Form 3-200-81 Special Purpose - Utility Permit Application Form

WHAT YOU SHOULD KNOW ABOUT A
FEDERAL SPECIAL PURPOSE UTILITY PERMIT
A Special Purpose Utility permit authorizes utilities to collect, transport and temporarily possess migratory birds
found dead on utility property, structures, and rights-of-way for avian mortality monitoring or disposal purposes. Permits can
also authorize active nest relocation or destruction in emergency circumstances. A utility includes, but is not limited to, a
business that owns or operates a facility that generates or transmits electricity, gas, oil, water, or communications structures
such as cellular towers, microwave transmitters and their related infrastructure, as well as resource development and
recovery businesses.
You should review Title 50 parts 10, 13 and 21.27 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-andregulations.php.
What does a Special Purpose Utility Permit authorize?
A Special Purpose Utility permit authorizes utilities to collect, transport and temporarily possess migratory birds found
dead on utility property, structures, and rights-of-way for avian mortality monitoring or disposal purposes. Authorization can
include emergency relocation or destruction of an active nest. This permit can also authorize a utility to remove bird remains
from an area and/or retain specimens for identification.

1.

Are utilities required to obtain a Special Purpose Utility Permit?
No. A Special Purpose Utility Permit is not required. However, the Service encourages utilities to obtain this permit. It
enhances a utility’s ability to accurately monitor migratory bird mortalities. Collecting and reporting the associated data to the
U.S. Fish and Wildlife Service (Service) contributes to our collective knowledge and understanding of the impacts of the utility
on migratory birds.

2.

3.

Can a consultant obtain a Special Purpose Utility permit?
No. This permit will be issued only to utility companies. A consultant may act on behalf of a company to develop the
monitoring plan, permit application materials, and reports, as well as and conduct the fieldwork. However, the Principal
Officer of the utility company must sign the application and is responsible for the activities that occur.
4. Does this permit authorize the killing or injury of migratory birds?
No. This permit does not authorize intentional or incidental killing or injury of migratory birds or eagles, nor does it
absolve the utility for liability from intentional or incidental killing or injury.
In the event you find a sick, injured, or orphaned migratory bird, including eagles, a federally permitted rehabilitator or
licensed veterinarian can assist with instructions.
5.

Can utilities move migratory bird nests that are at risk or pose a human safety risk?
Yes. Permits issued to utilities authorize the relocation or removal of active migratory bird nests on structures if they are
causing a safety risk, such as a fire or power outage, or operator safety. Inactive nests may be removed without a permit (See
Nest Destruction Memo at https://www.fws.gov/migratorybirds/pdf/policies-and-regulations/MBPM-2nest.pdf). To conduct
activities involving nests of Eagles or federally listed Threatened or Endangered Species, you must obtain additional
appropriate permit(s).
6.
Must utilities have an avian protection plan or migratory bird conservation plan to qualify for a Special Purpose
Utility Permit?
No. Although the Service encourages utilities to prepare an avian protection plan or other conservation plan in

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cooperation with the Service to guide siting, construction, and operation of energy facilities, a plan is not required for a
Special Purpose Utility Permit.
7.

Where can a utility obtain information about developing a post-construction mortality monitoring plan?
The Service’s Land-Based Wind Energy Guidelines and the Eagle Conservation Plan Guidance each provide
information about designing a scientifically rigorous avian mortality monitoring plan. Although both of these documents
are directed at wind energy facilities, the fatality monitoring methods and metrics may aid other types of utilities in siting
and operations. These documents are available at https://www.fws.gov/birds/management/project-assessment-tools-andguidance/guidance-documents/wind-energy.php
8.

Can a utility use migratory bird carcasses for searcher efficiency and scavenger removal trials?
Yes. Your permit may authorize migratory bird carcasses to be used for searcher efficiency and scavenger removal
trials. Birds salvaged under your permit may only be used AFTER they have been reported to the Regional Migratory Bird
Permit Office as required by the permit conditions. Eagles and species federally listed as Threatened or Endangered may not be
used.
9.

What type of research can I conduct under a Special Purpose Utility permit?
Research related to operation of the utility can be authorized by a Special Purpose Utility permit. This includes such
research as searcher efficiency trials, carcass remove trials, operational changes, etc. The Service will consider on a case-bycase basis applications for Scientific Collecting Permits for independent research that transcends the operations of an
individual utility.
10.

Can a utility multiple utility projects obtain a single Special Purpose Utility permit to cover all of their projects?
Yes. The Service can issue a single permit to a utility with multiple projects. This includes projects of the same type (i.e.
multiple wind projects) and projects of different types (i.e. transmission, wind, and solar). The utility should apply to the
Service Region where the majority of the activity is occurring. A list of the Service Regions is on the last page of this form.

