Form 3-200-50 Application - Approval of Sustainable Use Management Pla

FWS Form 3-200-50 (Rev. 01/2020)
U.S. Department of the Interior

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

APPROVAL OF SUSTAINABLE USE MANAGEMENT PLAN UNDER WBCA
☐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 3-200-50 (Rev. 01/2020)
U.S. Department of the Interior

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

E. APPROVAL OF SUSTAINABLE USE MANAGEMENT PLAN UNDER WBCA
NOTE 1: This application is for approval of a scientifically-based sustainable use management plan
that must be granted before wild-caught species can be imported from the approved exporting country.
Birds from an approved program can be imported into the U.S. without a Wild Bird Conservation Act permit.
Sustainable use management plans developed by the country of export should be submitted for species,
which breed in the country of export. If the species does not breed in the country of export, the Service will
consider sustainable use management plans only when the plan is scientifically valid and nesting (breeding)
information can be provided from countries in which the species breeds.
NOTE 2: Complete all questions on the application. Mark questions that are not applicable with "N/A".
Given the length of many of your responses, use separate sheets of paper to respond to the application
questions. On all attachments or separate sheets you are submitting, indicate the number of the application
question you are addressing.
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.
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.

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FWS Form 3-200-50 (Rev. 01/2020)
U.S. Department of the Interior

OMB Control No. 1018-0093
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4. Background Information, including:
a. Scientific and common name of the species to be covered under the plan;

b. Letters from the country of export's Management and Scientific Authorities transmitting the
management plan of this species;
c.

A summary of the country of export's legislation related to this species and legislation implementing
CITIES and where appropriate, a summary of implementing regulations;

d. A summary, from the country of export's Management Authority, of the infrastructure and law
enforcement and monitoring mechanisms to ensure both enforcement and compliance with the
requirements of the management plan, and that the number of birds removed from the wild or
exported will be consistent with the management plan;

e. Recent information on the distribution of the species within the country of export including scientific
references and maps, and historical information on distributions, if relevant; and

f.

The species' status and its current population trend in the country of export, including scientific
references and copies of the most recent non-detriment findings made by the exporting country's
Scientific Authority.

5. Habitat information, including:
a. A general description of habitats used by the species for each portion of the life cycle completed
within the country of export;

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FWS Form 3-200-50 (Rev. 01/2020)
U.S. Department of the Interior

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

b. Recent information on the size and distribution of these habitats throughout the country of export
and in each area or region of take, including scientific references and maps. The approximate
location of any reserves that provide protection for this species should be indicated on the
accompanying map(s), along with a brief description of how reserves are protected and how that
protection is enforced;

c.

Status and trends of the important habitats used by the species in the country of export as a whole
whenever available and within each area or region of take, including scientific references;

d. Factors, including management activities, favoring or threatening the species' habitat in the
foreseeable future within each area or region of take, and throughout the country of export
whenever available, including scientific references; and

e. A list of management plans that have been or are being planned, developed, or implemented for
the species' important habitats, if any.

6. Information on the role of the species in its ecosystem, including:
a. A description of the part(s) of the species' life cycle completed within the country of export;

b. A description of nest sites and/or plant communities that are most frequently used for placement of
nests and, if applicable, nesting habits;

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FWS Form 3-200-50 (Rev. 01/2020)
U.S. Department of the Interior

c.

OMB Control No. 1018-0093
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A general description of the species' diet and where the species forages (aerial feeder, tree
canopy, tree trunk, mid-story, under-story, open water or other), and seasonal changes in foraging
habits, including, when available, scientific references; and

d. Information on any species or plant community, which is dependent on the occurrence of the exotic
bird species.

7. Information on population dynamics of the species, including:
a. Recent population data for the population of the species in the country of export, as derived from
indices of relative abundance or population estimates, along with documentation for each estimate;

b. Within each area or region of take, documentation for recent population data or estimates,
conducted for at least 3 separate years or 1 year with a description of survey plans for future years.
These population assessments should have been conducted during the same season (breeding or
non-breeding) of each year for which documentation is submitted (i.e., be methodologically
comparable - both temporally and spatially);

c.

Within each area or region of take, a scientific assessment (with documentation) of recent
reproductive (nesting) success. This assessment should include information on the number of
young produced per egg-laying female per year or per nesting pair, or if scientifically appropriate
for the species to be exported, estimates on the number of young produced per year from prebreeding and post-breeding surveys conducted within the same annual cycle;

d. Within each area or region of take, estimation (with documentation) of annual mortality or loss
including natural mortality and take for subsistence use, export trade, and domestic trade in each
area of take; or

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FWS Form 3-200-50 (Rev. 01/2020)
U.S. Department of the Interior

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

e. When appropriate, information (with documentation) on the number of young, which can be taken
from the area, as a result of a conservation enhancement program.

8. Information on the determination of biologically sustainable use including:
a. Estimation of the number exported from the country during the past 2 years, and the number of
birds removed from the wild for export, domestic trade, illegal trade, subsistence use, and other
purposes (specify) for the country of export during the past 2 years;

b. The estimated number of birds that will be removed from the wild from each area of take each year
for all purposes (export trade, domestic trade, illegal trade, and subsistence use), including a
description of age-classes (nestlings, fledglings, sub-adults, adults, all classes), when applicable;

c.

For the projected take addressed in the management plan, a description of the removal process,
including, but not limited to, locations, time of year, capture methods, means of transport, and preexport conditioning;

d. Documentation of how each projected level of take was determined;
e. Explanation of infrastructure and law enforcement and monitoring mechanisms that ensure
compliance with the methodology in the management plan and that the species will be removed at
a level that ensures sustainable use; and

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FWS Form 3-200-50 (Rev. 01/2020)
U.S. Department of the Interior

f.

OMB Control No. 1018-0093
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Description of how species in each area or region of take will be monitored in order to determine
whether the number and age classes of birds taken are sustainable.

9. Information on species value including:
a. For species that are considered "pests" in the country of origin: documentation that such a species
is a pest, including a description of the type of pest, - e.g., agricultural, disease carrier; a
description of the damage the pest species causes to its ecosystem; and a description of how the
sustainable use management plan controls population levels of the pest species; or

b. For non-pest species: a description of how the sustainable use management plan promotes the
value of the species and its habitats. Incentives for conservation may be generated by
environmental education, cooperative efforts or projects, development of cooperative management
units, and/or activities involving local communities.

10. Supplemental information including:
a. Description of any existing enhancement activities developed for the species, including, but not
limited to, annual banding programs, nest watching/guarding, and nest improvement;

b. Description, including photographs and diagrams, of the shipping methods and enclosures
proposed to be used to transport the exotic birds, including but not limited to feeding and care
during transport, densities of birds in shipping enclosures, and estimated consignment sizes; and

c.

Any other information that may be appropriate to the evaluation of this plan.

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FWS Form 3-200-50 (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 9 hours (electronically) to 10 hours (paper-based),
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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