Form 3-200-34 Application - Export of American Ginseng

FWS Form 3-200-34 (Rev. 01/2020)
U.S. Department of the Interior

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

EXPORT OF AMERICAN GINSENG (Multiple Commercial Shipments)
☐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 5

FWS Form 3-200-34 (Rev. 01/2020)
U.S. Department of the Interior

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

E. EXPORT OF AMERICAN GINSENG (MULTIPLE COMMERCIAL SHIPMENTS)
Note: This application should be used to request authorization to export multiple commercial shipments of artificially
propagated and wild-harvested American ginseng (Panax quinquefolius). For a single shipment of American ginseng,
submit form 3-200-32.
This application establishes a Master File, valid for up to three years for artificially propagated American ginseng and one
year for wild-harvested American ginseng (both are renewable), for commercial exports. Once the Master File is
approved, you must obtain single-use permits, valid for 6 months for each export (50 CFR 13).
Activity being requested:
___ Three-year Artificially Propagated authorization (click this link for the fee)
___ Renewal of Artificially Propagated authorization; Master File #__________ (click this link for the fee)
___ One-year wild-harvested authorization for harvest season ______ (click this link for the fee)
___ Renewal of a one-year wild authorization for harvest season ______;
Master File #__________ (click this link for the fee)
How many single-use permits do you wish to request (anticipate using in the next 6 months) upon completion of this
Master File review? _____________. (Provide the fee for each single use 6-month permit)
Additional permits may be requested via form 3-200-74.
All processing fees are non-refundable.
To see the States and Tribes with a USFWS Approved Export Program for wild and artificially propagated American
ginseng, click here.
Complete Part I and either Part II (wild-harvested American ginseng) or Part III (artificially propagated American ginseng),
as appropriate. If both artificially propagated and wild ginseng are to be exported, submit a separate application for each.
For wild ginseng, submit a separate application for each harvest season. Complete all pages of the application, for your
requested activity.
PART I. ALL APPLICANTS 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
Page 2 of 5

FWS Form 3-200-34 (Rev. 01/2020)
U.S. Department of the Interior

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

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.
PART II. COMPLETE IF EXPORTING WILD AMERICAN GINSENG (PANAX QUINQUEFOLIUS).
4. Harvest season (year) that the ginseng was/will be harvested: _______________
5. List State(s) or Tribal lands where ginseng was/will be harvested:

6. Approximate number of pounds expected to be exported during the time your Master File is valid:

7. ENTER an “X” in the box that applies. Type of roots or other specimens to be exported:
___ Dried roots ___ Green roots ___ Other (ENTER a description: ________________________________)
Please note that all ginseng that is exported must be accompanied by valid State or Tribal documents that
certify the state of the root (i.e., green or dried), the weight of the roots, and that they were legally harvested
within the State or Tribal lands (50 CFR 23.68).
Roots must be exported in the same state (i.e., green or dried) as identified on the face of the State or Tribal
document.
Please attach a copy of your valid State license(s) or permit(s) authorizing you to deal in ginseng (if
uncertain, check with your State) and a copy of your valid USDA Protected Plant Permit.
CERTIFICATION STATEMENT: (ORIGINAL SIGNATURE IS REQUIRED)
I understand that all wild American ginseng to be exported must have been harvested within a single year, as
identified above and must be accompanied by valid State or Tribal documents that certify it was legally harvested in
the State(s) and/or on the Tribal lands listed above (#5) and identifies the state (i.e., dried or green) of the ginseng
root. I further acknowledge that the roots must be exported in the same state (i.e., dried or green) as is identified on
the State or Tribal land certificate(s).
Applicant's signature: ______________________________________________ Date: _______________

PART III. COMPLETE IF EXPORTING ARTIFICIALLY PROPAGATED AMERICAN GINSENG (PANAX QUINQUEFOLIUS).
NOTE: Artificially propagated American ginseng is defined under 50 CFR 23.64.
8. List State(s) or Tribal lands where ginseng was or will be harvested:

9. Approximate number of pounds expected to be exported each year during the time your Master File is valid:

Page 3 of 5

FWS Form 3-200-34 (Rev. 01/2020)
U.S. Department of the Interior

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

10. ENTER an “X” in the box that applies. Type of roots or other specimens to be exported:
___ Dried roots ___ Green roots ___ Other (ENTER a description: ________________________________)
Please note that all ginseng that is exported must be accompanied by valid State or Tribal documents that
certify the state of the root (i.e., green or dried), the weight of the roots, and that they were artificially
propagated within the State or Tribal lands. Roots must be exported in the same state (i.e., green or dried) as
identified on the face of the State or Tribal document.
If applicable, please attach a copy of your valid State license(s) or permit(s) authorizing you to deal in
ginseng (if uncertain, check with your State) and a copy of your valid USDA Protected Plant Permit.
CERTIFICATION STATEMENT: (ORIGINAL SIGNATURE IS REQUIRED)
I understand that all artificially propagated American ginseng to be exported must be accompanied by valid State
and/or Tribal documents which certify that it was artificially propagated in the State(s) and/or on the Tribal lands listed
above (#7).
Applicant's signature: ________________________________________________ Date: ______________

Page 4 of 5

FWS Form 3-200-34 (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: 20 minutes
Amended submission - paper-based: 15 minutes
Original submission - electronic: 25 minutes
Amended submission - electronic: 12 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.

Page 5 of 5