3-200-33 Application - Export of Artificially Propagated Plants (

Federal Fish and Wildlife Permit Applications and Reports--Management Authority; 50 CFR 13, 15, 16, 17, 18, 22, 23

3-200-33 App - Export Artificially Prop Plants Plant Parts 03092020

OMB: 1018-0093

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FWS Form 3-200-33 (Rev. 01/2020)
U.S. Department of Interior

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

CITES EXPORT OF ARTIFICIALLY PROPAGATED LIVE PLANTS OR PLANT PARTS
(Single and Multiple Commercial Shipments)
☐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 3-200-33 (Rev. 01/2020)
U.S. Department of Interior

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

E. CITES EXPORT OF ARTIFICIALLY PROPAGATED LIVE PLANTS OR PLANT PARTS
This form should be used for the commercial export of cultivated specimens (i.e., species, hybrids, cultivars) of
CITES-listed species that meet the criteria of ‘artificially propagated’, as defined by CITES Resolution Conf. 11.11
(Rev. CoP18; on Regulation of trade in plants). All plant scientific names must be published in a CITES
nomenclature reference (Res Conf. 12.11 (Rev. CoP18)) on Standard nomenclature or a recognized scientific
journal.
This form should NOT be used to:
• Request authorization to re-export artificially propagated plants; or for export or re-export of wild-collected plants or
plant materials; or for exports or re-exports of plant products (e.g., extracts, powders). Applicants should complete
application form 3-200-32.
• Request authorization for plants listed in the Endangered Species Act. For such export, applicants should complete
form 3-200-36.
• Request authorization for the import of wild-collected CITES Appendix I plants. For such imports, applicants should
complete form 3-200-35.
• Request additional partially completed certificates for artificially propagated plants under your existing Master File.
Applicants should complete application form 3-200-74.
This application may be used to:

☐ Request a single-use permit for commercial export of artificially propagated plants or plant materials that is
valid for 6 months from the date of issuance. For re-issuance or amendment of a single use permit, the original
permit must be returned with completed application form.
☐ Establish a Master File: A “Master File” with an approved plant list is valid for up to 3 years from the date of
issuance. Once approved, you must obtain partially completed certificates to export approved plants or plant parts.
Partially completed certificates are $5 each and are valid for 6 months. Certificates must be obtained prior to making
any shipment and must accompany the shipment.
☐ Amend an existing Master File: A “Master File” must be amended when there have been any changes to the
species or supplier information provided in your existing Master File. You need only provide the requested
information for the species or suppliers to be amended (i.e., you do not need to provide information for all of the
plants on your approved Master File plant list if it has not changed). However, if you intend to renew your current
Master File at the same time you are amending it, see below.
☐ Renew (or Amend and Renew) a Master File: To renew a Master File that has or will soon expire, you must
complete this entire application, including providing all of the information requested in this form for all plants to be
included in your Master File and information on any changes to your facility, operations, species, or suppliers for the
plant specimens that you wish to export.
Provide the file number of any previously established Master Files for artificially propagated plants.
_______________________
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.

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FWS Form 3-200-33 (Rev. 01/2020)
U.S. Department of Interior

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

This section is divided into FIVE (5) parts:
• All applicants should complete Parts I and V; and
• Part II, to export interspecific and intergeneric hybrids of Appendix-II CATTLEYA, CYMBIDIUM, DENDROBIUM (D.
phalaenopsis and D. nobile only), ONCIDIUM (non-native species only), PHALAENOPSIS, or VANDA, and
• Part III, to export other plants produced at your facility.
• Part IV, to export plants purchased and produced at different facility.

Part I: General information (if more space is needed, attach separate sheets and cross-reference any separate
pages by numbering them according to the question you are responding to).
1. Name and address where permit should be mailed, if different from page 1. If you want expedited shipping,
please enclose a self-addressed, pre-paid, computer-generated, courier service airway bill. Otherwise, all
documents will be mailed via 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.
4. Briefly describe your business operation, including how long you have been in business; and the number,
location, size, and types of growing facilities. Are all of the plants or plant material intended for export
propagated and grown at your facility? Do you have a single facility or multiple facilities? For plants/plant
material purchased from other producers, are plants maintained for long periods of time or is stock turned
over frequently? Do you only export plants/plant material obtained from other producers? If yes, do you
purchase plants/plant material only when you have an order to fill or do you maintain plants/plant material at
your facility until an order is submitted?
5. Provide labeled photographs of your growing facilities, parental stock, and plants to be exported. Clearly
indicate which species/hybrids/cultivars are depicted in the photos. If you purchase from a different facility,
please provide such photographs from that supplier(s).
6. Provide copies of the following documentation (cross-reference all document(s) by numbering them according
to the question number or plant item number that the document responds to):
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FWS Form 3-200-33 (Rev. 01/2020)
U.S. Department of Interior

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

a.

