birds undergoing rehabilitation?
Yes, under certain conditions only. Birds may be viewed via photographs, by using video equipment
or barriers (i.e. one-way viewing glass) that prevent the birds from both hearing and seeing the public. If
at any time a device that allows the public to view birds causes stress or harm, or impedes the
rehabilitation of any bird, it must be discontinued immediately. You may use photographs and/or videos
to highlight your rehabilitation activities (i.e. social media and print materials).
12. Can I keep a migratory bird to use for educational purposes?
No. This permit does not authorize you to possess birds for educational purposes. You must release
all recuperated birds to suitable habitat following the recovery of the bird as soon as seasonable
conditions allow. However, any bird that, after rehabilitation, cannot be released to the wild may be, with
prior authorization of your Regional Migratory Bird Permit Office, transferred to a Migratory Bird
Special Purpose Possession permit if the bird is suitable for use in educational programs, or may be
transferred to another type of permit as deemed appropriate, .
13. Can I keep imprinted migratory birds for educational purposes?
No. Under no circumstances will anyone be permitted to keep a bird that has been imprinted while
under their care. Orphaned migratory birds should be raised in a manner in which they are imprinted upon
their own species. Every precaution must be taken to avoid imprinting birds to humans. Except as
required to feed, water, and exercise animals, indoor and outdoor facilities, cages, pens, enclosures or
other areas must be sufficiently separate and protected from pets and from human living or work space to
prevent human contact with animals. You will be required to transfer any birds that are imprinted to
humans while in your care or a subpermittee’s care as directed by your Regional Migratory Bird Permit
Office. If a bird is imprinted prior to being received by you, you may request authorization to keep it as
an education bird provided you can demonstrate that the bird was imprinted prior to your care.
14. Can I transfer migratory birds, other than eagles, to other permit holders?
Yes. Dead and non-releasable live birds that are suitable for use in educational programs or research
projects can be placed with a qualified educational or scientific institution as defined in 50 CFR 10.12.
Live birds require permission from your Regional Migratory Bird Permit Office prior to transferring.
Prior to the transfer of any birds, rehabilitators must follow instructions on page 2 of Form 3-202-12
Migratory Bird and Eagle Acquisition and Transfer form and submit the form and required attachments to
the appropriate Regional Migratory Bird Permit Office. The form can be found on our website at:
http://www.fws.gov/forms/3-202- 12.pdf. Additional requirements apply for Bald Eagles, Golden Eagles,
and species listed as federally threatened or endangered.
15. Are there additional requirements if I admit a Bald Eagle or Golden Eagle or species listed as
federally threatened or endangered for rehabilitation?
Yes. You must report within 24 hours the acquisition of any (dead or live) eagle or species listed as
federally threatened or endangered (t/e) to your Regional Migratory Bird Permit Office. The permit office

will determine the disposition of all eagles and t/e species, including their transfer to another federally
permitted rehabilitator approved to rehabilitate eagles or t/e species.
16. How do I 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) In addition, you must provide pictures and diagrams (including a description of materials
used) of your cages if your physical address has changed.
17. Do I need a State permit to rehabilitate migratory birds?
Your permit is not valid unless you are also in compliance with State requirements, which may be
more restrictive. This means that if your State requires you to have a permit to possess migratory birds for
rehabilitation purposes, 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.
18. 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 bird that you possessed and its disposition, including whether the birds were released,
euthanized, died, are still undergoing rehabilitation in your care, or were transferred (including the name
of the person(s) or institution to whom birds were transferred).
19. Will anyone inspect my records or migratory birds in my care?
Yes. By accepting a Federal Rehabilitation permit, you authorize an agent of the Service to enter
your premises at any reasonable hour to inspect the wildlife in your care, your books and records. (See 50
CFR 13.47)
20. Will I be required to submit an annual report of activities?
Yes. The report form can be found on our website at http://www.fws.gov/forms/3-202-4.pdf or you
may 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.
21. 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))
(3-200-10b) Rev. 10/2017

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: Rehabilitation

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 $ 50.00 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 3-200-10b

Rev. 10/2017

Page 1of 6

SECTION E. REHABILITATION
(Migratory Bird Treaty Act, 50 CFR 21.31)

OMB Control No. 1018-0022
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Note​: ​A Federal Rehabilitation permit is required to acquire, temporarily possess, or transport sick and injured migratory birds, restore
them to health, and release them back to the wild. Birds undergoing rehabilitation may not be displayed to the public. Permits are
available to individuals and organizations with appropriate facilities as described in the NWRA/IWRC Minimum Standards for
Wildlife Rehabilitation (2000 version) and demonstrated experience in rehabilitating migratory birds. You must be at least 18 years old
to apply. A rehabilitation permit may be valid up to 5 years. Please read “What You Should Know About A Migratory Bird
Rehabilitation Permit” and the pertinent regulations before you sign and submit your application​.
Please provide the following information. You use the space provided and, where needed, a separate sheet of paper with your responses
numbered according to the application questions below. You should be as thorough and specific as possible in your responses.
Incomplete applications will be returned, delayed or abandoned.
1)

