Form 3-200-37f Application - Import of Live African Elephant from Botsw

FWS Form 3-200-37f (Rev. 01/2020)
U.S. Department of the Interior

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

IMPORT OF LIVE AFRICAN ELEPHANT FROM BOTSWANA, NAMIBIA, SOUTH AFRICA,
AND ZIMBABWE AND SOUTHERN WHITE RHINO FROM eSWATINI AND SOUTH AFRICA
☐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 3-200-37f (Rev. 01/2020)
U.S. Department of the Interior

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

E. Import of LIVE African Elephant from Botswana, Namibia, South Africa, and Zimbabwe, and

Southern White Rhinoceros from eSwatini and South Africa
General Information

This application covers activities involving the import of live African elephant (Loxodonta africana) from Botswana,
Namibia, South Africa, and Zimbabwe and Southern white rhinoceros (Ceratotherium simum simum) from eSwatini
and South Africa. The African elephant is listed as threatened under the U.S. Endangered Species Act as
threatened with a special rule (50 CFR 17.40(e) and the Southern white rhino is listed as threatened due to
similarity of appearance (50 CFR 17.52). The Service must make both an enhancement finding as well as the
CITES “appropriate and acceptable destination” annotation.
Review this application carefully and provide complete answers to all of the questions. If more space is
needed, attach a separate sheet with your responses numbered according to the questions.
Please allow at least 90 days for the application to be processed.
Questions
If you have any questions regarding an action you are requesting authorization for please contact the Division of
Management Authority at [email protected].

All applicants must complete
Electronic Information Submission
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. Point of contact if we have questions about the application (name, phone number, and email).

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 3-200-37f (Rev. 01/2020)
U.S. Department of the Interior

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

4. The current location of the animal(s) (if different from the physical address provided on pg. 1):
Name:
Address:
City:
State/Province:
Postal Code:
Country:
5. Sender:

●

Provide name and physical address of the exporter/re-exporter in the foreign country:

Name:
Address:
City:
State/Province:
Postal Code:
Country:
6.

For each animal involved in the import, provide the following information (you may use the table below):
a. Scientific name (genus, species, and if applicable, subspecies)
b. Common name
c.

Approximate birth date (mm/dd/yyyy)

d. Wild or captive-born
e. Quantity
f.

Sex (males.females.juveniles, 10..2.3)

g. Permanent markings or identification (microchip #, leg band #, tattoos, studbook #, etc.).

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FWS Form 3-200-37f (Rev. 01/2020)
U.S. Department of the Interior

a. Scientific name
(genus, species, and
if applicable,
subspecies)

EXAMPLE:
Pan troglodytes

b. Common
Name

Chimpanzee

OMB Control No. 1018-0093
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c. Approximate
Birth Date
(mm/dd/yyyy)

08/01/2006

d. Wild
(W) or
Captiveborn (C)

C

e.
Quantity

1

f. Sex
(male.
female.
juvenile,
ex:1.0.0)

1.0.0 OR
male

g. Permanent markings/ID
Information (e.g., microchip #,
leg band #,tattoos, studbook
#)

Studbook# 152;
Microchip# 00056321-00

SOURCE OF SPECIMEN
7.

For each captive-born animal(s), provide a signed and dated statement from the breeder or other appropriate
documentation (e.g. Species 360 report) that includes the following:
a.

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

b.

Common name,

c.

Name and address of the facility where the animal was bred and born,

d.

Birth date (mm/dd/yyyy),

e.

Identification information (studbook #, tattoo, microchip, leg band #, etc.),

f.

Name and address of the facility where the parental stock is located,

g.

A statement from the breeder that the animal was bred and born at the breeder’s facility (including the
facility’s name and address), and

h.

If you are not the breeder, documentation demonstrating the history of transactions (e.g., chain of custody
or ownership of the animal).

8. For each animal(s) taken from the wild, provide:
a.

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

b.

Common name,

c.

Specific location (e.g. county, state, province, country) where the animal was removed from the wild;

d.

The name of the individual(s) who collected the animal(s) and their authorization to do so, including
copies of foreign and domestic (Federal, State, and/or Tribal) government collecting permits, licenses,
contracts and/or agreements;

e.

Method of collection: capture protocol, approximate length of time held in captivity, and any injury and
mortality experienced during collection, transport, and holding;

f.

Information related to any remuneration, either financial or in-kind, provided for acquiring the animal(s);
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FWS Form 3-200-37f (Rev. 01/2020)
U.S. Department of the Interior

g.

