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pdfFWS Form 3-200-32 (Rev. 01/2020)
U.S. Department of the Interior
OMB Control No. 1018-0093
Expires ##/##/####
EXPORT/RE-EXPORT OF PLANTS (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.
Page 1 of 11
FWS Form 3-200-32 (Rev. 01/2020)
U.S. Department of the Interior
E.
OMB Control No. 1018-0093
Expires ##/##/####
EXPORT/RE-EXPORT OF PLANTS (CITES)
This application covers a wide range of CITES-listed plant specimens, including live or dead specimens, and any
readily recognizable parts, products, or derivatives unless otherwise noted as exempt in the CITES Appendices.
To determine whether a plant species is regulated under CITES, when the species was listed, and whether
exemptions apply to your requested activity and would therefore not require a CITES permit, see CITES listed
species. If you have any questions regarding your export, contact the Division of Management Authority at
[email protected].
Please review our webpages Wood & Other Tree Products, Musical Instruments, and if relevant, What Can I Do With My
Ivory?, for important guidance and information.
Use this application form for exports or re-exports of:
• wild plants/plant parts or products
• non-commercial shipments of cultivated plants/plant parts or products
• pre-Convention 1 plants/plant parts or products (including commercial shipments of musical instruments)
• commercial shipments of finished products or lumber
• re-exports under an ATA Carnet
• non-commercial shipments as part of a household move or plant society exhibition
This form should NOT be used to:
•
•
Request authorization for commercial exports of live plants that are artificially propagated in the United States.
For such exports, applicants should complete form 3-200-33.
Request authorization for plants listed in the Endangered Species Act. For such exports, applicants should
complete form 3-200-36.
PERMIT TYPES
Single-use Permit: A single-use permit is valid for 6 months from the date of issuance. For re-issuance or amendment of
a single use permit, the original permit must be returned with this completed application form:
☐ For export: A one-time export of CITES-listed plants or plant products.
☐ For re-export: A one-time export of plants or plant products that were previously imported under a CITES
permit.
☐ For pre-Convention specimens: A one-time export of plants or plant products that were obtained before the
species was listed under CITES. NOTE: No CITES import permit is required for an Appendix-I specimen that
qualifies as pre-Convention.
☐ For personal/household plants: A one-time export of personally-owned, live potted plants or plant
products that are not intended for commercial sale.
☐ Master File: This application form allows you set up a Master File, valid for up to 3 years and is renewable, for
exports or re-exports of wild, or artificially propagated plants, parts or products, or pre-Convention specimens. Once
the Master File is approved, you must also obtain partially completed permits, valid for 6 months, for each export (50
CFR 13.11).
Specimen was acquired (removed from the wild or held in captivity or a controlled environment) before the date the species was
included in the CITES Appendices. The listing date is found at CITES species list. 50 CFR 23.45(b)(1).
1
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FWS Form 3-200-32 (Rev. 01/2020)
U.S. Department of the Interior
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☐ To amend an established Master File: Allows you to amend a currently valid Master File. You must complete
the relevant sections within the application (FWS form 3-200-52 may not be used to amend or renew this
Master File), provide information on any changes to your facility, operations, species, or suppliers for the plant
specimens that you wish to export.
☐ To reissue, or amend and reissue an established Master File: Allows you to renew your Master File that has
or will soon expire. You must complete relevant sections within the application (3-200-52 may not be used to
amend or reissue this Master File), including providing information on any changes to the quantity, your facility,
operations, species, or suppliers for the plant specimens that you wish to export.
☐ A fee is required for partially completed permits to accompany each shipment under a Master File:
Once the Master File is approved, you must also obtain partially-completed permits to accompany each export
(50 CFR 13.11). The partially-completed permits will be valid for 6 months and can be requested using this
form when establishing or renewing a Master File. For future shipments, additional permits may be requested
using FWS Form 3-200-74.
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.
GENERAL INFORMATION
Review this application carefully and provide complete answers to all of the questions in the sections relevant to
the activity for which you are requesting authorization. If you are applying for multiple species, be sure to indicate
which species you are addressing in each response. If a question is not applicable, answer with "N/A". If more space is
needed, attach a separate sheet with your responses numbered according to the questions.
To accommodate the different purposes of this application, please complete all sections that are applicable to your
request as laid out below:
Part I
All applicants must complete (questions 1-4).
Part II
Wild plants or plant parts collected or originating in the United States (questions 5-13).
Part III
Timber, lumber, or live plants (questions 14-22).
Part IV
Medicinal or extract-based products (non-wood) (questions 23-28).
Part V
Manufactured wood products (rosewood guitars, etc.) (questions 29-39).
Part VI
Exhibition at plant society or trade shows (non-commercial) (questions 40-46).
Part VII
Personal household plants (non-commercial) (questions 47-50).
