Form 3-200-85 Application - Establishment of a Master File for the Exp

FWS Form 3-200-85 (Rev. 01/2020)
U.S. Department of the Interior

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

ESTABLISHMENT OF A MASTER FILE FOR THE EXPORT OF LIVE ANIMALS BRED IN
CAPTIVITY IN THE UNITED STATES (CITES)
☐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 3-200-85 (Rev. 01/2020)
U.S. Department of the Interior

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

E. ESTABLISHMENT OF A MASTER FILE FOR THE EXPORT OF LIVE ANIMALS BRED IN CAPTIVITY IN
THE UNITED STATES (CITES)
This application allows you set up a Master File for exports of live animals bred in captivity under
CITES. The Master File is valid for three years and is renewable. Once the Master File is approved
you must obtain single-use permits, valid for 6 months, for each export (50 CFR 13.11).
Note 1: Species that are listed on pages 5 and 6 of this application are currently eligible for inclusion
in a master file. This list contains species where it has been determined that specimens were born or
hatched from parents mated in captivity in the United States qualify as Bred-in-Captivity in
accordance with CITES Resolution Conf. 10.16 (Rev.) and are therefore eligible for issuance of
certificates under the provisions of CITES Article VII, paragraph 5. If a species you are interested in
including on a master file is not listed, you may either submit application form 3-200-24 or complete
questions 6 through 10 of this application to request that specimens produced at your facility be
considered Bred-in-Captivity. If it is determined that your specimens do not meet the criteria under
Resolution Conf. 10.16 (Rev.), you may still be eligible to obtain individual export permits for the
specimens.
Note 2: We may not be able to issue CITES documents for the commercial export of Appendix-I
specimens, unless the specimens were produced at a commercial breeding operation that is
registered with CITES Secretariat. For more information on registering commercial breeding
operation for Appendix-I wildlife, contact the Division of Management Authority at
[email protected].
Electronic submission of inventories, photographs, and receipts/invoices: If you wish to provide information
electronically, please include a flash drive containing your information with your physical application.
This application can be used to:
____ ESTABLISH A NEW MASTER FILE
This application allows you set up a Master File, valid for one year and renewable, for exports of
live animals bred in captivity in the United States under CITES. Once the Master File is approved,
you will need to obtain single-use permits, valid for 6 months, for each export (50 CFR 13.11)
____RENEW AND/OR AMEND AN EXISTING MASTER FILE, # _________
For either the establishment of a new registration or renewal/amendment of an existing
registration, please Indicate the number of single-use permits you anticipate using in the next 6
months _____________ (Provide $5 for each 6-month permit.) Additional permits may be
requested by submitting form 3-200-74.
Please respond to each of the following questions and provide all information requested. Mark items
that are not applicable with “N/A”. If needed, use separate sheets of paper. Please indicate the
question/item number you are addressing on all attachments or separate sheets you submit. If you
are applying for multiple species, be sure to indicate which species you are addressing in each
response.
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.

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FWS Form 3-200-85 (Rev. 01/2020)
U.S. Department of the Interior

OMB Control No. 1018-0093
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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.
4. For EACH wildlife species to be shipped, provide the following information:
a.

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

b.

Common name;

c.

Typical description of specimens to be exported (e.g., hatchlings, sub-adults; typical size);

d.

Estimated annual production of specimens;

e.

Estimated annual export of specimens; and

f.

Normal mortality rates at your facility.

5. Where are the specimens currently located? (e.g., physical address of facility including county).
Name:
Street Address:
City/Province:
State:
Country, Postal Code:

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FWS Form 3-200-85 (Rev. 01/2020)
U.S. Department of the Interior

OMB Control No. 1018-0093
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6. As the Breeder, sign (in ink) the following statement:
I hereby certify that the species listed above to be exported were bred and born/hatched from parental stock
at my facility listed below. (Additional information on the parental stock may be requested upon receipt of
your application).
a.

Name and address of your facility where the animals were bred and born/hatched:

b.

Name of facility/operation:

c.

Street Address:

d.

City, State, Zip Code:

e.

Current location of parental stock:

f.

Street Address:

g.

City, State, Zip Code:

Signature _____________________________________________ Date __________________
7. If you are NOT the breeder of the specimen(s), provide copies of documentation showing that you acquired
the Animal(s) from the breeder or documentation demonstrating the history of transactions (chain of
ownership of each animal) and a signed statement from the breeder or breeder's record that includes:
a.

