Form 3-200-7 Federal Fish and Wildlife Permit Application Form - Migr

Form 3-200-7 (Rev. 03/2020)
U.S. Department of the Interior

FEDERAL FISH AND WILDLIFE PERMIT APPLICATION FORM

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

Migratory Bird and Eagle Scientific Collecting
(Migratory Bird Treaty Act, 50 CFR 21.21, 21.23; Eagle Act, 50 CFR 22.21)
U.S. Fish and Wildlife Service
Division of Migratory Bird Management
BEFORE FILLING OUT THIS FORM, please access the
Return Addresses (to obtain the email/postal mail addresses where
this form can be returned), review the Frequently Asked Questions,
and read the form Instructions. Please retain the "NOTICES" page
for your records.

TYPE OF REQUEST
New Application
Renewal
Amendment
If requesting a renewal or amendment, provide 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
instruction page(s) for information on how to make your application complete and help avoid unnecessary delays.

Complete if applying as an individual

A.

1.a. Last name

1.b. First name

2. Date of birth (mm/dd/yyyy)

B.

3.b. Alternate telephone number

3.a. Telephone number

1.c. Middle name or initial

1.d. Suffix

3.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.f. Country

1.e. County/Province

2.a. Mailing Address (include if different than physical address; include name of contact person if applicable)
2.b. City

D.

2.c. State

2.d. Zip code/Postal code:

2.e. County/Province

2.f. Country

All applicants MUST complete

1. A nonrefundable processing fee is required to process this permit, please attach check or money order payable to the U.S. FISH AND WILDLIFE
SERVICE. Federal, Tribal, State, and local government agencies, and those acting on behalf of such agencies, are exempt from the processing fee –
Please see link for processing fee cost and fee exempt status as outlined in 50 CFR 13.11(d).
Click here for Processing Fees
2. Do you currently have or have you ever had any Federal Fish and Wildlife permits?
No
Yes
If yes, list the number of the most current permit you have held or that you are applying to renew/re-issue:
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 stamped signatures. Electronic signatures accepted.)

Date of signature (mm/dd/yyyy)

Please continue to next page
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Form 3-200-7 (Rev. 03/2020)
U.S. Department of the Interior

FEDERAL FISH AND WILDLIFE PERMIT APPLICATION FORM
Migratory Bird and Eagle Scientific Collecting

(Migratory Bird Treaty Act, 50 CFR 21.21, 21.23; Eagle Act, 50 CFR 22.21)
U.S. Fish and Wildlife Service
Division of Migratory Bird Management

NOTE: A Federal Migratory Bird Scientific Collecting permit can authorize you to collect, transport or possess migratory birds (live
or dead), their parts, nests, or eggs for scientific purposes. A scientific collecting permit may be valid for up to 3 years. You must
be at least 18 years old to apply. You must be at least 18 years old to apply for a migratory bird permit. Please read
“Frequently Asked Questions” and the pertinent regulations before you sign and submit your application.
Please provide the information requested below. If additional information needs to be provided that does not fit in the designated
spaces, add additional sheets to your application submission. You may use as many additional sheets as needed. Please
number pages accordingly using the page number box provided at the bottom of the sheet, and the corresponding question
number.
You should be as thorough and specific as possible in your responses. Incomplete applications will be returned.
As the permittee, you are legally responsible for ensuring that your subpermittees, staff, and volunteers adhere to the terms of
your permit.

SECTION E.
Questions
1) a) What is the purpose of your request? (check all that apply)
Museum Specimen Collection
Scientific Research
Other (specify):
b) Do you wish to salvage?
No, I do not want/need the standard salvage permit condition
Yes, as part of my research
Yes, opportunistically
2) Attachments - In additions to this form, you should also attach the following to complete your application:
a) A statement of purpose and justification for the proposed research/collection. Include an outline of any research project(s).
Describe how the research/collection will advance the science of (a) the species taken, (b) other wildlife species, (c) humans,
or (d) archival collections.
b) Copies of any other permits related to the proposed activity (e.g. USGS Banding Permit, State Permit).
c) If required, state authorization for release to the wild.
d) Copies of any authorizations for access to state, federal, or tribal land.
e) Collecting Activity Table.
f) Institutional Animal Care and Use Committee (IACUC) approval, if this is required for your research. Many universities and
some federal agencies require this. If you have one of these, you can attach it in lieu of answering question 7 in Section E.
g) If you are renewing your permit, include your current annual report with your renewal application. The annual report form may
be found at the following website: https://www.fws.gov/forms/3-202-1.pdf
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Form 3-200-7 (Rev. 03/2020)
U.S. Department of the Interior

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3) 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, Have Attached
None Required

4) What is your requested start date (month/year) (Typical application processing time is a minimum of 60 days)

5) What is your anticipated completion date (month/year) including collection and holding of birds.

