Form 3-200-27 Application - Export of Wildlife Removed from the Wild (

FWS Form 3-200-27 (Rev. 01/2020)
U.S. Department of the Interior

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

EXPORT OF WILDLIFE REMOVED FROM THE WILD (Live/Samples/Parts/Products)
(CITES)
☐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 3-200-27 (Rev. 01/2020)
U.S. Department of the Interior

E.

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

EXPORT OF WILDLIFE REMOVED FROM THE WILD (LIVE/SAMPLES/PARTS/PRODUCTS) (CITES)

Note 1:
• If you are requesting to re-export wildlife, submit form 3-200-73.
• Export pre-Convention wildlife; submit form 3-200-23.
• Export live captive-born animals; submit form 3-200-24.
• Export/Re-export of Wildlife Sample and/or Biomedical Samples (CITES); submit form 3-200-29.
• Export or Interstate Take of Animals (Live/Samples/Parts/Products) (ESA and/or CITES); submit form 3-200-371.
• Export of caviar; submit form 3-200-76.
• Registration of a production facility for certain native species, submit form 3-200-75.
• Export of hunting trophies; submit form 3-200-28
1 Forms 3-200-37a, 3-200-37b, 3-200-37d, or 3-200-37e
(All forms are available on our website.)
Note 2: Be aware that the U.S. FWS may not be able to issue CITES documents for the commercial export of Appendix-I
species.
Provide the following information. Complete all questions on the application. Mark questions that are not applicable with
"N/A". If needed, use a separate sheet of paper. On all attachments or separate sheets you submit, indicate the
application question number you are addressing. If applying for more than one specimen, be sure to answer all relevant
questions for each specimen.
Electronic submission of inventories, photographs, and receipts: 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)?

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FWS Form 3-200-27 (Rev. 01/2020)
U.S. Department of the Interior

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

3. Have you or your client (if a broker applying on behalf of your client), 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.

4. What is the purpose of the export?
____ Commercial

____ Personal ____ Exhibition

____ Scientific

____ Breeding ____ Other (specify: _____________________________)

5. Applicants residing or located outside the United States conducting commercial activities. The name,
physical address and telephone number of your agent that is located in the United States who will maintain
your records for five (5) years from the expiration of the permit (50 § 13.12 and 13.46 requires this
information). U.S. address (not a P.O. Box) for foreign applicant.
Name:
Street Address:
City:
State/Province, Country, Postal Code:
6. For EACH animal or specimen to be exported, provide (a table is provided on page 6 for your convenience):
a.

Scientific name (genus, species, and, if applicable, subspecies) and common name

b.

Birth or hatch date or approximate age

c.

Gender, if known

d.

Description (e.g., live or dead, tattoo#, band #, ISIS #, studbook #, size, weight, skull, mount; for
parts/products – type, quantity, and container)

e.

Specific location of where, when, and by whom (name and address) the animal or specimen was
removed from the wild;

f.

Describe of the method of removal from the wild;

g.

Purpose of removal and, if alive, length or approximate length of time held in captivity;

h.

Copy of any permits, licenses, or other documents from the State or local wildlife authorities required
to remove the specimen(s) from the wild;

i.

Documentation showing that the specimens were legally obtained by the applicant (e.g., transfer
documents, sales receipts); and

j.

Copies of any applicable State permits or licenses that are required to house, maintain, breed, and/or
sell these specimens (contact your State for information).
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FWS Form 3-200-27 (Rev. 01/2020)
U.S. Department of the Interior

k.

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

For Alaskan native handicrafts, provide the name of the artist and Tribal affiliation.

If your specimen is American alligator or furbearer skin that must be tagged with a CITES tag, provide a
list of the complete CITES Tag numbers [e.g. FL MIS 0712345] or Replacement Tag numbers [e.g. FWS
REPL 0123456]. Tags must be inserted through the skins and permanently locked in place at the time of
export. NOTE: Replacement tags must be obtained before submitting your application (broken tags must
be surrendered at the time of requesting replacement tags) [See 50 § 23.69(c)].
NOTE: When products made from skins are exported, you may be requested to surrender the tags from
the skins used in manufacture; therefore, do not destroy or dispose of tags until after the application
process is complete.
7. Current location of specimen(s) (address – City, State/Province, country):

8. Is this shipment is a sample collection being exported for temporary exhibition or display purposes and is
accompanied by a valid U.S. ATA carnet number?
NO_______YES_____ - provide ATA carnet document number _________________
9. Provide the name and address of person/facility receiving the shipment (if self, provide address abroad).
Name:
Street Address:
City:
State/Province, Country, Postal Code:
10. For the export of migratory birds, their parts, nests, or eggs (50 § 10.13), provide copies of the Federal and
State permits or licenses authorizing possession, acquisition, or disposition of such birds, their parts, nests, or
eggs.
11. 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.

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FWS Form 3-200-27 (Rev. 01/2020)
U.S. Department of the Interior

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

12. For the non-commercial export of Appendix-I species, provide a copy of the CITES import permit, or evidence
one will be issued by the Management Authority of the country to which you plan to export the specimen(s).
In accordance with Article III of the CITES treaty, it is required that import permits are issued before the
corresponding export permit.
13. If you are a CITES-Registered Commercial Operation for Appendix I wildlife, no CITES import is required.
Please provide the name and registration number of the operation:
____________________________________
All international shipment(s) must be through a designated port. A list of designated ports (where an inspector is
posted) is available. 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 3-200-27 (Rev. 01/2020)
U.S. Department of the Interior

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

For EACH animal or specimen to be exported, provide (refer to p.3 question 6)
a.

Scientific name (genus, species, and, if applicable, subspecies) and common name

b.

Birth or hatch date or approximate age

c.

Gender, if known

d.

Description (e.g., live or dead, tattoo#, band #, ISIS #, studbook #, size, weight, skull, mount; for
parts/products – type, quantity, and container)

e.

Specific location of where, when, and by whom (name and address) the animal or specimen was removed
from the wild;

f.

Describe of the method of removal from the wild;

g.

Purpose of removal and, if alive, length or approximate length of time held in captivity;

h.

Copy of any permits, licenses, or other documents from the State or local wildlife authorities required to
remove the specimen(s) from the wild;

i.

Documentation showing that the specimens were legally obtained by the applicant (e.g., transfer
documents, sales receipts); and

j.

Copies of any applicable State permits or licenses that are required to house, maintain, breed, and/or
sell these specimens (contact your State for information).

k.

For Alaskan native handicrafts, provide the name of the artist and Tribal affiliation.

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FWS Form 3-200-27 (Rev. 11/2019)
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 36 minutes (electronically) to 45 minutes (paperbased), 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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