That the animal was bred and born/hatched at his/her facility;

b.

Birth/hatch date, and, if applicable, band/tag number, or other identifiers;

c.

Sex of each specimen he/she bred;

d.

Location (name, street address, city, state) of parental stock;

e.

Complete name and address of the breeder's facility.

8. Provide labeled photographs depicting the facilities for the specimens described in your application.
9. If the species you intend to export appears on the attached list, skip questions 11–15.

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FWS Form 3-200-85 (Rev. 01/2020)
U.S. Department of the Interior

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

10. For species that are NOT included on the attached list: As stated above, in order to establish a master
file, the species being proposed for export must be on the attached list (see SPECIES THAT QUALIFY AS
CAPTIVE-BRED). For species that are NOT included on the attached list, you can request that the species
be approved for your facility by completing the questions 11-15:
On A Separate Sheet of Paper:
11. Provide information about the breeding facility, including:
a.

Property size;

b.

Size and type of facility buildings (such as, food prep room and incubation facilities);

c.

Size and type of cage or enclosure used to house juveniles, adults, hatchlings, as appropriate;

d.

Are the cages or enclosures indoors or outdoors?,

e.

How many cages and enclosures does the facility provide?;

f.

How is the location secured (i.e., fence, guard dog, electric wire, etc.) from both theft and natural
disaster?,

g.

How are animals uniquely identified (pit tags, leg bands, notching, photos)?

12. Provide documentation that demonstrates that the founder stock was legally obtained in accordance to CITES
and with foreign, State and local laws (all original stock used to produce the offspring even if now dead or no
longer able to breed). Examples of documentation include CITES Permits, State Collecting Permits, receipts,
or letters of affidavit from original breeder on how they obtained these animal, and receipts showing the chain
of custody.

13. Provide any available documentation that the breeding stock was acquired in a manner that was not
detrimental to the species. Examples of documentation include information on status of the species in the
wild; the availability of the species in the domestic and international trade; and the ease/difficulty of breeding
the species in captivity.

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FWS Form 3-200-85 (Rev. 01/2020)
U.S. Department of the Interior

OMB Control No. 1018-0093
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14. Provide evidence that applicant is able to consistently produced offspring of second or subsequent
generations (F2 or greater) in a controlled environment, or that you are managing in a way that has been
demonstrated to be capable of reliably producing second generation offspring and has produced first‐
generation offspring, including:
a.

List of breeding stock that includes identification (name or number) of specimens, born/hatched date,
location born/hatched, and sex;

b.

Pedigrees of the breeding stock;

c.

How long have you bred the species?

d.

How many generations has the applicant produced (F1, F2, F3 etc….)?

e.

How many breeding females and breeding males?

f.

Has the applicant held back offspring produced to be parental stock? If so how many male and
females?

g.

What is the estimated annual production?

h.

Average mortality rate/year (juveniles and adults)?

i.

What is the anticipated annual export amount?

15. What are your future plans for supplementing their breeding stock especially as it pertains to introducing new
wild stock?
a.

Will specimens be added either to prevent or alleviate deleterious inbreeding?

b.

Is there captive stock available in the United States or elsewhere such that supplementation from the
wild is not necessary?

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FWS Form 3-200-85 (Rev. 01/2020)
U.S. Department of the Interior

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

All Applicants complete the following:
16. The transport conditions for live animals 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) live animal regulations
(contact airline for information). As such, describe:
a.

The type, size, and construction of any shipping container; and

b.

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

17. Attach copies of any applicable State permits or licenses, such as commercial breeding or sales licenses
(contact your State for information).

18. If the species is part of an approved WBCA Cooperative Breeding Program, identify the breeding operation
and provide an explanation of how the specimen is surplus to the operation.

All international shipment(s) 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, please contact
the Office of Law Enforcement for a Designated Port Exemption Permit (form 3-200-2).

