3-200-37a Application - Import/Export-Re-Export of Live Animals (C

FWS Form 3-200-37a (Rev. 01/2020)
U.S. Department of the Interior

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

IMPORT/EXPORT/RE-EXPORT OF LIVE ANIMALS (CITES/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.
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FWS Form 3-200-37a (Rev. 11/2019)
U.S. Department of the Interior

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

E. Import/Export/Re-export of LIVE animals (CITES/ESA)

General Information
This application covers activities involving LIVE CITES and ESA listed animals.
Review this application carefully and provide complete answers to all of the questions. If you are applying for
multiple species, be sure to indicate which species you are addressing in each response. If more space is
needed, attach a separate sheet with your responses numbered according to the questions.
Please allow at least 90 days for the application to be processed.

How do I determine whether the species is protected under CITES and/or the ESA?
To determine whether an animal species is
protected under CITES, when the species was
listed, or whether exemptions apply to your
requested activity, see the list of CITES species

To determine whether an animal species is
protected under the ESA, please review the list of
ESA-listed species in the Code of Federal
Regulations.
Please be aware that any permit request involving
an ESA endangered species must be published in
the Federal Register for a required 30-day public
comment period.

Questions
If you have any questions regarding an action you are requesting authorization for please contact the Division of
Management Authority at [email protected].
Please note: for renewal or amendment of a multi-use permit being requested within the 5 year Federal Register
public notice period, use application 3-200-52
This form should NOT be used for:
●
●
●
●

Pre-Convention, Pre-Act, antique (antique exemption criteria) (use application 3-200-23)
Captive Bred Wildlife Registration (use application 3-200-41)
ESA Plants (use application 3-200-36)

Import of LIVE African Elephants from Botswana, Namibia, South Africa, and Zimbabwe and Southern White
Rhinoceros from eSwatini and South Africa (use form 3-200-37f)

Electronic Information Submission
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. Point of contact if we have questions about the application (name, phone number, and email).

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U.S. Department of the Interior

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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. Type of Activity:

☐ Import
☐ Export
☐ Re-export (e.g. exporting a specimen that was previously imported into the United States)

5. The current location of the animal(s) (if different from the physical address provided on pg. 1):
Name:
Address:
City:
State/Province:
Postal Code:
Country:
6. Recipient/Sender:

●

If export/re-export, provide name and physical address of the recipient in the foreign country.

●

If import, provide name and physical address of the exporter/re-exporter in the foreign country.

Name:
Address:
City:
State/Province:
Postal Code:
Country:
7. For each animal involved in the import/export/re-export, provide (you may use the table below):
a. Scientific name (genus, species, and if applicable, subspecies)
b. Common name
c.

Approximate or actual birth/hatch date (mm/dd/yyyy)

d. Wild or captive-born
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FWS Form 3-200-37a (Rev. 11/2019)
U.S. Department of the Interior

OMB Control No. 1018-0093
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e. Quantity
f.

Sex (males.females.unknown sex, 10.2.3)

g. Permanent markings and/or identification information (microchip #, leg band #, tattoos, studbook #).
a. Scientific name
(genus, species, and
if applicable,
subspecies)

EXAMPLE:
Pan troglodytes

b. Common
Name

Chimpanzee

c. Approximate
or Actual
Birth/Hatch
Date
(mm/dd/yyyy)

08/01/2006

d. Wild
(W) or
Captiveborn (C)

C

e.
Quantity

1

f. Sex
(male.
female.
unknown
sex, ex:
1.0.0)

1.0.0 OR
male

g. Permanent markings/ID
information (e.g., microchip #,
leg band #, tattoo, studbook #,
etc.)

Studbook# 152;
Microchip# 00056321-00

SOURCE OF SPECIMEN
8. For each captive-born/captive-hatched animal(s), provide a signed and dated statement from the breeder or other
appropriate documentation (e.g. Species 360 report) that includes the following:
a.

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

b.

Common name,

c.

Name and address of the facility where the animal was bred and born,

d.

Birth/hatch date (mm/dd/yyyy),

e.

Identification information (studbook, microchip, leg band, etc.),

f.

Name and address of the facility where the parental stock is located,

g.

A statement from the breeder that the animal was bred and born at the breeder’s facility (including the
facility’s name and address), and

h.

If you are not the breeder, provide documentation demonstrating the history of transactions (e.g., chain of
custody or ownership of the animal).

9. For each animal(s) taken from the wild, provide:
a.

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

b.

Common name,

c.

Specific location (e.g. county, state, province, country) where the animal was removed from the wild;

d.

The name of the individual(s) who collected the animal(s) and their authorization to do so, including
copies of foreign and domestic (Federal, State, and/or Tribal) government collecting permits, licenses,
contracts and/or agreements;
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FWS Form 3-200-37a (Rev. 11/2019)
U.S. Department of the Interior

OMB Control No. 1018-0093
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e.

