Form 3-200-47 Application - Import of Birds for Scientific Research or

Federal Fish and Wildlife Permit Applications and Reports--Management Authority; 50 CFR 13, 15, 16, 17, 18, 22, 23

3-200-47 App - Import Birds Research Breeding Display WBCA 03092020

Application - Import of Birds for Scientific Research or Zoological Breeding and Display (WBCA) (Form 3-200-47) - Government

OMB: 1018-0093

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FWS Form 3-200-47 (Rev. 01/2020)
U.S. Department of the Interior

OMB Control No. 1018-0093
Expires ##/##/####

IMPORT OF BIRDS FOR SCIENTIFIC RESEARCH OR ZOOLOGICAL BREEDING AND
DISPLAY (WBCA)
☐New

☐Reissue/Renew ☐Amendment

Complete Sections A or B, and C, D, and E of this application. U.S. address may be required in Section C.**
A. Complete if applying as an individual
1.a. Last name
2 Date of birth
(mm/dd/yyyy)

5.a. Telephone number

1.b. First name
5.b. Alternate telephone
number

1.c. Middle name or initial

1.d. Suffix

6. E-mail address

B. 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.a. Description of business, agency, Tribe, or institution

4.a. Principal officer (P.O.) last name 4.b. P.O. first name

4.c. P.O. middle initial

5. Primary contact name

6. Primary e-mail address

7.a. Business telephone number

7.b. Alternate phone no.

3.b. Website URL (if applicable)
4.b. P.O. Title

8.a. Primary contact telephone no.

C. 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

D.

2.c. State

2.d. Zip code/Postal code

2.e. County/Province

2.f. Country

All applicants MUST complete
1. Include a check or money order, payable to the U.S. FISH AND WILDLIFE SERVICE, a nonrefundable processing fee (see the fee
schedule). 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))
2.
3.

If you are requesting a reissue/renew/amendment, what is your permit/file number?
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.

The individual/principal officer of the business must print and sign the application. (No photocopied or stamped signatures)

Date (mm/dd/yyyy)

** Click here for additional instructions on completing the above form (link to instruction page). See the last page for information on the Privacy Act,
Paperwork Reduction Act, Estimated Burden, and Freedom of Information Act aspects of this application form.
Mail your application(s) to Division of Management Authority, Branch of Permits, MS:IA 5275 Leesburg Pike, Falls Church, VA 22041-3803.
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FWS Form 3-200-47 (Rev. 01/2020)
U.S. Department of the Interior

OMB Control No. 1018-0093
Expires ##/##/####

E. IMPORT OF BIRDS FOR SCIENTIFIC RESEARCH OR ZOOLOGICAL BREEDING AND DISPLAY
(WBCA)
Complete all questions on the application. Mark questions that are not applicable with "N/A". Given the
length of many of the responses, please use a separate sheet of paper. On all attachments or separate
sheets you are submitting; please indicate the number of the application question you are addressing. In
addition, if applying to import multiple birds, be sure to indicate which bird is being addressed in each
response.
Electronic submission of inventories, photographs, and receipts/invoices: If you wish to provide information electronically,
please include a flash drive containing this information with your physical application.
1. Name and address where you wish the permit to be mailed, if different from page 1. If you would like expedited
shipping, please enclose a self-addressed, pre-paid, computer-generated, courier service airway bill. If
unspecified, all documents will be mailed via regular mail through the U.S. Postal Service.

2. Who should we contact if we have questions about the application (name, phone number, and e-mail)?

3. Have you or any of the owners of the business (if applying as a business, corporation, or institution), been
assessed a civil penalty or convicted of any criminal provision of any statute or regulation relating to the
activity for which the application is filed; 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; forfeited collateral; OR are currently under charges for any violation of the laws mentioned above?
☐ No

☐ Yes

If you answered “Yes” to Question 3, 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. Please be aware that a “Yes” response
does not automatically disqualify you from getting a permit.

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FWS Form 3-200-47 (Rev. 01/2020)
U.S. Department of the Interior

OMB Control No. 1018-0093
Expires ##/##/####

4. For each SPECIES/SPECIMEN, provide:
a. Scientific name
(genus, species, and, if
applicable,
subspecies)

b. Common Name

c. Actual or
Approximate
Hatch date

d. Quantity

e. Sex
(m/f)

f. Removed from the
wild or captive-bred?

