Form 3-200-20 Application - Import of Sport-Hunted Trophies (Appendix

FWS Form 3-200-20 (Rev. 01/2020)
U.S. Department of the Interior

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

IMPORT OF SPORT-HUNTED TROPHIES (Appendix I of CITES and/or ESA)
☐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 3-200-20 (Rev. 01/2020)
U.S. Department of the Interior

E.

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

IMPORT OF SPORT-HUNTED TROPHIES (Appendix I of CITES and/or ESA)
Note 1: This form should be used to request authorization to import trophies of species included in Appendix I of
CITES and/or as threatened or endangered under the ESA (examples include elephants, lions,
cheetahs, wood bison, and markhor).
PLEASE USE FORM 3-200-19 FOR SOUTHERN AFRICAN LEOPARD TROPHIES AND NAMIBIAN
SOUTHERN WHITE RHINOCEROS TROPHIES.
Note 2: If you hold an import permit for trophy/trophies that you did not use, please return the unused original
permit. If you are requesting reissuance of a permit because you have taken a trophy, but were unable
to import it prior to the expiration of the permit, please use the renewal form (3-200-52) and return your
original permit with that form.
Note 3: Applications for species listed as endangered under the U.S. Endangered Species Act are published in
the Federal Register for a 30-day public comment period. Please allow at least 90 days for the
application to be processed.
Note 4: Sport-hunted trophy is defined at 50 CFR 23.74 as follows: Sport-hunted trophy means a whole dead
animal or a readily recognizable part or derivative of an animal specifically identified on the accompanying
CITES document that meets the following criteria:
• Is raw, processed, or manufactured;
• Was legally obtained by the hunter through hunting for his or her personal use;
• Is being imported, exported, or re-exported by or on behalf of the hunter as part of the transfer from its
country of origin ultimately to the hunter's country of usual residence; and
• Includes worked, manufactured, or handicraft items made from the sport-hunted animal only when:
i.
Such items are contained in the same shipment as raw or tanned parts of the sport-hunted animal
and are for the personal use of the hunter;
ii.
The quantity of such items is no more than could reasonably be expected given the number of
animals taken by the hunter as shown on the license or other documentation of the authorized
hunt accompanying the shipment; and
iii.
The accompanying CITES documents (export document and, if appropriate, import permit)
contain a complete itemization and description of all items included in the shipment.
Note 5: Certain hunting trophies, including elephants, are subject to restrictions on their use after import into the
United States. Please see 50 CFR 23.55 for more information or contact the Division of Management
Authority.
•
•
•
•

1.

Complete all questions on the application.
Mark questions that are not applicable with "N/A".
If applying for more than one trophy species, be sure to answer questions 4, 5 and 6 for each
trophy.
If importing trophies from more than one country, you must submit a separate application for
each shipment in order to obtain separate import permits.

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 the U.S. Postal Service.

Page 2 of 11

FWS Form 3-200-20 (Rev. 01/2020)
U.S. Department of the Interior

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

2.

Who should we contact if we have questions about the application (name, phone number, and e-mail)?

3.

Have you or your client (if a broker applying on behalf of your client), 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.

For each trophy to be imported, provide:
a. Scientific name (genus, species, and, if applicable, subspecies) and common name.
b. Sex (if known).

5.

IF ANIMAL IS CURRENTLY LIVING IN THE WILD, please include the following information:
a. Country and location (e.g., area, region, GIS coordinates, ranch, conservancy, management area, or
hunting block, AND nearest city) where wildlife is to be taken from the wild:

b. Date wildlife is to be hunted:

c.

Name of hunting outfitter, safari company, or professional hunter you will be hunting with:

Page 3 of 11

FWS Form 3-200-20 (Rev. 01/2020)
U.S. Department of the Interior

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

IF ANIMAL HAS ALREADY BEEN TAKEN, please include the following:

6.

a.

Country and location (e.g., area, region, GIS coordinates, ranch, conservancy, management area, or
hunting block, AND nearest city) where trophy was removed from the wild:

b.

Date wildlife was hunted:

c.

Approximate age of animal:

d.

Name of hunting outfitter, safari company, and/or professional hunter you hunted with:

e.

The current location of the trophy (address and country) [the U.S. CITES import permit will identify this
country as the country of export/re-export and must match with the CITES export/re-export document]:

7. Please provide a copy of any applicable foreign government permits, licenses, or tags, that were required to
remove this animal from the wild (if you have not hunted yet and do not currently hold any such permits or
licenses, please indicate so).