11.

If the company or operation is sold, can the permit be transferred to the new owner?
No. Permits are not transferrable (50 CFR 13.25). The new owner must submit an application for a new permit
referencing the previous permit number, and the previous owner must request discontinuance of the activities associated with
the sold operation.

Who are the personnel identified on my permit and what are they authorized to do, i.e. principal officer,
primary contact and subpermittee?
(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 legally responsible for the application,
any permitted activities, and the annual reporting requirements.
(b) Primary Contact. The Primary Contact is the person in the organization who is available to answer
questions about the application or permitted activities. They often organize and complete documents for
the Principal Officer’s signature and maintain records. This person may be the same or different than the
Principal Officer. The Primary Contact is not authorized to conduct permitted activities 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) specifying activities (including location and
duration) they are authorized to conduct.

12.

As the permittee, you are legally responsible for ensuring that your subpermittees, staff, and volunteers are
properly trained and adhere to the terms of your permit If subpermittees maintain birds or records off-site,

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their physical location must be listed on your permit. Subpermittees must be at least 18 years of age.
Individuals younger than 18 and staff/volunteers not identified as subpermittees must have a permittee or
subpermittee present when conducting activities.

13.

Are other permits needed to conduct permitted activities?
A Federal Special Purpose Utility permit is not valid unless the permittee also complies with other applicable Federal,
State, Tribal, or local requirements. This means that if a State requires you to have a permit to collect dead migratory birds,
you must have one in order for the Federal permit to be valid. It is the permittee’s responsibility to ensure compliance with
any other permit requirements.
14.

Does this permit authorize the Service to inspect utility property?
Yes. Acceptance of a permit authorizes the Director's agent to enter the permittee’s premises at any reasonable
hour to inspect the wildlife, records, and property, and for compliance with the terms of the permit.
15.

Will a company be required to keep records of its activities?
Yes. Every Special Purpose Utility permit holder must maintain accurate records, legible written or reproducible in
English, of the permitted activities on a calendar-year basis. Your permit will specify the records you must keep which may
include all of the data associated with each formal carcass search any incidental find and each carcass or part collected. These
records must be kept for at least 5 years after the expiration of the permit.

16.

What is the reporting requirement for Special Purpose Utility Permits?
Permit holders are required to report to the Service all birds found dead or injured on utility property. Generally,
report requirements include such information as species (if known), date discovered, condition of the specimen, GPS
coordinates or other identifying information for where found, suspected cause of mortality, and disposition of carcass or
injured bird.

17.

What is the process for reporting?
The Service is transitioning from a paper format to an electronic format. Ultimately, all Service permitting and
reporting will be done through an online database currently under development. In the interim, submit your Annual Report
(form 3-202-17, available at: http://www.fws.gov/forms/3-202-17.xlsm) via email to BOTH:

•
•

Your Regional Migratory Bird Permit Office (see contact information on the last page of this form)
And, [email protected]

Use the subject line: “Annual Report - Permittee Name” (e.g. Annual Report - Windy Hill Farm)
18.

Will the Service protect the application and report information submitted by the permittee?
The Freedom of Information Act (FOIA) provides the public with access to agency records unless the records are
protected from disclosure by a specific exemption. Exemption 4 protects trade secrets and commercial or financial
information that is privileged or confidential. When Service has reason to believe that information that is responsive to a
FOIA request may be protected from disclosure under Exemption 4, we will follow the Department of the Interior’s (DOI)
FOIA regulations for handling confidential information, and, if required, inform the applicant/permittee of the request and
provide an opportunity to object to release. The DOI FOIA regulations for handling confidential information are located at:
43CFR2.26 – 2.36 (http://www.ecfr.gov/cgi-bin/textidx?SID=1ae96f673cc70e043eee67771516067e&node=43:1.1.1.1.2&rgn=div5). Nevertheless, when a company submits an
application or report, it should clearly identify any information in its application or report that should be considered
confidential business information.
19. What is the process for permit renewal?
If you wish to renew your permit, you must submit a renewal application to your Regional Migratory Bird Permit Office

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at least 30 days prior to the expiration of your permit and include a copy of your current State permit, 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 the Service acts upon your renewal application. 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))
20.

What information is required in the renewal application?
In addition to any updates in monitoring protocols, a renewal application must include information on any adjustments or
measures that were taken by the permittee to avoid or minimize mortalities as a result of the monitoring, and if so, any
preliminary results of those modifications. Additional information may be required based on the type of utility.