6) Provide the physical locations for all components of your research: where bird(s) will be collected, held in captivity,
released to the wild, etc.

7) Describe your methods. Include the information below as applicable. If this information is in another document (i.e. grant
proposal, IACUC approval, etc.), you may provide that document with an index to the page and section or paragraph numbers
where each item is specifically answered.
a)Trapping: explain your choice of trap, frequency of trap checks, and what, if any, lure you will use
b)Lethal Collection: explain why nonlethal methods do not meet your objectives
c)Euthanasia: describe your euthanasia method. For more information see the American Veterinary Medical
Association (AVMA) Guidelines for the Euthanasia of Animals
d)Invasive Procedures: describe your methods and how you will minimize pain and stress
e)Captivity: describe where and how long birds will be kept in captivity. Include a description, dimensions,
and/or photographs of permanent and transport enclosures. Include the diet and enrichment you will
provide.
f)Release to the Wild: describe your choice of release location(s). Provide state authorization, if required. If
held longer than 24 hours, describe how birds will be conditioned and evaluated for release.
g)Game Species: explain if collection will differ from hunting regulation(s)

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Form 3-200-7 (Rev. 03/2020)
U.S. Department of the Interior

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7) (continued)

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Form 3-200-7 (Rev. 03/2020)
U.S. Department of the Interior

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8) Prior to making decisions, federal agencies are required to comply with the National Environmental Policy Act
(NEPA) to assess the environmental effects of proposed actions, including permit issuance. To assist us, please
check the box below if you anticipate any effects to the environment by your activities on the item listed. If yes,
describe below. We may contact you for more information regarding your responses. (For more information on
NEPA, see the USFWS’s NEPA FAQ Sheet)
Breeding birds or other seasonality concerns
Populations of Birds of Conservation Concern and bird species with small local populations
Potential disease transmission
Non-target species
Threatened or endangered species
Spread of invasive species
Other natural resources including natural lands and waters
Cultural resources including historical sites
Low income, minority and/or Native American populations
Public health and safety

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Form 3-200-7 (Rev. 03/2020)
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9) Describe in detail your experience in conducting the proposed activities. Include the source and duration of experience for
each of the proposed activities. If you do not currently have experience in a proposed activity, identify who will be serving as a
mentor. For example, if you are trapping, provide a copy of your USGS Bird Banding Lab permit or a letter of reference regarding
your trapping experience from a Master Bander or other experienced trapper.

10) The name and address of the public scientific or educational institution(s) to which all migratory bird specimens will be
donated upon completion of the study.

11) If you reside or are located outside of the United States: provide the name of a contact, address, and telephone number
where you can be reached in the United States.

No
12) Are you requesting authorization to import/export?
Yes
If “yes”, include the following:
a) anticipated import/export dates and shipment(s),
b) species, number, and type of specimen per shipment
c) to and from whom the specimens will likely be shipped
d) the U.S. port(s) of entry/exit you will use (see https://www.fws.gov/le/designated-ports.html).

(Note: You must use a Designated Port (see http://www.fws.gov/le/ports-contact-information.html) unless you obtain a Port Exception
Permit from FWS Office of Law Enforcement. You may require additional permits for species protected by the Convention on
International Trade in Endangered Species (CITES), the U.S. Endangered Species Act, or the Wild Bird Conservation Act. Live Bald or
golden eagles or live eggs of those birds may not be imported or exported.
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Form 3-200-7 (Rev. 03/2020)
U.S. Department of the Interior

OMB Control No. 1018-0022
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13) Anyone who will be assisting you with the permitted activities or acting as your agent must either have their own Federal
migratory bird permit for the activity or be identified by you, in writing, as a subpermittee under your permit. They may also
require a State permit. Subpermittees must be at least 18 years old. As the primary permittee, you will be responsible for
ensuring that your subpermittees are properly trained and adhere to the terms of your permit. Provide the name of any
subpermittees who will be conducting activities under your permit.

14) You must retain records legibly written or reproducible in English relating to the activities conducted under your
permit for at least 5 years after 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.

