Form 3-200-42 Application - Import/Transport of Injurious Wildlife

FWS Form 3-200-42 (Rev. 01/2020)
U.S. Department of the Interior

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

IMPORT/TRANSPORT OF INJURIOUS WILDLIFE
☐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 3-200-42 (Rev. 01/2020)
U.S. Department of the Interior

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

E. IMPORT/TRANSPORT OF INJURIOUS WILDLIFE
General information:
Under the Lacey Act (18 U.S.C. 42), any importation of injurious wildlife regulated under 50 CFR 16 into
the United States or its territories or possessions must be authorized under a permit issued by the U.S.
Fish and Wildlife Service. In addition, for any injurious specimens listed in 50 CFR 16, transport between
the continental United States, the District of Columbia, Hawaii, the Commonwealth of Puerto Rico, or any
territory or possession of the United States by any means whatsoever must be authorized by the Service.
If you are requesting authorization for activities that involve a species listed under the Endangered
Species Act, you must complete Section E of form 3-200-37 and include your responses with this
application.
Complete all questions on this application. Mark questions that are not applicable with "N/A". If
needed, use a separate sheet of paper. On all attachments or separate sheets you submit, please
indicate the application question number you are addressing. If you are applying for multiple
specimens, be sure to indicate which specimen you are addressing in each response.
When do I need an injurious wildlife permit?
New import
Movement between listed jurisdictions
(Continental United States, D.C., Hawaii, Puerto
Rico, or any other United States possession)
Movement between different institutions for
animals that were previously permitted for import
or progeny of such an individual (documentation
required)

●

When do I not need an injurious wildlife
permit?
Movement between States within the continental
United States for individuals (or progeny) not
previously imported under a permit
Acquisition of an injurious wildlife species
Movement from one facility or exhibit to another
within the same permitted institution
Importation or transport of dead natural-history
specimens of wildlife or their eggs for museum or
scientific collection (excluding migratory birds or
dead game mammals from Mexico)
Importation or transport of any live wildlife for
direct use by a Federal agency (excluding
migratory birds)
Export

For transport of injurious wildlife that was previously imported under an injurious wildlife
permit, or is progeny of wildlife that was imported under an injurious wildlife permit, the sending
institution applies for the permit.
● Previous permit conditions, which require that future transport of that animal or its
progeny must be permitted, continue to apply to permitted animals.
● “Progeny” means ANY animal in the lineage, not just direct descendent.

What is the proposed activity (check appropriate section)?
___ Importation (other permits may be necessary under CITES, ESA, or both)
___ Transportation between the continental United States, the District of Columbia, Hawaii, the
Commonwealth of Puerto Rico, or any territory or possession between facilities that have
been previously permitted for the species (other permits may be necessary under ESA)
___ Transportation between the continental United States, the District of Columbia, Hawaii, the
Commonwealth of Puerto Rico, or any territory or possession for educational purposes
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FWS Form 3-200-42 (Rev. 01/2020)
U.S. Department of the Interior

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

Purpose of Activity (check all appropriate choices):
____ Scientific

____ Zoological

____ Educational

____ Medical

If you have an animal that needs to be permitted, all previous permit conditions still apply:
●

Double escape-proof containment

●

USFWS Office of Law Enforcement must be notified within 24 hours if animal or progeny
escapes

If there is no evidence that the specimens in question or their ancestors were previously permitted for
import or transport between listed jurisdictions, they are not considered permitted, and conditions do
not apply.
For the import of any species in the family Salmonidae, an authorized health certificate is required in lieu
of an injurious wildlife import permit. For more information on how to obtain this certificate, please contact
Joel Bader with the USFWS Fish and Aquatic Resource Conservation Program at e-mail address is being
set up.
Even if your injurious wildlife no longer requires a permit under the new ruling, we highly
recommend that you continue to use double escape-proof containment to hold and transport.
Electronic submission of inventories, photographs, and receipts or invoices: If you wish to provide
information electronically, please include a flash drive containing your 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 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” 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 3-200-42 (Rev. 01/2020)
U.S. Department of the Interior

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

4. For EACH species or specimen, provide:
a. Scientific name (genus, species, and if applicable, subspecies) and common name
b. Birth or hatch date (MM/DD/YYYY)
c.

Gender (if known)

d. Description or identification (such as dead, live, studbook number)
5. Current location of specimen(s)

6. Provide a brief description of your proposed activity (i.e., project proposal, education
program, etc.)

7. Name and address of your facilities where specimens will be housed and maintained.

8. Injurious wildlife must be maintained in double escape-proof enclosures (that is, two
separate containment systems to ensure against escape) at all times. Provide a
description, including photos or diagrams (no blueprints) of the following that identifies how
containers and facilities are double escape-proof:
a. All transportation containers that will be used with the species; and
b. All permanent facilities where specimens will be held, including display facilities,
off-display holding areas, and veterinarian or medical facilities where the species
might be held.
9. Provide:
a. Qualifications of the individuals who care for or who will care for and handle the
animals, including the number of years of experience with this species or similar
species; and
b. The overall experience of the institution in holding and maintaining the species.
10. Provide copies of State authorization(s) required for your facility to possess and maintain
injurious wildlife species or the name and phone number of the State contact person or
office for verification that no authorization is required. If moving animals across State lines
for export purposes, you may be required to meet regulatory requirements of each State.
Please indicate what States you will be traveling through and copies of any authorizations
required.
11. For import, provide the name and address of person(s) or institution(s) in the foreign
country from whom you will obtain the specimens(s).

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FWS Form 3-200-42 (Rev. 01/2020)
U.S. Department of the Interior

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

12. For import or transport of live bat species, provide CDC transport permit. CDC transport
permit is only required for original imported specimens, not their progeny.
13. For acquiring specimens from within the United States:
a.

Provide the name and address of person(s) or institution(s) from who you will obtain the
specimen(s).

b.

If the animal(s) was previously imported, specify the name of the importer and permit
number under which the animal(s) was imported; OR

c.

If the animal(s) is the progeny of a previously imported animal, provide the information on
the location and date of birth of the original animal imported under a permit.

14. If maintaining ownership and transporting for educational purposes: Provide a description of your
education program and the materials or script of the program. Please also discuss how the
specimen being moved will be maintained in double escape proof containment throughout the
transport and presentation of the specimen.

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FWS Form 3-200-42 (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.

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