Form 3-200-51 Application - Approval of a Foreign Breeding Facility un

FWS Form 3-200-51 (Rev. 01/2020)
U.S. Department of the Interior

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

APPROVAL OF A FOREIGN BREEDING FACILITY UNDER 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 3-200-51 (Rev. 01/2020)
U.S. Department of the Interior

E.

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

APPROVAL OF A FOREIGN BREEDING FACILITY UNDER WBCA

This application is to be completed by a non-US breeding facility currently breeding CITES-listed bird species that would
like to export live birds to the United States. All imports of live CITES-listed birds from non-approved facilities must be
accompanied by a U.S. Wild Bird Conservation Act (WBCA) import permit. Breeding facilities that have been approved by
the U.S. Fish and Wildlife Service can export birds into the United States with only the required CITES documents.
Complete all questions on the application. Mark questions that are not applicable with "N/A". Given the length of many of
your responses, please use separate sheets of paper. On all attachments or separate sheets you are submitting, indicate
the number of the application question you are addressing.
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.

BACKGROUND INFORMATION
4. List of bird species being bred at the breeding facility, including the common and scientific names of the species.

5. The name and address of the foreign breeding facility.

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FWS Form 3-200-51 (Rev. 01/2020)
U.S. Department of the Interior

OMB Control No. 1018-0093
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6. A summary of the legislation implementing the Convention in the country in which the facility is located.

BREEDING FACILITY – Please provide the following:
7. A statement of the facility's capability of producing captive-bred birds of the species identified in question 1 and in
the numbers they anticipate exporting to the United States on an annual basis.

8. Relevant experience of persons involved in the operation of the facility.

9. Current stock of the facility, including total number, ages, sexes, and numbers of breeding pairs.

10. Production levels that have been achieved at the facility, at least for the past two complete calendar years,
including numbers of eggs produced, chicks hatched, and chicks reared to independence.

11. Anticipated future production.

12. A breeding protocol, including a genetic management plan and a description of breeding methods. Breeding
methods should include whether breeding is continuous or seasonal (including descriptions of photoperiod
manipulations used to stimulate or control breeding, if any) and whether breeding birds are induced to produce
multiple clutches by the removal of eggs for artificial incubation.

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FWS Form 3-200-51 (Rev. 01/2020)
U.S. Department of the Interior

OMB Control No. 1018-0093
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13. Descriptions of incubation and rearing methods, as well as any other methods used to enhance production,
including artificial insemination when applicable.

14. A statement describing the facility and demonstrating that it is operated in a humane and healthful manner,
including:
a.

Diagrams and photographs of the facility;

b.

Descriptions of enclosures, including dimensions, construction materials, substrates, availability of water,
lighting, ventilation, the need for supplemental heat or cooling and how these are provided, and shading
(for outdoor enclosures);

c.

Densities of birds in enclosures;

d.

Internal features of enclosures, including perches, nest boxes, and plantings; and

e.

A description of any facility features designed to satisfy unique requirements of the particular species.

15. A description of the care and maintenance practices of the facility, including:
a.

Husbandry practices, feeding regimes (number of feedings per day), and diet;

b.

Hygienic practices, including methods and frequency of cleaning and disinfection of equipment and
facilities;
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FWS Form 3-200-51 (Rev. 01/2020)
U.S. Department of the Interior

OMB Control No. 1018-0093
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c.

A statement as to the availability of routine professional veterinary care, including annual flock inspection
or examination, and medication/vaccination schedules;

d.

Records of mortality and disease outbreaks for both adults and chicks for at least the past two
yearsEpisodes of high mortality or disease should be explained, and measures taken to prevent similar
mortality or disease outbreaks in the future should be described; and

e.

Qualifications and experience of the personnel who will be responsible for the care of the exotic birds.

16. A statement that all birds exported or to be exported from the facility are bred at the facility and are marked with
closed leg bands or an electronic marking system.

17. Details on the system of record keeping and tracking of birds and their progeny hatched at the facility, including:
a.

Documentation that the facility maintains records of hatch dates and band numbers of all birds produced
at the facility;

b.

Documentation that the facility maintains records of all birds traded from the facility, including both within
the country in which the facility is located and internationally; and

c.

Copies of these production and trade data shall be included with the application for the past two calendar
years.

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FWS Form 3-200-51 (Rev. 01/2020)
U.S. Department of the Interior

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

ADDITIONAL INFORMATION
18. A statement demonstrating that the facility is operated in a manner that is not detrimental to the survival of the
species in the wild, including:
a.

The number and origin of original breeding stock (founders);

b.

If any parental breeding stock was wild-caught, a statement as to the country of origin, date of acquisition,
and certification by the Management Authority in the country in which the facility is located that the
parental breeding stock was legally acquired; and

19. Certification, in writing, from the Management Authority of the country in which the facility is located that:
a.

The facility has the capability of breeding the species in captivity in the numbers to be traded without
detriment to the wild population;

b.

The operator of the facility has not been convicted of any violations of the country's laws governing trade
and export of avian species; and

c.

Adequate controls on the breeding facility, including inspections, are in place to prevent the use of the
facility for the export or re-export of wild-caught stock, including a statement on security at the facility and
any prior losses due to theft.

20. A statement from the Scientific Authority of the country in which the facility is located attesting that the parental
stock was established in a manner that was not detrimental to the survival of the species in the wild.

21. A statement from the breeding facility operator of any anticipated need for augmentation of breeding stock with
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FWS Form 3-200-51 (Rev. 01/2020)
U.S. Department of the Interior

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

specimens from other sources. If augmentation is to be from the wild, please provide an explanation as to why
the removal of additional specimens from the wild shall be included. This explanation must address whether
other captive-bred stock is available and describe breeding strategies employed at the facility to avoid deleterious
inbreeding so that the need for augmentation from the wild is minimized.

22. Any other information that the applicant considers to may be appropriate to the evaluation of this plan.

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FWS Form 3-200-51 (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 7 hours (electronically) to 8 hours (paper-based),
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: 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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