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pdfFWS Form 3-200-46 (Rev. 01/2020)
U.S. Department of the Interior
OMB Control No. 1018-0093
Expires ##/##/####
IMPORT/EXPORT/RE-EXPORT OF PERSONAL PETS
(CITES and/or Wild Bird Conservation Act)
☐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 3-200-46 (Rev. 01/2020)
U.S. Department of the Interior
E.
OMB Control No. 1018-0093
Expires ##/##/####
IMPORT/EXPORT/REEXPORT OF PERSONAL PETS (CITES and/or Wild Bird Conservation Act) Note:
This form is for the one-time import, export, or re-export of pets.
• If you are a U.S. resident and intend to travel with your pet in and out of the United States
several times over the next few years, use form 3-200-64 to apply for a U.S. CITES Certificate
of Ownership.
• This form may also be used by non-U.S. residents, with pet birds intending to travel to the
United States under a foreign CITES Certificate of Ownership, applying for a matching 3-year
WBCA permit.
• Please review our webpage “Personal Pets” for important guidance and reminders Personal
Pets Information.
• Per USDA requirement, birds may not enter the U.S. at a land border port from Mexico.
Complete all questions on the application. Mark questions that are not applicable with "N/A". If needed,
use separate sheets of paper. On all attachments or separate sheets you submit, indicate the application
question number you are addressing. For each individual animal listed provide documentation. Be sure to
indicate which animal is being addressed in each response.
1.
Name and address where you wish the permit to be mailed, if different from page 1 (All permits will be
mailed via the U.S. Postal Service, unless you identify an alternative means below). If you wish expedited
delivery, please provide a self-addressed, pre-paid, computer-generated courier service airway bill.
2. Who should we contact if we have questions about the application? (Include name, phone number, and email):
3. Have you or anyone associated with your operation or 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” 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” answer does not automatically
disqualify you from getting a permit.
4. Are you requesting authorization to: (please check one)
___ Import your pets into the United States? (Only two (2) birds allowed per person for import).
___ Export your pet from the United States?
___ Re-Export your pet from the United States (see question 9)?
5. What is your expected date of import/export: _______________________________________
(Note: please allow 60 days, for the processing of this application.)
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FWS Form 3-200-46 (Rev. 01/2020)
U.S. Department of the Interior
OMB Control No. 1018-0093
Expires ##/##/####
6. Please provide your foreign address, including country for imports, or for exports/re-exports provide a U.S.
address:
Name:
Street Address:
City:
State/Province:
Country, Postal Code:
7. For EACH pet to be imported or exported provide the following: If needed, use separate sheets of paper.
Scientific name
(genus, species, and, if
applicable,
subspecies)
Common
Name
Hatch date
mm/dd/yyyy
Sex
Permanent
marking 1
Household
name
Source
(wild/
captiveborn)
Country where
the animal was
acquired
8. What is the current location of your pet(s)?
9. Will you be traveling on holiday (vacation) or relocating with your pet?
Origin Of Your Pet: On a separate sheet of paper answer question 9 if your pet was wild-caught; question 10 if
your pet was captive-born; and question 11 if you do not know the origin of your pet.
10. For animals that were wild caught:
a.
1
If your pet was removed from the wild within the United States, provide:
i.
Evidence that it was legally acquired (State authorization);
ii.
The purpose for which the pet was removed from the wild; and
iii.
The date the pet was removed from the wild.
(e.g., tattoo number, band number, microchip number, type, and location on animal, prominent scars)
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FWS Form 3-200-46 (Rev. 01/2020)
U.S. Department of the Interior
iv.
OMB Control No. 1018-0093
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Documentation demonstrating the history of transactions (e.g., chain of ownership of pet(s)).
If your pet was removed from the wild outside the United States, provide:
b.
i.
Country of origin;
ii.
Evidence that it was legally imported into the U.S. (you may refer to question 9);
iii.
The purpose for which the pet was removed from the wild;
iv.
The date the pet was removed from the wild; and
v.
The date you acquired the pet.
vi.
Documentation demonstrating the history of transactions (e.g., chain of ownership of pet(s)).
11. For animals that were captive-born:
Provide a dated and signed statement from the breeder that includes the following:
i.
Scientific and common name(s) of animal;
ii.
Hatch date, band/tag number or identifying markings, and sex of the animal;
iii.
Name and address of the facility where the animal was bred and born;
iv.
Location of parental stock; and
v.
A statement that the animal was bred at the above facility.
vi.
In addition, provide documentation demonstrating the history of transactions (e.g., chain of
ownership of pet(s)).