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FWS Form 3-200-85 (Rev. 01/2020)
U.S. Department of the Interior

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

FOR THE PURPOSE OF EXPORT FROM THE UNITED STATES
SPECIES THAT QUALIFY AS CAPTIVE-BRED
IN ACCORDANCE WITH CONF. 10.16

MAMMALS
Order Primates
Callithrix jacchus - Common marmoset [App. II]
Cercocebus agilis – Agile mangabey [App. II]
Lophocebus spp. – Mangabeys [App. II]
Erythrocebus patas - Patas monkey [App. II]
Macaca fascicularis - Crab-eating macaque [App. II]
Macaca mulatta - Rhesus monkey [App. II]
Order Carnivora
Caracal (=Felis) caracal - Caracal [excluding Asian population]
Leptailurus (=Felis) serval - Serval [App. II]
Order Artiodactyla
Antilope cervicarpa - Blackbuck [App. III]
Hexaprotodon liberiensis- Pygmy hippopotamus [App. II]
Hippopotamus amphibius - Hippopotamus [App. II]
Lama guanicoe - Guanaco [App. II]
BIRDS
Order Anseriformes
Cygnus melanocoryphus - Black-necked swan [App. II]
Order Falconiformes
Buteo buteo - European buzzard [App. II]
Order Galliformes
Argusianus argus - Great argus pheasant [App. II]
Gallus sonneratii - Sonnerat'sjunglefowl, Gray junglefowl [App. II)
Polyplectron bicalcaratum - Gray peacock pheasant [App. II]
Polyplectron germaini - Germain's peacock pheasant [App. II]
Polyplectron malacense - Malaysian peacock pheasant [App. II]
Order Psittacifornies
Agapornis roseicollis - Peach-faced lovebird [App. II]
Aratinga jandaya - Jendaya parakeet [App. II]
Barnardius zonarius barnardi - Malice ringneck parrot [App. II]
Bolborhynchus lineola - Lineolated parakeet [App. II]
Cyanoramphus auriceps - Yellow-fronted parakeet [App. II] (excluding C. a. forbesi)
Forpus coelestis - Pacific parrolet [App. II]
Neophema bourkii – Bourke’s parrot [App. II]
Neophema chrysostoma - Blue-winged parrot [App. II]
Neophema elegans - Elegant parrot [App. II]
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FWS Form 3-200-85 (Rev. 01/2020)
U.S. Department of the Interior

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Neophema pulchella - Turquoise parrot [App. II]
Neophema splendida - Scarlet-chestedparrot [App. II]
Platycercus adscitus - Pale-headed rosella [App. II]
Platycercus elegans - Crimson rosella [App. II]
Platycercus eximius - Eastern rosella [App. II]
Platycercus icterotis - Western (Stanley) rosella [App. II]
Platycercus venustus - Northern rosella [App. II]
Polytelis alexandrae - Princess parrot [App. II]
Polytelis anthopeplus - Regent parrot [App. II]
Polytelis swainsonii - Superb parrot [App. II]
Psephotus haematonotus - Red-rumped parakeet [App. II]
Psephotus varius - Mulga parakeet [App. II]
Psittacula eupatria - Alexandrine parakeet [App. II]
Purpureicephalus spurius - Red-capped parrot [App. II]
Trichoglossus chlorolepidotus - Scaly-breasted lorikeet [App. II]
Order Passeriformes
Poephila cincta cincta - Parson finch [App. II]
REPTILES
Order Squamata
Antaresia childreni - Children's python [App. II]
Antaresia maculosa - Spotted python [App. II]
Antaresia perthensis - Pygmy python [App. II]
Boa constrictor - Boa constrictor [App. II] (includes B. c. constrictor, B. c. imperator, B. c. melanogaster, B.
c. mexicana, and B. c. ortonii)
Eryx johnii - Blunt-tailed sand boa [App. II] (includes E. j. johnii and E. j. persicus)
Eunectes murinus - Green anaconda [App. II] (includes E. m murinus, E. m. gigas, and E. m. noteaus)
Morelia spilota variegata - Carpet python [App. II]
Python curtus - Sumatran short-tailed python [App. II] (includes P. c. curtus, P. c. breitensteini, P. c.
brongersmai)
Python reticulatus - Reticulated python [App. II]
Python molurus bivittatus - Burmese python [App. II]
Python regius - Ball or royal python [App. II]
Python sebae - African rock python [App. II]
Python sebae natalensis - Southern African rock python [App. II]
AMPHIBIANS
Order Caudata
Ambystoma mexicanum - Axolotl [App. II]

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FWS Form 3-200-85 (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: 45 minutes
Original submission - electronic: 45 minutes
Amended submission - electronic: 30 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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