8. Complete name and address of overseas person or business shipping the trophy to you. If you are applying to
import a trophy directly from Namibia, you must provide the name and address of the professional hunter listed
on your Namibian hunting permit [this name will appear on the face of the export permit].
Name:
Business Name:
Address:
City:
State/Province:
Country, Postal Code:

9. For species listed under the Endangered Species Act, please be aware that the U.S. Fish and Wildlife Service
must make a finding that your activities will enhance or benefit wild populations of the species involved. While we
Page 4 of 11

FWS Form 3-200-20 (Rev. 01/2020)
U.S. Department of the Interior

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

will communicate with the range country for the species you will hunt or have hunted when making the required
findings, please include the Operator Enhancement Questionnaire provided in Annex I filled out by the
operator or professional hunter of the concession in which you hunted or will hunt. You may attach an updated
report of operations from this concession in lieu of this questionnaire if information regarding the enhancement of
the survival or propagation of the species in the wild is made available in the report.
10. If required by the country in which you hunted, please include the government-endorsed hunter return form.
11. Provide the name of the operator, safari company, or professional hunter with whom you hunted or will hunt.
Name (Company/Professional Hunter):
E-mail:
Phone number:

CERTIFICATION STATEMENT (original signature must be provided for either 11 or 12 below)
12. If you are a broker or taxidermist applying on behalf of a U.S. hunter or foreign national, provide
documentation to show you have a Power of Attorney to act on your client’s behalf and sign the following
statement.
I acknowledge that the sport-hunted trophy/trophies to be imported has been/will be personally hunted by my
client and is being imported only for my client's personal use (i.e., not for sale, transfer, donation, or exchange
that is reasonably likely to result in economic use, gain, or benefit). If applying for the import of a leopard
trophy, I understand that my client may only import two leopard trophies in one calendar year.
Taxidermist/Broker’s signature: _________________________________ Date: ______
13. If you are the hunter applying to import your own trophy, please read and sign the following statement.
I acknowledge that the sport-hunted trophy/trophies to be imported has been/will be personally hunted by me and
is being imported only for my personal use (i.e., not for sale, transfer, donation, or exchange that is
reasonably likely to result in economic use, gain, or benefit).
Applicant's signature: _________________________________________ Date: _______
Be aware that there may be additional permitting or approval requirements by your local or state governments, as
well as required by other Federal agencies or foreign government to conduct your propose activity. While the
Service will attempt to assist where possible, it is your responsibility to obtain such approval.
14. All international shipment(s) must be through a designated port. A list of designated ports (where an inspector is
posted) is available from the list of designated ports. If you wish to use a port not listed, please contact the
Office of Law Enforcement for a Designated Port Exemption Permit (form 3-200-2).

Page 5 of 11

FWS Form 3-200-20 (Rev. 01/2020)
U.S. Department of the Interior

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

ANNEX I

OPERATOR ENHANCEMENT QUESTIONNAIRE
Operator Information

a.
b.
c.
d.

Name of Area Operator:
Years in business:
Name of company conducting hunt:
Country:

Concession

a. Name of Concession:
b. Area in Km2:
c. Land tenure:
____ Government Lease
____Community
____Private Ranch
____ Private Conservancy
d. Length of concession agreement:
e. Can it be renewed?
f. Length of renewal, if applicable:
g. Estimated trophy fees:
h. Are there any special obligations under the Concession Agreement (e.g. annual reporting,
poaching control, qualification requirements, community investment/employment? If so,
please explain (attach extra documents if needed):
i.
j.
k.
l.

Provide concession location and nearest city:
Please attach a map or maps with marked boundaries and nearest city
If the concession border a National Park, provide park name:
Describe general and distinctive habitat/water features:

Communities in the concession

a.
b.
c.
d.

Are there any communities living in the concession?
____Yes
If so, estimated number of people/villages in the concession:
Are there communities bordering this concession?
____ Yes
If so, estimated number of people/villages around the concession:

____No
____ No

Page 6 of 11

FWS Form 3-200-20 (Rev. 01/2020)
U.S. Department of the Interior

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

Relevant Game Populations in the Concession

Species
Elephant
Lion
Prey Species (if
applicable)
Other: ___________

Relative Abundance
Dense

Avg.

Sparse

Estimated
Population

3-Year Trend
Up

Down

Stable

How is it
Monitored?

a. If there are any population studies or reports being done in or around the concession area, please provide a copy
with your application.
b. Are there any actions being taken to conserve game community habitat? If so, please explain and attach any
relevant project photos or reports.
Local Community Participation

a. Total employment number:
b. Total employment in off-season:
c. Identify the number and type of all employees:

Employee Type
Professional Hunters
Trackers
Anti-poaching Scouts/Rangers
Other Anti-poaching
Cooks/Housekeepers
Community Coordinators
Managers
Biologists
Others: ____________________

Number of Employees

Number of Employees
from Local Communities

Number of Employees in
the Off-Season

Anti-Poaching Efforts

a.
b.
c.
d.
e.
f.
g.
h.
i.

