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DEPARTMENT OF THE INTERIOR
U.S. Fish and Wildlife Service
Form 3-186
Date Received
______/_____/_____
Initials:
NOTICE OF TRANSFER OR SALE OF MIGRATORY WATERFOWL
SENDER (Permittee)
Name
Permit Number:_____________
RECIPIENT
Name
Address
Address
City
State
Zip Code
City
State
Phone Number:
Phone Number:
E-mail Address:
E-mail Address:
DATE OF SHIPMENT:
Zip Code
METHOD OF MARKING (excluding eggs):
BIRDS AND/OR EGGS TRANSFERRED
Number of
Males Females Eggs
Species
Species
Number of
Males
Females
Eggs
I certify that the information submitted above is true and correct to the best of my knowledge. I understand that making a false statement may
subject me to the criminal penalties of 18 U.S.C. 1001.
_______________________________________ _______________
Permittee’s Signature
Date
Form 3-186
________________________________ ____________
Recipient’s Signature
Date
Rev4/2017
Instructions for Completing Form 3-186
If you are...
then you need to do the following:
1.
selling, trading, or giving
away migratory waterfowl
2.
directly to the recipient,
3.
4.
5.
conducting your
transaction by mail,
OMB Control No. 1018-0022 Expires XX/XX/XXX
1.
2.
3.
4.
You (the seller) must complete all sections of the form and sign the certification, even if you
are giving the birds or eggs as a gift.
Make sure that the recipient of the birds or eggs (whether buying them or receiving them as a
gift) signs the certification.
Give the recipient the original copy of the completed form.
Retain one copy as your record of the transaction.
Mail one copy to the Regional FWS Migratory Bird Permit Office responsible for your State
before the end of the month in which you transfer the birds or eggs.
You (the seller) must complete all sections of the form and sign the certification, even if you
are giving the birds or eggs as a gift.
Send the completed form to the recipient of the birds or eggs (whether buying them or
receiving them as a gift) on the date the birds are shipped.
a. Have the recipient sign the certification.
b. Have the recipient keep the original copy and return a copy to you.
Retain one copy as your record of the transaction.
Mail one copy to the Regional FWS Migratory Bird Permit Office responsible for your State
before the end of the month in which you transfer the birds or eggs.
Notice
Privacy Act (5 U.S.C.552a): The gathering of information on fish and wildlife is authorized by the Migratory Bird Treaty Act (16 U.S.C. 703 et seq.), and
Parts 13 and 21 of Title 50 of the Code of Federal Regulations. Disclosure of the requested information is necessary for administration of permits under
MBTA and is a condition of your permit. Failure to disclose all of the requested information may be sufficient cause for revocation of your permit. The
information will be used to monitor take and disposition of migratory birds. If the information indicates a violation of a statute, regulation, rule, order, or
license, whether civil, criminal, or regulatory in nature, the information may be transferred to the appropriate Federal, State, local, or foreign agency charged
with investigating or prosecuting such violations. (Ref. 69 FR 5261, Sept 4, 2003) Paperwork Reduction Act (44 U.S.C.3501): 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. The reporting
burden estimate for reviewing instructions, gathering and maintaining data, and completing this form is 15 minutes. 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.
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 Type | application/pdf |
File Title | U.S. Fish and Wildlife Service Form 3-186 |
Subject | Notice of Transfer or Sale of Migratory Waterfowl Report Form |
Author | U.S. Fish and Wildife Service |
File Modified | 2018-02-01 |
File Created | 2014-07-09 |