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Form 3-200-7 (Rev. 03/2020)
U.S. Department of the Interior

OMB Control No. 1018-0022
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15) Disqualification factor. Have you, the permittee, or your client (if a broker on behalf of your client):
• Been assessed a civil penalty or convicted of any criminal provision of any statue or regulation relating to the activity for
which the application is filed (50 CFR 13.21(b) (1);
• Been convicted, or entered 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. (50 CFR 13.21 (c)(1)):
• Had a permit revoked within the last five years for willfully violating any Federal or State statute or regulation, or any Indian
tribal law or regulation, or any law or regulation of any foreign country, which involves a violation of the conditions of the
permit or of the laws or regulations governing the permitted activity (50 CFR 13.28 (a)(1)) or failing to correct deficiencies
that were the cause of a permit suspension within 60 days (50 CFR 13.28 (a)(2)).
Answer "yes" if ANY of the events listed immediately above have occurred. Answer "no" if none of the events listed immediately
above have occurred.
Yes
No
If you answered “Yes”, provide: a) the individual’s name; b) date of conviction, civil penalty assessment or revocation;
c) charge(s), or reason(s) for revocation; d) location of the incident; e) court (if applicable, ticket, federal/state/tribal court etc.);
and f) legal action taken for each violation (i.e. fine, incarceration, probation…). Please be aware that a “Yes” response does not
automatically disqualify you from getting a permit.

16) Are you eligible for Fee Exempt Status? Fee exempt status applies to government agencies (Federal, State, Tribal,
and municipal governments). 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, or the agencies tax exempt form.
Yes - Government Agency
Yes - Acting on behalf of Government Agency
Documentation Included
No - not eligible for Fee Exempt Status

17) I acknowledge that I have read the form Instructions and Frequently Asked Questions, and have accessed the page with the
Return Addresses to obtain the address where I should return this form. I have also filled out all fields and questions in this
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application. Check this box to acknowledge:

OMB Control No. 1018-0022
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Form 3-200-7 (Rev. 03/2020)
U.S. Department of the Interior

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
We estimate public reporting for this collection of information averages:
Original submission - paper-based: 5 hours
Amended submission - paper-based: 3 hours 45 minutes
Original submission - electronic: 3 hours 45 minutes
Amended submission - electronic: 3 hours 30 minutes
These estimates include 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: PRB/PERMA (JAO), Falls Church, VA 22041-3803, or via email at
[email protected]. Please do not send your completed form to this address.
FREEDOM OF INFORMATION ACT
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 nonconfidential summary and remaining documents may be made available to the public under FOIA [43 CFR 2.26 – 2.33].

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Form 3-200-7 (Rev. 03/2020)
U.S. Department of the Interior

OMB Control No. 1018-0022
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Migratory Bird Scientific Collecting Permit Application Collecting Activity Table

In the table below, list the species (scientific and common name listed in 50 CFR 10.13) and quantity of migratory birds and eggs you propose to collect; the location(s) where collecting is proposed (State
and, if known, specific Counties or sites); and the type of collecting you propose (e.g., lethal collection, viable egg collection, trap and retain, trap and release, trap and relocate). Trap & retain is intended for
birds retained in captivity (i.e. held for more than 8 hours and/or moved off-site). Trap & release is intended for temporary possession for sampling or similar activities. Trap & relocate is for birds that are
trapped for the purposes of relocation. If this will be a multi-year project, indicate the species and quantities to be collected each year or throughout the duration of the project. Use a separate line for each
year. See the accompanying Instructions for Completing the Scientific Collecting Activity Table below. Use the categories provided below as much as possible but if your collecting request does not fit the
categories below, provide further clarification in your written outline, study proposal, or justification. Attach the completed table to your Scientific Collecting Application.