Method of collection: capture protocol, and any injury and mortality experienced during collection,
transport, and holding;

f.

Information related to any remuneration, either financial or in-kind, provided for acquiring the animal(s);

g.

Efforts to use captive specimens (e.g., captive-born, captive-held), in lieu of taking animals from the wild.

10. For each animal being re-exported (e.g., exporting animal(s) previously imported into the United States), provide:

a.

A copy of the CITES export or re-export document issued by the appropriate CITES office in the country
from which the wildlife was imported (this document is stamped cancelled by USFWS Office of Law
Enforcement upon import inspection); and

b.

A copy of your Declaration for Importation or Exportation of Fish or Wildlife (Form 3-177) cleared by
USFWS Office of Law Enforcement.

c.

A copy of the ESA permit that authorized the original import.

d.

If you did not make the original import, provide documentation outlining chain-of-ownership since import,
including:
1. A copy of the importer's clearance documents (a, b & c above) and,
2. Subsequent invoices (or other documentation) showing the history of transactions leading to your
ownership of the animals after import (chain of custody).

DESCRIPTION AND JUSTIFICATION FOR REQUESTED ACTIVITY
Describe the purpose of your proposed activity.
11. If scientific research, provide:
a. A copy of the research proposal (outlining the purpose, objectives, and methods),
b. Detailed information on capture methods including:
i. who will be capturing the animals
ii. equipment used
iii. measures taken to prevent injuries and mortalities
c. An explanation of whether other similar work has already been conducted or is currently being conducted,
d. A copy of the study’s Institutional Animal Care and Use Committee (IACUC) form (if applicable),
e. Peer-reviewed scientific papers published from this research (if applicable).
12. If conservation education and/or zoological display, provide:

a. Objectives of proposed activity in support of an education program,
b. Copies of educational materials (e.g., handouts, text of signage or public presentations), incorporating the
following information:

i. Status in the wild
ii. Current threats
iii. Conservation efforts
13. If captive propagation for the conservation and survival of the species, provide:

a. A description of how the species will be propagated (e.g. artificial insemination, breeding pairs/groups),
b. Documentation showing your participation in an established breeding program (example: current breeding
plan outlining your role in the program AND letter from the breeding coordinator confirming your
participation in this breeding program.
c.

How your breeding stock is managed to maintain genetic vitality, including:
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FWS Form 3-200-37a (Rev. 11/2019)
U.S. Department of the Interior

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i. avoidance of inbreeding,
ii. considerations of average kinship,
iii. and differences in paternal and maternal average blood relationships/relatedness,
iv. carrying capacity of your facility,
v. disposition of progeny.
d.

Plans and agreements for future re-introduction (if applicable).

14. Please provide a detailed description on how the proposed activities will enhance or benefit the wild population
within its native range (e.g., direct or indirect conservation efforts) and provide documentation (e.g., signed
memorandums of understanding) demonstrating your commitment to supporting the program and how the program
contributes directly to the species identified in your application.

TECHNICAL EXPERTISE & FACILITIES
●
●
●

For export/re-export, provide information for the receiving institution.
For import, provide information for your institution.
For import to multiple facilities, provide information for all receiving institutions.

15. CV or resume outlining the technical experience of each caretaker working with, maintaining, and/or propagating
each species, as it relates to the proposed activities, including experience with similar species.
16. Current inventory of the species at the facility (males.females.unknown sex., 10.2.3),
17. Number of years the species has been maintained at the facility,
18. Number of births per species per year over the last 5 years,
19. Number of mortalities per species (or similar species) per year over the last 5 years and steps taken to avoid or
decrease such mortalities,
20. A detailed description, diagrams, and photos clearly depicting the existing facilities where the wildlife will be
maintained including: dimensions, construction materials, and protection from the elements. Do not provide
blueprints;
21. Approximate carrying capacity for the species at the facility.

TRANSPORT/SHIPMENT OF LIVE ANIMALS.
22. Transport conditions for live animals must comply with the CITES Guidelines for Transport of Live Animals. All air
transport must also comply with the International Air Transport Association (IATA) live animal regulations (contact
airline for information). As such, provide:
a.
b.

The type, size, and construction of any shipping container and,
The arrangements for watering or otherwise caring for the wildlife during transport.

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).

CITES APPENDIX I & MARINE MAMMAL SPECIES

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FWS Form 3-200-37a (Rev. 11/2019)
U.S. Department of the Interior

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

●

For export of a CITES Appendix I-listed species, provide a copy of the CITES import permit, or evidence one
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, it is required that import permits are issued before the
corresponding export permit.

●

For import of CITES Appendix-I listed species, provide information to show the import is not for primarily
commercial purposes as outlined in Resolution Conf. 5.10 (Rev. CoP 15).

●

For import of live CITES Appendix-I marine mammals, provide a copy of your FWS or NMFS Marine Mammal
Protection Act (MMPA) permit or authorization.

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FWS Form 3-200-37a (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: 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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