OMB Control No. 1018-0093
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Efforts to use captive specimens (e.g., captive-born, captive-held), in lieu of taking animals from the wild.

DESCRIPTION AND JUSTIFICATION FOR REQUESTED ACTIVITY
Describe the purpose of your proposed activity.
9.

If scientific research, provide:
a. A copy of the research proposal (outlining the purpose, objectives, and methods),
b. Detailed information on capture methods including:
i. who will be capturing the animals
ii. equipment used
iii. measures taken to prevent injuries and mortalities
c. An explanation of whether other similar work has already been conducted or is currently being conducted,
d. A copy of the study’s Institutional Animal Care and Use Committee (IACUC) form (if applicable),
e. Peer-reviewed scientific papers published from this research (if applicable).

10. If conservation education and/or zoological display, provide:

a. Objectives of proposed activity in support of an education program,
b. Copies of educational materials (e.g., handouts, text of signage or public presentations), incorporating the
following information:

i. Status in the wild
ii. Current threats
iii. Conservation efforts
11. If captive propagation for the conservation and survival of the species, provide:

a. A description of how the species will be propagated (e.g., artificial insemination, natural breeding
pairs/groups),

b. Documentation showing your participation in an established breeding program, including name of
program, program coordinator, breeding guidelines/agreements, list of program participants, and other
relevant program information.
c.

A copy of your breeding protocol including information regarding separation of mother and young, use of
cameras, etc.

d. How your breeding stock is managed to maintain genetic vitality, including:
i. avoidance of inbreeding,
ii. considerations of average kinship,
iii. and differences in paternal and maternal average blood relationships/relatedness,
iv. carrying capacity of your facility,
v. disposition of progeny.
e.

Plans and agreements for future re-introduction (if applicable).

12. Please provide a detailed description on how the proposed activities will enhance or benefit the wild
population within its native range (e.g., direct or indirect conservation efforts) and provide documentation
(e.g., signed memorandums of understanding) demonstrating your commitment to supporting the program
and how the program contributes directly to the species identified in your application.

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FWS Form 3-200-37f (Rev. 01/2020)
U.S. Department of the Interior

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

TECHNICAL EXPERTISE & FACILITIES
●
●

For import, provide the following information for your institution.
For imports to multiple facilities, provide information for all receiving institutions.

13. Provide copies of or cite any elephant and rhino care/husbandry manuals, protocols, or guidelines that are used at
the facility.
14. Describe the facility’s record keeping.
15. CV or resume outlining the technical experience and expertise of each caretaker, veterinarian, and administrator
with direct oversight of the elephants or rhinos working with, maintaining, and/or propagating each
species/specimen, as it relates to the proposed activities, including experience with similar species.
16. Current inventory of the species or similar species at the facility (males.females.unknown [e.g., 10.2.3]),
17. Number of years the species or similar species have been maintained at the facility,
18. Number of births by species or similar species per year over the last 5 years at the facility,
19. Number of mortalities by species or similar species per year over the last 5 years and steps taken to avoid,
decrease, or mitigate such mortalities,
20. A detailed description, diagrams, and photos clearly depicting the existing facilities where the specimens will be
maintained, including dimensions, type of construction materials, structures for the provision of food and water,
climate conditions, and protective measures from the elements (e.g., direct sun, rain, snow). Do not provide
blueprints.
21. Approximate carrying capacity for the species at the facility.
22. Describe any plans for ongoing staff training with regard to safety, security, record keeping, or animal
management.
23. Describe any plans for ongoing animal training with regard to husbandry behaviors (e.g., crate or chute
acclimation) or veterinary procedures (e.g., health exam or blood collection).
24. Describe how the dietary needs of the species will be met.
25. Describe how the facility addresses the social well-being and behavior of the species such as social grouping,
methods of integration, and appropriate social and behavioral enrichment.
26. Will this import affect the current specimens at the facility? Are there any planned transfers of specimens currently
at the facility? If so, provide detailed information regarding the transfer plans.
27. If accredited by a regional or national animal care organization, please identify the organization and provide proof
of accreditation.
28. Please provide copies of any State or Federal licenses to display, exhibit, or hold elephants or rhinos, as well as a
copy of the most recent USDA APHIS inspection report.