APPLICANT NAME:

Species
(Scientific and Common Name)
Example - 1 year study (2022)
Anas strepera (gadwall)
Example - 2 year study (2020-2021)
Anas crecca (green-winged teal)

“

“

““

“

DATE (mm/dd/yyyy):
SCIENTIFIC COLLECTING ACTIVITY TABLE
Collection
Period
County or Site
Lethal
Trap &
Viable Eggs
State
(Calendar Collection
(if known)
Retain
Years)
OR Harney
5
5
0
2022
(Malheur NWR)

Trap &
Release
(includes
sampling)
100

Maximum
Total
Annual
Quantity
Total
Requested
Requested
0
110
330

Trap &
Relocate

VA

2020

10

0

0

50

0

60

“

2021

50

0

0

200

0

250

310

Form 3-200-7 (Rev. 03/2020)
U.S. Department of the Interior

Applicant Name:

Species
(Scientific and Common Name)

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SCIENTIFIC COLLECTING ACTIVITY TABLE – SUPPLEMENTAL SHEET

Supplemental Page Number:

State

County or Site
(if known)

Collection
Period
(Calendar
Years)

Lethal
Collection

Viable Egg
Collection

Trap &
Retain

Trap &
Release

Trap &
Relocate

Total
Maximum
Quantity
Annual
Total
Requested
Requested

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Form 3-200-7 (Rev. 03/2020)
U.S. Department of the Interior

INSTRUCTIONS FOR COMPLETING COLLECTING ACTIVITY TABLE
Species
Identify the species you propose to collect. Use the scientific and common name(s) listed in 50 CFR 10.13. (See list at
https://www.fws.gov/birds/management/managed-species/migratory-bird-treaty-act-protected-species.php
State
Specify the state where you propose to collect the species. Enter only one state per row.
County or Site (If Known)
You may enter one or more counties, boroughs, or specific collection sites where the collection will occur per row. This block may be left blank.
Collection Period (Calendar Years)
If your project is a single year project, the collection period is “Year 1.” If your project is a multiyear project and you intend to collect the same number of specimens annually, the
collection period is “Annually.” If your project is a multiyear project, the quantity of specimens will vary each year, and you will be collecting opportunistically each year, the collection
period is “Permit Duration (3 years).” If your project is multiyear and the number of specimens will vary each year but you intend to collect a specific quantity of specimens each year,
the collection period is “Year 1,” “Year 2,” and “Year 3,” as needed; you will need to duplicate rows for that species.
Types of Collecting Activities
Do not overlap quantities; the quantities entered in the various types of collecting activities across each row must be mutually exclusive.
Lethal Collection
Enter the maximum quantity of specimens of that species that you propose to kill. This includes shooting or any other proposed method of lethal collection.
Viable Egg Collection
Enter the maximum quantity of eggs (believed to be viable) you plan to collect. If you plan to collect nests with eggs, estimate the maximum number of eggs per nest. This also
includes viable eggs that are collected, incubated, and the hatchlings retained or released. Collection of eggs known to be nonviable is considered salvage and should not be
included here.
Trap & Retain
Enter the maximum quantity of specimens of that species that you propose to live-trap and retain in captivity permanently (either life-long or euthanized upon completion of the study).
Trap & Release
Enter the maximum quantity of specimens of that species that you propose to live-trap and release at the capture site (e.g., after collection of samples or data). This may include
prolonged holding prior to release.
Trap & Relocate
Enter the maximum quantity of specimens of that species that you propose to live-trap at the capture site and release at another location. This may include prolonged holding prior to
release.

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My Collecting Request Doesn’t Fit Your Collecting Categories
Use the categories provided as much as possible; provide further clarification in your written outline, study proposal, or justification.
Maximum Annual Total Requested
Add the quantities per species from all types of collecting that you have listed; enter the sum in this column (e.g. [Maximum Annual Total Requested] = [Lethal Collection] + [Viable
Egg Collection] + [Trap & Retain] + [Trap & Release] + [Trap & Relocate]). If your project is a multiyear project, the quantity of specimens will vary each year, and you will be
collecting opportunistically each year, you may leave the Maximum Annual Total Requested block blank.
Total Quantity Requested
If your project is a single year project, the Total Quantity Requested is the same as the Maximum Annual Total Requested. If your project is a multiyear project and you intend to
collect the same number of specimens annually, the Total Quantity Requested is three times the Maximum Annual Total Requested (e.g. [Total Quantity Requested] = 3 x
[Maximum Annual Total Requested]). If your project is a multiyear project, the quantity of specimens will vary each year, and you will be collecting opportunistically each year, the
Total Quantity Requested is the sum of all types of collecting that you have listed (e.g. [Maximum Annual Total Requested] = [Lethal Collection] + [Viable Egg Collection] + [Trap &
Retain] + [Trap & Release] + [Trap & Relocate]). If your project is multiyear and the number of specimens will vary each year but you intend to collect a specific quantity of specimens
each year, add the Maximum Annual Totals for Year 1, Year 2, and Year 3 (as applicable).