5. If the bird(s) is/are still in the wild or was/were taken from the wild, include:
a. The country and specific location where the removal will occur or occurred;
b. Date specimen(s) was/were removed from the wild or will be removed;
c. A description of the status of the wild population of the species in the region of removal; and
d. A copy of all foreign collecting permits or authorizing letters from the proper government authority
allowing the collection of the bird(s).
e. Provide a description of where the bird(s) is/are currently being held and of the husbandry and care
currently being provided.
6. If the bird(s) was/were captive-bred, include:
a. Specimen report; or
b. A signed statement from the breeder containing the scientific and common name certifying that the
bird(s) was/were hatched and bred by the breeder, including the name and address of the breeder,
hatch date, and the identity and location of the parental birds; AND
c. Documentation showing how the bird(s) was/were acquired including the history of transactions
(e.g., chain of ownership), if applicable; and
d. Provide documentation on the parental stock of the requested bird(s) including from where the
parental stock was originally sourced and any other information detailing their acquisition. In some
instances, we may request documentation going back more than two generations.
7. Complete name and address of overseas person or business shipping the bird(s) to you:
Name:
Address:
City/Province:
State, County, Postal Code:
8. List all facilities that will be receiving birds from this shipment, either immediately after importation or within
the next year. If you are unsure, of which facilities may be receiving birds (e.g., final decisions on
placement have not been made), please indicate likely candidates and the mechanism that will be used to
determine recipient facilities.

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FWS Form 3-200-47 (Rev. 01/2020)
U.S. Department of the Interior

OMB Control No. 1018-0093
Expires ##/##/####

9. For each facility listed in question 8, provide:
a. Detailed description and photographs (no blue prints, please) of current facilities, including the total
number of enclosures to house incoming birds, the dimensions of each enclosure for the birds
intended for import, and the number of birds to be housed in each;
b. A description of husbandry practices; and
c. Qualifications of the personnel, within each facility receiving birds, who will be overseeing/caring for
the bird(s) (e.g., resume/brief curricula vitae).
10. If the purpose is for scientific research, include:
a. Research proposal including formal research protocol with timetable;
b. If research includes the production of progeny, include a full justification for the breeding;
c.

The relationship of such research to the conservation of the species in the wild;

d. A discussion of possible alternatives and efforts to obtain birds from other sources within the United
States;
e. The disposition of the imported birds and any progeny upon completion of the research project; and
f.

Qualifications of the personnel (within each facility receiving birds) conducting the research,
collecting samples, and caring for the bird(s) (brief curricula vitae are acceptable).

11. If the purpose is for zoological breeding and display, provide the following for each facility receiving
birds:
a. A history of the zoological facility's breeding programs with the same or similar species, including:
i.
Participation in any cooperative breeding programs and/or efforts to collaborate with other
managed zoological breeding programs;
ii.
Breeding and inventory records for the last two years, including hatching, survival, and
mortality records;
iii.
Plans for developing or maintaining a self-sustaining population of the exotic bird species
in captivity;
iv.
Causes of any previous mortalities and corrections to prevent future mortalities.
b. The relationship of the zoological breeding and display program to the conservation of the species
in the wild;
c.

The education program, both display graphics and other educational activities, provided to the
public on the ecology and/or conservation status of the species;

d. The number of visitors the facility receives annually;
e. A discussion of possible alternatives and efforts to obtain birds from other sources within the U.S.;
and
f.

Plans for disposition of the birds and any progeny.

12. The transport conditions must comply with the CITES Guidelines for Transport of Live Animals or, in the
case of air transport, with the International Air Transport Association (IATA) live animal regulations
(contact airline for information). As such, describe:
a. The type, size, and construction of any shipping container; and
b. The arrangements for watering or otherwise caring for the wildlife during transport.
All international shipments must be through a designated port. A list of designated ports (where an
inspector is posted) is available from the list of designated ports. If you wish to use a port not listed,
please contact the Office of Law Enforcement for a Designated Port Exemption Permit (form 3-200-2).

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FWS Form 3-200-47 (Rev. 01/2020)
U.S. Department of the Interior

OMB Control No. 1018-0093
Expires ##/##/####

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 Marine Mammal Protection Act (16 U.S.C. 1361, et seq.), 50 CFR 18; 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 which
affect protected species. This helps 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
We are collecting this information subject to the Paperwork Reduction Act (44 U.S.C. 3501) in order provide the U.S. Fish
and Wildlife Service the information necessary, under the applicable laws governing the requested activity, for which a
permit is requested. 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 applicable 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. 1018-0093.
ESTIMATED BURDEN STATEMENT
We estimate public reporting for this collection of information averages:
Original submission - paper-based: 2 hours
Amended submission - paper-based: 1 hour 45 minutes
Original submission - electronic: 1 hour 45 minutes
Amended submission - electronic: 1 hour 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.

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