For commercial shipments of live plants, timber, sawn wood, veneer, lumber, or plant products, you will be required to have
a current state nursery license and/or current U.S. Department of Agriculture (USDA) Protected Plant Permit (formerly
known as General Permit). For products that contain both plants and animal species, you will also need an FWS
Import/Export license.
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FWS Form 3-200-32 (Rev. 01/2020)
U.S. Department of the Interior
OMB Control No. 1018-0093
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PART I
ALL APPLICANTS MUST COMPLETE
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.
4. Provide the permit number of any previously held CITES permits you have held:
5. If requesting a single-use permit, provide the name and address of foreign recipient (if shipping to
yourself, include your foreign address):
Name:
Business Name:
Address:
City:
State/Province:
Country, Postal Code:
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FWS Form 3-200-32 (Rev. 01/2020)
U.S. Department of the Interior
OMB Control No. 1018-0093
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PART II
WILD PLANTS COLLECTED OR ORIGINATING IN THE UNITED STATES
For each species to be shipped provide:
6. Scientific name (genus, species or subspecies) and common name.
7. Number and age class of specimens collected (e.g., 100 seedling; 50 mature).
8. Specific location and date of collection or harvest for each specimen.
9. Who (name and address) collected the specimens.
10. Copies of documents that indicate that the plants were legally collected (e.g., collection permits or licenses,
landowner's permission). Be sure to correlate each document to the corresponding plant.
11. Collection methodology.
12. Estimate the number of plants collected, and the number of plants at the location (e.g., whether the specimens were
removed from an area of few to several patches of plants, percentage of specimens removed). Provide
photographs of the collection site(s) where the plants or plant parts were harvested and photos of the plants or
plant parts that were harvested.
13. If you purchased the plants and/or seeds, provide the invoice or other document that shows the name,
address, telephone number, or e-mail address of the person from whom you purchased the plants and the
date of purchase for each specimen (such documentation should trace back to the original collector).
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14. For wild-collected Appendix I plants or plant parts, provide a copy or the CITES import permit issued by
the Management Authority of the country to which you plan to export the plant(s) or plant specimen(s).
PART III
TIMBER, LUMBER, OR LIVE PLANTS
For each specimen to be shipped provide:
15. Scientific name (genus, species, and if applicable, hybrid, or subspecies) and common name.
16. General description, quantity, and size of specimen(s) to be exported/re-exported.
17. Form of product (e.g., live, plywood).
18. Unit description (in metric units), including volume/amount of specimen(s) (if applicable).
19. Country where the plant or specimens were acquired.
20. Source of the specimen (e.g., removed from the wild or cultivated).
21. Receipts documenting your acquisition of the specimens to be exported/re-exported.
22. If the product (or CITES-listed components) were previously imported into the United States, provide copies
of validated CITES documents issued by the country of export. The copies must be endorsed by the foreign
country at the time of export, AND validated by U.S. Customs and Border Protection or USDA Animal and
Plant Health Inspection Service (APHIS) at the time of import; AND
a. If you were not the original importer, provide a copy of the invoice or other documentation that shows
how you acquired the specimens from the original importer. Be sure to correlate each document
(CITES permit # and issuance date) to the corresponding specimen.
b. Date of import for each specimen (of CITES-listed component).
23. For lumber, timber, or plants acquired prior to the date the species was included in the CITES
Appendices, provide documentation, a signed statement, or other evidence that the specimen was
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harvested/cultivated and/or imported prior to its CITES listing date (e.g., bill of sale, USDA or foreign
phytosanitary certificate). To check dates species were listed in CITES, please visit CITES species list.
PART IV
MEDICINAL OR EXTRACT-BASED PRODUCTS (NON-WOOD)
24. For each specimen to be shipped provide, a description in tabular or spreadsheet form of the following
information:
•
Scientific Name
•
Product Name
•
Product Description (e.g., extract, tablet, capsules, powder)
•
Individual Packaging Unit (e.g., bottles, box)*Include size if applicable.
•
Amount of Product Per Package Unit
•
Number of Packing Units
•
Total Amount of Product to be Shipped
25. Country where the specimens were harvested/cultivated.
26. Country where the specimens were acquired.
27. Receipts documenting the acquisition of the specimens to be exported/re-exported (e.g., bills-of-sale
documenting history of transactions).
28. If the product was previously imported into the United States, provide copies of validated CITES documents
issued by the country of export. The copies must be endorsed by the foreign country at the time of export,
AND validated by U.S. Customs and Border Protection or USDA Animal and Plant Health Inspection Service
(APHIS) at the time of import; AND
a. If you were not the original importer, provide a copy of the invoice or other documentation that
shows how you acquired the specimen(s) from the original importer. Be sure to correlate each
document (CITES permit # and issuance date) to the corresponding specimen requested in
question 7.
b. Date of import for each specimen.