12. If you do not know the origin of your pet, provide a signed and dated statement with a complete
description of the circumstances under which you acquired the pet, including when, where, from whom, and
any other pertinent information. Include pet store receipts or other information that would assist in
determining the source of your pet.
13. For the EXPORT of an APPENDIX I bird 2, provide a copy of the foreign CITES import permit or evidence that one
will be issued.
14. For RE-EXPORT (pet was previously imported into the United States), provide evidence that the pet was legally
imported, including:
2
a.
Copies of canceled CITES export permits or re-export certificates issued by the appropriate CITES office in
the country from which the pet was imported, and a copy of the cleared Declaration for Importation (Form 3177).
b.
If you did not make the original import, provide copies of the importer’s documents outlined above and any
invoice or other documents that show you purchased or otherwise obtained the bird from the original importer.
If you did not obtain the wildlife from the original importer, include documentation demonstrating the history of
transactions.
c.
For birds previously imported, provide a copy of your Wild Bird Conservation Act (WBCA) import authorization
(non-native birds) or Migratory Bird Treaty Act authorization (native birds).
If you are not sure which Appendices your pet is listed under, contact the Division of Management Authority at 800/358-2104.
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FWS Form 3-200-46 (Rev. 01/2020)
U.S. Department of the Interior
OMB Control No. 1018-0093
Expires ##/##/####
15. For pets that are pre-Convention (i.e., the pet was born or removed from the wild before the species was
listed under CITES), provide documents, signed statements, or other evidence that the specimen was
obtained prior to the date CITES applied to it (i.e., bill of sale, signed breeder’s records, or signed affidavit
attesting to age of animal). [If you are not sure of the listing date for the species, consult Species+ for
CITES listed species or contact the Division of Management Authority.]
16. FOR IMPORT OF BIRDS ONLY:
a.
Provide documentation that shows you have continually resided outside of the United States for at least
one (1) year (from 1 year ago and the most recent month)just prior to submission of this application. (e.g.,
employment records, utility bills, etc.).
b.
Provide your primary addresses where you resided for the last full year consecutively.
c.
__________________________________________
From _________To_______
__________________________________________
From _________To_______
__________________________________________
From _________To_______
Have you imported any non-native birds in the last 12 months?
Yes ___ No ___ If yes, how many? ____________
16. If you are applying for a three-year WBCA import permit (i.e., you are a non-US resident traveling through the
United States), you must provide a copy of your valid foreign CITES Certificate of Ownership (Pet Passport).
17. For the EXPORT of a migratory bird (listed in 50 CFR 10.13), provide Federal and State permit or license
numbers that authorize possession and acquisition, where such document is required.
18. 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) (http://iata.org) live animal
regulations (contact airlines for additional information). Please provide a description of the shipping
conditions including:
a. The type, size, and construction of any shipping container; and
b. The arrangements for watering or otherwise caring for your pet during transport.
19. When travelling with your pet, there may be animal health requirements specific for that destination. As
soon as you know your travel details, contact your local veterinarian to assist with the pet travel process.
Factors to consider may include meeting time frames for obtaining a health certificate, updating
vaccinations, diagnostic testing, or administration of medications/ treatments. Please contact:
https://www.aphis.usda.gov/aphis/pet-travel
20. Be aware that certain States require pet possession certificates. Contact your State Conservation Agency
for pertinent requirements, and submit copies of applicable documentation with your application.
21. CERTIFICATION STATEMENT (All applicants must complete with an original signature)
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FWS Form 3-200-46 (Rev. 01/2020)
U.S. Department of the Interior
OMB Control No. 1018-0093
Expires ##/##/####
I understand that the purpose for the pet(s) identified in this application is to import, export, or re-export my
personally owned pet(s) and I have no intention of selling the pet(s) or using the pet(s) for any commercial
activity.
Applicant’s signature: _______________________________________ Date: _________________
22. All international shipment(s) of wildlife must be declared to the U.S. Fish and Wildlife Service at the time of
export/import. A list of designated ports (where a wildlife inspector is posted) is available from the list of
designated ports. If you wish to use a port not listed, additional authorization to use a non-designated port
will be required. If you wish to use several different non-designated ports, you may be required to contact
the Office of Law Enforcement for additional authorization.
Enter the U.S. port(s) through which the [export/re-export/import] is anticipated to occur:
_____________________________________________________________.
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FWS Form 3-200-46 (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 20 minutes (electronically) to 30 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.
Page 7 of 7
File Type | application/pdf |
File Title | NPS Form 10-29 |
Author | dhaas |
File Modified | 2020-03-09 |
File Created | 2020-01-24 |