Your current State nursery license.

b.

Your current U.S. Department of Agriculture Protected Plant Permit (formerly known as General
Permit).

c.

Validated CITES import permits and Phytosanitary Certifications with inventory lists for all plants or
plant parts imported to the United States (including imports used to establish parental stock).

d.

Authorizations (e.g. collection permits, land-owner permission, salvage permits) for any wild plants or
plant parts collected in the United States used to establish parental stock.

e.

Invoices showing the name, address, and telephone number or e-mail address of the person/facility
that you purchased the plants/specimens, and the date of purchase for any plant part obtained from
other suppliers (including purchases you made to establish parental stock at your facility). If not
available, provide a signed and dated notarized propagator’s statement that includes the following
information:
i.

Propagator’s contact information (name, telephone number or e-mail, and business, if
applicable)

ii.

Recipient’s contact information (name, telephone number or e-mail, and business, if
applicable)

iii.

Year the parental stock was established

iv.

Type of plant material and whether it was wild-collected or cultivated

v.

Date of purchase

7. Describe the type of shipping containers and the arrangements for LIVE plant care during shipment.

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FWS Form 3-200-33 (Rev. 01/2020)
U.S. Department of Interior

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

PART II. Hybrids of Cattleya, Cymbidium, Dendrobium phalaenopsis and D. nobile only, Oncidium (non-native species only), Phalaenopsis, and Vanda
orchids. Provide information requested in Table 1. All parents must be from these groups, including interspecific and intergeneric hybrids. Refer to Codes below
for sections b-d and specify your answer in the space provided if you select “other”. For all other plants, including other orchid hybrids, proceed to Part III.
TABLE 1. HYBRIDS of CATTLEYA, CYMBIDIUM, DENDROBIUM phalaenopsis and D. nobile, ONCIDIUM (non-native), PHALAENOPSIS, or VANDA
Item
No.

a. Name of Hybrid
(Include parental genera or grex)

b. Plant Description
at the time of export
specify code

c. Growing Environment
specify code

d. Propagation Method(s)
specify code

e. Name of Propagating Facility

(Provide complete address in Table 4)

b. Plant Description: 1=Seedling; 2=Juvenile; 3=Mature/blooming; 4=Cutting/division; 5=Root/rhizome; 6= Other (specify)
c. Growing Environment: 1 = Greenhouse; 2 = Shadehouse; 3 = Lab; 4 = Field; 5 = Other (specify).
d. Propagation Method to produce the specimens to be exported: 1 = Seeds; 2 = Stem or root/rhizome cuttings/divisions; 3 = In vitro; 4 = Other (specify).

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FWS Form 3-200-33 (Rev. 01/2020)
U.S. Department of Interior

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

PART III. Plants produced and grown at the applicant’s facilities (excluding hybrids in Part II). Provide the information requested in Table 2 for all plants or
plant materials requested for export that were produced at your facilities. Refer to the Codes below for sections b, c, d, f, and j; and specify your answer in the
space provided if you select “other”.
TABLE 2. PLANTS PRODUCED AT THE APPLICANT’S FACILITIES
INFORMATION ABOUT THE PLANTS TO BE EXPORTED

Item a. Scientific Name & Common b. Description
specify code
No. Name
(If hybrid, list parental species &
hybrid name)

c. Growing d.
e. No. of
Environme Propagati Parental
on Method Stock
nt
specify code specify code

INFORMATION ABOUT THE PARENTAL STOCK

f. Growing For cultivated,
h.
i.
j. Type of
For wild origin,
Environme provide supplier provide collection Date(s) Quantity plant
nt specify
acquired obtained material
location (specify
name
code
obtained
(provide complete country and see
address in Table 4) footnote) 1

k. How often
do you obtain
additional
stock? (either

specify code wild or cultivated)

b. Specimen Plant Description: 1=Seedling; 2=Juvenile; 3=Mature/blooming; 4=Cutting/division; 5=Root/rhizome; 6= Other (specify)
c. Growing Environment of Plants: 1=Greenhouse; 2=Shadehouse; 3=Lab; 4=Field; 5=Other (specify)
d. Propagation Method to produce the specimens to be exported: 1=Seeds; 2=Stem or root/rhizome cuttings/divisions; 3=In vitro; 4=Other (specify)
f. Growing Environment of Parental Stock: 1=Greenhouse; 2=Shadehouse; 3=Lab; 4=Field; 5=Other (specify)
j. Plant part obtained: 1=Seeds; 2=Flasks; 3=Seedlings; 4=Juvenile size; 5=Mature/blooming size; 6=Cuttings/divisions; 7=Roots/rhizomes; 8=Other (specify).