29. For specimens acquired prior to the date the species was included in the CITES Appendices, provide
documents, a signed statement, or other evidence that shows the specimen(s) was harvested/cultivated
and/or imported prior to its CITES listing date (e.g., bill of sale, USDA or foreign phytosanitary certificate). To
check dates species were listed in CITES, please visit CITES species list.
PART V
MANUFACTURED WOOD PRODUCTS (E.G., ROSEWOOD GUITARS)
30. Please provide a brief overview of your business practices (supply chain, how often you obtain
additional stock, how often you export, and who you typically ship to).
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FWS Form 3-200-32 (Rev. 01/2020)
U.S. Department of the Interior
31. Are there multiple CITES-listed species in the product to be shipped?
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No
Yes
If no, for each species provide the quantity of products (as requested in Question 32, below).
If yes, for each species, provide the quantity in cubic meters (as requested in Question 33, below).
For each species to be shipped provide:
32. Scientific name (genus, species, and if applicable, subspecies) and common name.
33. General description of the product to be exported/re-exported (e.g., finished guitar, guitar parts).
34. Quantity and size (in metric units) of product(s) (e.g., 1 table, 220 x 84 cm).
35. Country and approximate year that the wood was harvested.
36. Country where you acquired the specimen/product.
37. Provide receipts documenting your acquisition of the wood to be exported/re-exported (e.g., bills-of-sale
documenting history of transactions).
38. Provide copies of validated CITES documents issued by the country of export for specimens/wood of CITES
listed species previously imported into the United States. The copies must be endorsed by the foreign
country at the time of export, AND validated by U.S. Customs and Border Protection or USDA Animal and
Plant Health Inspection Service (APHIS) at the time at import; AND
a. If you were not the original importer, provide a copy of the invoice or other document that shows how you
acquired the product from the original importer. Be sure to correlate each document (CITES permit #
and issuance date) to the corresponding product.
b. Date of import for each product (of CITES-listed species).
39. If requesting to export finished products manufactured prior to their listing date under CITES
(as laid out below), attest to the following certification statement:
Dalbergia nigra (Appendix I): June 11, 1992.
For the listing dates of additional species, please visit CITES species list.
I certify that all the products to be exported under my Master File were manufactured from preConvention _____________________ (scientific name) wood, harvested prior to the date implemented
in CITES ____________________ (date). The manufacture date of each product will be documented
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by a serial number. If requested by the U. S. Fish and Wildlife Service, I am willing to report the
number of products and their identification numbers that may be exported under my Master File when I
request additional partially completed CITES documents under my Master File.
Applicant's signature:________________________________________ Date: _______________
40. If requesting to export finished products manufactured after the date the species was listed in CITES,
but manufactured with pre-Convention (acquired prior to the CITES listing date) wood, please provide a
copy of the current inventory (a list of each product and the species contained in each product that is
currently in your possession).
PART VI
EXHIBITION BY PLANT SOCIETY AND TRADE SHOWS (NON-COMMERCIAL)
For each specimen to be shipped provide:
41. Scientific name (genus, species, and if applicable, hybrid, or subspecies) and common name.
42. A general description of specimens and quantity of each (e.g., 100 live plants).
43. Provide documentation or a signed statement of how, from whom, where, and when the plants were acquired.
44. The names, dates, and countries of the shows/events you are participating in.
45. Approximate date of re-import into the United States.
46. Provide a signed statement certifying that none of the specimens to be exported will be sold/traded and all of the
specimens will be returned to the United States through a CITES designated port upon conclusion of the show.
47. Will the shipment be exported for temporary exhibition or display purposes and accompanied by a valid ATA
carnet (for single use permits only)?
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____ No ____ Yes: provide ATA carnet document number: _________________________.
PART VII
PERSONAL, HOUSEHOLD PLANTS (NON-COMMERCIAL)
For each specimen to be shipped provide:
48. Scientific name (genus, species, and if applicable, hybrid, or subspecies) and common name.
49. A general description of specimens and quantity of each (e.g., 100 live plants).
50. If known, provide the source of the specimen (e.g., removed from the wild or cultivated).
51. Receipts documenting your acquisition of the specimens to be exported OR a signed statement regarding
the source of your plants, when you obtained them, and how and where you obtained them.
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FWS Form 3-200-32 (Rev. 01/2020)
U.S. Department of the Interior
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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: 1 hour for private sector and 2 hours for individuals
Amended submission - paper-based: 45 minutes for private sector and 1 hour 45 minutes for individuals
Original submission - electronic: 45 minutes for private sector and 1 hour 45 minutes for individuals
Amended submission - electronic: 30 minutes for private sector and 1 hour 30 minutes for individuals
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.
Page 11 of 11
File Type | application/pdf |
File Title | NPS Form 10-29 |
Author | dhaas |
File Modified | 2020-03-09 |
File Created | 2020-01-24 |