TRANSPORT/SHIPMENT OF LIVE ANIMALS.
29. Transport conditions for live animals must comply with the CITES Guidelines for Transport of Live
Animals. All air transport must also comply with the International Air Transport Association (IATA) live
animal regulations (contact airline for information). As such, provide:
a. Duration of the trip (including airline flights and ground transport).
b. The type, size, and construction of any shipping container and,
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FWS Form 3-200-37f (Rev. 01/2020)
U.S. Department of the Interior

c.

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The arrangements for watering, feeding, or otherwise caring for the wildlife during transport.

d. Will a veterinarian or animal keeper accompany the specimen and be able to provide any necessary
care?
e. CV or resume of the individual(s) arranging and/or conducting the transport of the specimen(s).
For additional information, please see: https://cites.org/eng/prog/imp/Transport_of_live_specimens
All international shipment(s) entering the United States 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, contact the Office of Law Enforcement for a
Designated Port Exemption Permit (form 3-200-2).
Imports must also comply with U.S. Department of Agriculture, Animal and Plant Health Inspection Service inspection and
quarantine requirements. For additional information, please see: https://www.aphis.usda.gov/aphis/ourfocus/importexport

APPROPRIATE AND ACCEPTABLE DESTINATION
For import of live African elephant from Botswana, Namibia, South Africa, and Zimbabwe and Southern white
rhinoceros from eSwatini and South Africa, a determination that the importing facility meets the CITES “appropriate
and acceptable destination” annotation must be made.
For additional information, please see: Conf. 11.20 (Rev. CoP18) on Definition of the term ‘appropriate and acceptable
destinations’ at; https://cites.org/sites/default/files/document/E-Res-11-20-R18.pdf.
NOTE: For any CITES permit authorizing trade of live rhinoceroses under an “appropriate and acceptable destination”
annotation, the rhinoceros horn from these animals and their progeny may not enter commercial trade and the animals
may not be sport hunted outside of their historic range.
30. Identify all persons and/or facilities who will be receiving a specimen, including persons and/or facilities who are
likely to receive a specimen within 1 year after it arrives in the United States.
31. For each person and/or facility identified in question 30, please provide the following information:
a. Description of the facility, including diagrams, photographs, or construction plans;
b. Description of the enclosures and their construction and maintenance, including information on whether
or not there is sufficient space provided to the specimen(s) to allow each animal to make normal postural
and social adjustments with adequate freedom of movement;
c.

Description of the adequacy of the enclosures or holding areas to prevent escape or unplanned exchange
of genetic material with specimens of the same or similar species outside the facility;

d. Description of environmental enrichment elements provided to the specimen(s);
e. If the specimen(s) is/are on public display, provide a description of any off-exhibit area, consisting of
indoor and outdoor accommodations, as appropriate, that can house the specimen(s) on a long-term
basis, if necessary;
f.

Provision of water and nutritious food of a nature and in a way that are appropriate for the species (if
grazing in natural areas, provide information on the natural vegetation present);

g. Copies of all Standard Operating Procedures (protocols) used at the facility for the care and housing of
the specimen(s). Examples include, but are not limited to: quarantine, diet, veterinary care, animal and
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FWS Form 3-200-37f (Rev. 01/2020)
U.S. Department of the Interior

OMB Control No. 1018-0093
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staff training, enrichment, daily and seasonal routines, emergency measures, record keeping, routine
medical examinations, etc.;
h. Description and resumes of the recipient staff who will care for the specimen(s), including information on
staff’s training and experience in providing proper daily care and maintenance for the species being
imported, or for a closely related species;
i.

Readily available veterinary care or veterinary staff experienced with the species or a closely related
species, including emergency care (e.g., veterinarian names, clinic/facility names and locations, full-time
or part-time vets, staff or contract vets, 24/7 availability);

j.

Security measures to prevent theft or harm of specimens and measures taken to rectify any previous
theft, harm or security problems involving elephants or rhinos;

k.

Survival rate of specimens of the same species or, alternatively, closely related species at the facility,
mortalities for the previous 5 years, significant injuries to wildlife, occurrence of significant disease
outbreaks during the previous 5 years, and measures taken to prevent similar mortalities, injuries,
damage, or diseases. (Note: Significant injuries, damage, or disease outbreaks are those that are
permanently debilitating or re-occurring);

l.

Sufficient funding on a long-term basis to cover the cost of maintaining the facility and the specimens
imported.

m. Written documentation demonstrating that the proposed activity would promote in-situ conservation of the
species.

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FWS Form 3-200-37f (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: 1 hour
Amended submission - paper-based: 30 minutes
Original submission - electronic: 45 minutes
Amended submission - electronic: 20 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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