Number of anti-poaching staff:
Are patrols conducted during the hunting season, off season or both?
Months patrols are conducted:
Number of patrols per month:
Estimate the percentage of trophy fees that go toward anti-poaching efforts:
Description of anti-poaching equipment, vehicles, gear, etc.
Do government-sponsored game scouts conduct patrols?
If so, do they have the ability to arrest?
Do you offer rewards to poaching informants leading to arrest?
____ Yes

____ No

j.

Do you offer rewards to poaching informants upon conviction?

____ No

____ Yes

Page 7 of 11

FWS Form 3-200-20 (Rev. 01/2020)
U.S. Department of the Interior

k.

Please describe the operator’s anti-poaching expenditures for the past 3 years below:
Type of Expense
Scout Salaries
Equipment
Vehicles
Fuel
Rewards
Others:________
Totals

j.

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

Year 1 (_____)
Spending

Year 2 (_____)
Spending

Year 3 (_____)
Spending

Remarks

What currency are the expenditures given in?

Anti-Poaching Results

Type
Poaching Incidents Discovered
Elephant Carcasses Observed
Lion Carcasses Observed
Leopard Carcasses Observed
Ivory Poachers Observed
Bush Meat Poachers Observed
Illegal Logging Observed
Other Poachers Observed
Poachers Convicted
Snares/Traps Collected
Firearms Confiscated
Vehicles Confiscated
Bicycles Confiscated
Boats/Nets Confiscated
Tusks Recovered
Others: _______________

Year 1
(____)

Year 2
(____)

Year 3
(____)

Remarks

Community Investment

a. Does the company contribute money or goods/services to local communities?
________Yes ________No
b. If so, what percentage/amount is shared and how often, and how much is voluntary (i.e., more
than required by law)?
c. Does the company provide game meat to nearby communities?
________ Yes ________No

Page 8 of 11

FWS Form 3-200-20 (Rev. 01/2020)
U.S. Department of the Interior

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

d. If so, estimate the amount/value of meat contributed in the last year and describe the
distribution program:
e. Are there any programs run by the company that address human-wildlife conflict (e.g. patrolling
fields during harvest, PAC hunts, insurance programs); please describe.

f.

Describe any consolation payments made to local residents that have incurred damage by
game species:

Species

Damage Caused

Elephant
Lion
Leopard
Other:
_________

Consolation
Paid, Year 1
(____)

Consolation
Paid, Year 2
(____)

Consolation
Paid, Year 3
(____)

Remarks

g. What currency are the expenditures reported in?
h. Describe any community projects paid for by the company:

Product
Education (classrooms, offices)
Education (supplies, fees)
Health (clinics, offices)
Health (equipment, salaries)
Community Scout Salaries
Community Anti-Poaching
Local Government Activities
Infrastructure Improvements
Sports Teams Funded
Construction Materials Donated

Spending,
Year 1
(____)

Spending,
Year 2
(____)

Spending,
Year 3
(____)

Remarks

Other: ________________
Other: ________________
TOTALS
i.

What currency are the expenditures reported in?

j.

Include receipts and photographs of projects, if available.

Page 9 of 11

FWS Form 3-200-20 (Rev. 01/2020)
U.S. Department of the Interior

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

Company Clientele

a. How many U.S. clients did the company have in the past 3 years, what percentage of clients were from the U.S.,
and what fees did they pay?

Number of U.S.
Clients

Percentage of
U.S. Clients

Trophy Fees Paid
by U.S. Clients

Elephant
Year 1 (____):

Lion
Year 1 (____):

All Species
Year 1 (____):

Year 2 (____):

Year 2 (____):

Year 2 (____):

Year 3 (____):

Year 3 (____):

Year 3 (____):

Year 1 (____):

Year 1 (____):

Year 1 (____):

Year 2 (____):

Year 2 (____):

Year 2 (____):

Year 3 (____):

Year 3 (____):

Year 3 (____):

Year 1 (____):

Year 1 (____):

Year 1 (____):

Year 2 (____):

Year 2 (____):

Year 2 (____):

Year 3 (____):

Year 3 (____):

Year 3 (____):

b. Approximate amount/percentage of company’s revenue from U.S. clientele:
Hunting Policies

a. List the expertise required for the company’s professional hunters (i.e. abilities and
experience):
b. Are there age/sex requirements for take of trophies? If so, please describe how this is
enforced for each species (attach methodology if available):
c.

Are there hunt return forms that must be reported to officials? If so, please include a copy of
these forms or confirmation of their receipt for the past 3 years.

Other Information

Provide a narrative of other enhancement information about the operation, such as any additional hunting policies,
maintenance of the concession, management activities, research, community involvement and outreach, etc.

I declare that the foregoing is true and correct:

Signature

Date

Print-Full Name

Title
Page 10 of 11

FWS Form 3-200-20 (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 45 minutes (electronically) to 1 hour (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 2 of X