Form 3-200-24 Application - Export of Live Captive-Born Animals (CITES

FWS Form 3-200-24 (Rev. 01/2020)
U.S. Department of the Interior

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

EXPORT OF LIVE CAPTIVE-BORN ANIMALS AND PRODUCTS/PARTS FROM FOREIGN
LISTED CAPTIVE-BORN ANIMALS (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 3-200-24 (Rev. 01/2020)
U.S. Department of the Interior

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

EXPORT OF LIVE CAPTIVE-BORN ANIMALS AND PRODUCTS/PARTS FROM FOREIGN LISTED CAPTIVE-BORN ANIMALS (CITES)
Note 1: This application can be used to apply for a permit to export non-native live captive-born animals AND/OR parts
and products manufactured from such animals from the United States. If you are exporting parts or products
manufactured from ntive-listed species, such as bobcat or alligator, please use form 3-200-26 or 3-200-27.
Note 2: The U.S. Fish and Wildlife Service may not be able to issue documents for the commercial export of Appendix-I
species, unless the specimens were produced at a CITES-registered Appendix-I commercial breeding operation. For
more information on registering an Appendix-I commercial breeding operation, contact the Division of Management
Authority at [email protected].
Provide the following information. Complete all questions on the 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, indicate the
application question number you are addressing. If applying for more than one animal, be sure to indicate to which animal
the required documentation relates.
Electronic submission of inventories, photographs, and receipts: 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 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.

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FWS Form 3-200-24 (Rev. 01/2020)
U.S. Department of the Interior

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

4. For EACH animal, part, or product to be exported, provide the information below (for your convenience a table
has been provided on page 5 of this application):
a.

Scientific name (Genus, species, and, if applicable, subspecies) and common name;

b.

Birth/Hatch date (MM/DD/YYYY) (if live);

c.

Gender (if known) [male:female:unknown sex];

d.

Specimen is live or specimen is a part or product;

e.

Source;

f.

If live, microchip, Tag, or Band number, length or carapace length, or other identifying characteristics;

g.

If parts or products, provide description of item.

5. Current location of specimen(s):

6. What is the purpose of the export?
____ Commercial

____ Personal ____ Exhibition

____ Scientific

____ Breeding ____ Other (specify: _____________________________)

7. Provide the name and address of the recipient of the shipment.
Name:
Address:
City, State/Province:
Country, Postal Code:
8. If you (the applicant) are the Breeder1 of the specimen, sign (in ink) the following statement:
I hereby certify that the animal(s) or the parts or products listed above to be exported was/were bred and born (if
live) or produced from animals bred and born from legally obtained parental stock at my facility listed below
Name and address of your facility where the animals were bred and born:

Current location of parental stock (if different from above):

Signature______________________________________________

Date __________________
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FWS Form 3-200-24 (Rev. 01/2020)
U.S. Department of the Interior

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

9. If you are NOT the breeder1 of the specimen(s), provide copies of documentation showing that you acquired
the animal or parts or products from the breeder (e.g., receipts), documentation demonstrating the history of
transactions (e.g., chain of ownership of each animal or product in the form of invoices), and a signed and
dated statement from the breeder or breeder's record that clearly includes the following:
a.

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

b.

Statement that each animal was bred and born/hatched at his/her facility;

c.

Birth/hatch date (mm/dd/yyyy), and, if applicable, identification information ;

d.

Name and address of the breeder’s facility; and

e.

Location (name of facility, address, city, State/province, postal code) of parental stock.

Please note that additional information on the parental stock may be required upon receipt of your
application.

1

10. 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.

11. For the non-commercial export of CITES Appendix-I specimens, provide a copy of the CITES import permit,
OR evidence a permit will be issued by the Management Authority of the country to which you plan to export
the specimen(s). In accordance with Article III of the CITES treaty (www.CITES.org), it is required that import
permits are issued before the corresponding export permit. (Certain species have been certified as “bred-incaptivity”, as identified in CITES Resolution Conf. 10.16 (Rev.), and would not require a CITES import permit;
please contact the Division of Management Authority if you are not sure if this designation would apply to your
specimens.)
12. For the commercial export of CITES Appendix-I species, Are you registered with the CITES Secretariat as an
operation that breeds Appendix I species for commercial purposes? ____ If yes, please provide your
Registration number: ______________
(The export of specimens from a CITES-Registered Commercial Operation for Appendix I wildlife do not require a
CITES import permit).
13. Attach copies of any applicable State permits or licenses, such as State commercial breeding or sales
licenses (you may need to contact your State for information
14. For the export of migratory birds (50 CFR 10.13) or their eggs, provide copies of your Federal and/or State
permits or licenses authorizing possession, acquisition, or disposition of such birds, or their eggs, where such
a permit is required.
15. If the species is part of an approved Wild Bird Conservation Act 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 3-200-24 (Rev. 01/2020)
U.S. Department of the Interior
a. Scientific name (Genus, species,
and, if applicable, subspecies) and
common name;

OMB Control No. 1018-0093
Expires ##/##/####
b. Birth/Hatch date
(MM/DD/YYYY) (if
live);

c. Gender (if known)
[male:female:unknown
sex];

d. Specimen is live or
specimen is a part or
product;

e. Source;

f. If live, microchip, Tag, or Band
number, length or carapace length,
or other identifying characteristics;

g. If parts or products,
provide description of
item.

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FWS Form 3-200-24 (Rev. 11/2019)
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 36 minutes (electronically) to 45 minutes
(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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