What groups of species do you intend to rehabilitate?
Songbirds/Passerines
⬜​ ​Waterfowl
⬜​ ​Marsh Birds
Raptors ⬜
​ ​ ​Eagles

⬜​ ​Wading Birds

⬜​ ​Shorebirds

⬜​ ​Seabirds

2)

You must have at least 100 hours of hands-on experience rehabilitating the types of migratory birds you intend to rehabilitate (e.g.,
waterbirds, raptors), or other comparable training and experience.
a) (a) Describe in detail your experience and training, including the source and the duration, in treating and rehabilitating migratory
birds. List the species you have worked with and the approximate number of hours or years of experience in each of the following
areas:
b) handling, capturing, and restraining
c) transporting
d) providing daily care and feeding; and
e) ) the types of medical treatments provided and management of injuries.

3)

Provide the name, address, and telephone number of the federally authorized facility where your experience was obtained. If you are
using training in lieu of up to 20 experience hours, include the course/seminar, provider/instructor, number of hours, and date completed.

4)

Provide a letter of recommendation from a federally permitted rehabilitator familiar with your training and experience. Also attach a
letter from a federally permitted rehabilitator stating his or her willingness to provide you with assistance. If these are the same
individual, a single letter may be submitted.

5)

Describe your rehabilitation facilities for restricted, limited, and unlimited care. Attach photographs and diagrams of your indoor and
outdoor enclosures. Diagrams must include dimensions (width, length, and height) and a description of interior and exterior construction
materials, such as flooring and netting materials. Indicate the species or type of species to be housed in each. If your facilities are not
physically located at the mailing or physical address provided on page 1, section C.1., of this application provide the physical location
(street address or legal description).

6)

Describe how birds will be conditioned for release. If you will use creance flying, describe in detail the techniques you will use and your
experience with these techniques.

7)

Describe the diet you will administer for each group of species you propose to rehabilitate, and indicate your food source.

8)

Provide the name and telephone number of your State Wildlife Law Enforcement contact.

9)

Subpermittees: Provide the name of anyone who will be responsible for the permitted activities in your absence. Anyone authorized to
conduct permitted activities in your absence must be at least 18 years old

10)

As the permittee, you are legally responsible for ensuring that your subpermittees, staff, and volunteers adhere to the terms of your permit
when conducting migratory bird rehabilitation activities. Some states may require Federal subpermittees to have their own state permit.
Any individual(s) regularly transporting birds directly to your facility or from your facility directly to another facility must either be listed
under your permit as a subpermittee or possess their own rehabilitation permit.

11)

Location(s): Provide the physical address where rehabilitation will occur. If you are requesting authorization to rehabilitate at multiple
locations, provide the following information: subpermittee name; physical address; age; description of their migratory bird rehabilitation
experience; type of species they will care for; type of care they will provide; diagrams (width, length, and height dimensions) and
photographs of their facilities. Off-site subpermittees caring for young songbirds/passerines may also be required to include enclosure
information.

12)

Attach a letter from a licensed veterinarian stating their willingness to work with you by providing any necessary veterinary assistance.

13)

You must retain records of each migratory bird you receive for at least 5 years following the end of the calendar year covered by the
records. The records must include the date each bird is received, type of injury or illness, disposition, and date of disposition.

Form 3-200-10b

Rev. 10/2017

Page 2 of 6

OMB Control No. 1018-0022
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14)

Is the physical address you provided in Section C on page 1 of this application the address where your records will be kept?
✔ Yes
a) ⬜​
⬜​ ​No If “no,” provide the physical address.

15)

If you are renewing your permit, include your current annual report with your application. The annual report form may be found at the
following website: ​https://www.fws.gov/forms/3-202-4.pdf​.

16)

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?

17)

✔

Yes

If “yes,” attach a copy of the approval(s). ◻ Have applied (Send copy when issued)

◻​ None required

18)

If you are operating as a ​private individual​, as opposed to a business or nonprofit organization, indicate if the Service may include
your name, address, and telephone number in a public list of permitted migratory bird rehabilitators?
a)
Yes (I am operating as a private individual and ​you may post my contact information​ .
b)
No (I am operating as a private individual and y​ ou may ​ not ​ post my contact information​ .
c) ✔ Not Applicable (I am operating as a nonprofit organization, business, agency, or other institution.)

19)

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
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.

Form 3-200-10b

Rev. 10/2017

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. Form 3-200-10b

Rev. 10/2017

Page 4 of 6

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 3-200-10b is 7 hours for the application and 5 hours 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 nonconfidential summary and remaining documents may be made available to the public under FOIA [43 CFR 2.26 – 2.33].

Rev. 10/2017

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]