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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 Utility

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 $ 100.00 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

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E. MIGRATORY BIRD SPECIAL PURPOSE – UTILITY
(Migratory Bird Treaty Act, 50 CFR 21.27)

OMB Control No. 1018-0022
Expires ##/##/####

Note: A Federal Migratory Bird Special Purpose - Utility permit is required for utilities to collect, transport and
temporarily possess migratory birds found dead on utility property, structures, and rights-of-way as well as, in emergency
circumstances, relocate or destroy active nests. Utilities include facilities that generate or transmit electricity, gas, oil,
water, or communications structures such as cellular towers, microwave transmitters and their related infrastructure, as
well as resource development and recovery businesses. Permits will be issued to the utility; companies contracted to
conduct the permitted work may act as subpermittees under the utility’s permit. A Migratory Bird Special Purpose –
Utility permit may be valid for up to 3 years.
This permit does not authorize intentional or incidental killing or injury of migratory birds or eagles, nor does it absolve
the utility for liability from intentional or incidental killing or injury.
Please provide the information requested on a separate sheet(s) of paper with your responses numbered according to the
questions below. If you submit a supplemental document in answer to these questions, please include an index with the
section(s) and page number(s) where each question below is answered. You should be as thorough and specific as possible
in your responses. Incomplete applications will be returned, delayed, or abandoned. You should submit your application at
least 60 days prior to the date that you need your permit (50 CFR 13.11(c)). We cannot accept pages that are over 8.5” x
11” or DVDs.

A. UTILITY INFORMATION
(1) Name of project(s) and type of utilities to be covered (e.g. Windfarm Alpha - Wind, LineCo Beta - Transmission,
etc.)
(2) Location of each utility/project.
(a) Transmission utilities (e.g., electric, pipeline) - provide the general location of the transmission territory
where the collecting activity will be conducted. Including:
(i) State(s)
(ii) A map generally delineating the territory
(iii) A general description of the type of habitat surrounding the structures (e.g., desert, wetland, mountain
ridge, prairie, cropland, forest)
(b) Generation facilities (e.g., wind, solar, communications, mining) - provide the location of each project
or site where the collecting activity will be conducted. Including:
(i) State(s)
(ii) Location of property, including city, county, and latitude and longitude in decimal degrees.
(iii) A map delineating the property
(iv) A description of the type of habitat surrounding the structures (e.g., desert, wetland, mountain
ridge, prairie, cropland, forest)
(3) Description of utility/project.
(a) Transmission utilities, provide a general description of utility, such as number of poles/towers, number of
substations, and any generation or other facilities.
(b) Generation facilities: provide a detailed description of the utility footprint, equipment and structures,
including the height and configuration of structures.
B.

COLLECTING INFORMATION
(1) Indicate whether collection will occur as standardized searches, opportunistic collections, or both.
(2) Specify the purpose and goals of the collection or activity.
(3) If standardized fatality monitoring studies are proposed, provide a detailed description of the proposed collecting
project or activity, including:
(a) Search methods proposed (e.g., transects)
(b) Search frequency, search months, and search years proposed
(c) Whether searcher efficiency trials and scavenger removal trials will be conducted and their frequency
(4) If standardized fatality monitoring searches are proposed, provide the name, address, and qualifications of the
individual(s) ` who will be in charge of the monitoring and collecting activities.
(5) Provide copies of any supporting documents that may assist us in evaluating your application, such as your avian

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OMB Control No. 1018-0022
Expires ##/##/####

protection plan, post-construction monitoring protocols, etc.
(6) Indicate the intended disposition of migratory bird specimens. If specimens will be temporarily stored, provide the
location. If specimens will be donated, provide the name and address of the prospective recipient (e.g., public
scientific or educational institution or State agency).
C.

ADDITIONAL INFORMATION
(1) If your operations occur on land not owned by you, your permit will require that you inform landowners on what to
do if they find a dead bird. Please provide your outreach materials with the procedure landowners should follow and
your outreach schedule.
(2) Describe any measures you have taken to avoid, reduce, or mitigate migratory bird mortalities that may be
caused by the utility infrastructure or operations.
(3) If you are working with a Service field office or enforcement agent, provide the name and contact information. If
you are working with a State agency, provide the name and contact information for your contact.
(4) Identify any federally permitted migratory bird rehabilitator that will receive injured birds. The utility
permittee is responsible for rehabilitation costs of birds injured by utility operations or infrastructure.
(5) 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 same address where your records will be kept? If not, provide the
physical address.
(6) Subpermittees. 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. 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.
(7) 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?
If you have obtained all required approvals, answer “Yes” and attach a copy of the approval(s).
If you have applied for any required approvals, answer “Have applied” and send copy when issued.
If no State or Tribal permits or approvals are required, answer “None required.”
(8) 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? Answer “Yes” or “No.” (you must provide an answer). 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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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.

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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 ​as 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 - Utility permit application is 14.5 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 b​ urden 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]