1

For planting stock collected/harvested from the wild in the United States, provide the number and age class of specimens collected; the specific location (including city and county) and date(s) of
collection for each specimen; the name, address, and phone number of the collector; collection/harvest methods; and the estimated number of plants and the proportion of plants collected/harvested at
each location. If wild-origin planting stock is from non-U.S. origin, copies of the validated CITES documentation will be adequate.
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FWS Form 3-200-33 (Rev. 01/2020)
U.S. Department of Interior

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

Part IV. Plants produced at facilities other than the applicant’s facilities (excluding hybrids in Part II). Provide information requested in Table 3 for all plants or plant parts
requested for export. Refer to the Codes below for sections b, c, d, f, and j; and specify your answer in the space provided if you select “other”. Use the same plant item number from
Table 2 if the plant name is the same. If you obtain plants from more than one supplier, use the same item number, but separate lines for each supplier.
Table 3. PLANTS PRODUCED AT DIFFERENT FACILITIES

INFORMATION ABOUT THE PLANTS TO BE EXPORTED

Item a. Scientific Name & Common b.
c. Growing
No. Name
Description Environment
(If hybrid, list parental species & at the time specify code
of export
hybrid name)
specify code

INFORMATION ABOUT THE PARENTAL STOCK

d.
e. No. of
f. Growing
g. Origin of Parental Stock
Propagation Parental
Environment For cultivated, For wild origin,
provide supplier provide collection
specify code
Stock
Method
name
location
specify code
maintained

(provide
(specify country and
complete address see footnote)2
in Table 4)

h.
i.
j. Type of
Date(s) Quantity plant
acquired obtained material
obtained

k. How often
do you obtain
additional
stock? (either

specify code wild or cultivated)

b. Plant Description: 1=Seedling; 2=Juvenile; 3=Mature/blooming; 4=Cutting/division; 5=Root/rhizome; 6= Other (specify)
c. Growing Environment of Plants: 1=Greenhouse; 2=Shadehouse; 3=Lab; 4=Field; 5=Other (specify)
d. Propagation Method to produce the specimens to be exported: 1=Seeds; 2=Stem or root/rhizome cuttings/divisions; 3=In vitro; 4=Other (specify)
f. Growing Environment of Parental Stock: 1=Greenhouse; 2=Shadehouse; 3=Lab; 4=Field; 5=Other (specify)
j. Plant part obtained: 1=Seeds; 2=Flasks; 3=Seedlings; 4=Juvenile size; 5=Mature/blooming size; 6=Cuttings/divisions; 7=Roots/rhizomes; 8=Other (specify).

-

________________________________
2
For planting stock collected/harvested from the wild in the United States, provide the number and age class of specimens collected; the specific location (including city and county) and date(s) of
collection for each specimen; the name, address, and phone number of the collector; collection/harvest methods; and the estimated number of plants and the proportion of plants collected/harvested
at each location. If wild-origin planting stock is from non-U.S. origin, copies of the validated CITES documentation will be adequate.

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FWS Form 3-200-33 (Rev. 01/2020)
U.S. Department of Interior

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

PART V. Supplier Information (To be completed by all applicants). Provide the information requested in Table 4. Use the same plant item number from
Tables 1, 2, or 3, as applicable. If you obtain plants or plant parts from more than one supplier, use separate lines for each supplier.
TABLE 4. SUPPLIER CONTACT DETAILS

Item
number

Name of Supplier

Full Address
(street address, city, state,
country, zip code)

Telephone
Number

Fax Number
(if available)

E-Mail/website (if
available)

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FWS Form 3-200-33 (Rev. 01/2020)
U.S. Department of 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: 2 hours
Amended submission - paper-based: 1 hour 45 minutes
Original submission - electronic: 1 hour 45 minutes
Amended submission - electronic: 1 hour 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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File TitleNPS Form 10-29
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