Form 3-202-12 Migratory Bird and Eagle Acquisition and Transfer Reques

OMB Control No. 1018-0022
Expires ##/##/####

FWS Form 3-202-12 (Rev. 01/2020)
U.S. Department of the Interior

MIGRATORY BIRD AND EAGLE ACQUISITION AND TRANSFER REQUEST
BEFORE FILLING OUT THIS FORM, please access the Return Addresses (to
obtain the email/postal mail addresses where this form can be returned).
(Please see page 2 for instructions)
If you:
A. wish to transfer a live bird to: another permittee; another permit you hold; or to an institution
exempt from the permit requirement under 50 CFR 21.12,

complete these sections
1, 2, 3, 4, 5, and 6.

B. lost a bird due to its escape; theft; or death,

1, 2, and 6.

C. wish to acquire a live bird from another permittee (or from another permit you hold),

1, 2, 3, 4, 5, and 6.

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SPECIES:
Sex:  Male  Female Unknown

Band number or other identification (if applicable): ______________________
Age:  Nestling  Immature  Adult
Source:  Wild Captive-bred

SENDER (person transferring bird) Name: ________________________________________________
Telephone:_________________

Fax:____________________________

Email: ____________________________________

Address:_________________________ City: _____________ State:_______Zip:______________
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Type:  Rehabilitation Education
Is this bird being:

Transferred

Permit #: ______________

 Exhibition  Other Specify ______________________________________________
Released

Died - date & cause of death:______________________________________________

Escaped - date & explanation:__________________________________________________________________________
Other - date & explanation:____________________________________________________________________________
Reason bird is unreleasable: ______________________________________________________________________________
RECIPIENT (person acquiring bird)
Telephone:

Name: ___________________________________________________________
Fax:______________________

3 Address:

City:

Permit #:_____________________

Permit Type:

Zip:_____________

State:

 FWS Education

 FWS Native American Eagle Aviary  FWS Exempt Institution

E-mail: ____________________________________

 FWS Eagle Exhibition

 State Falconry

 Other (specify): ____________________________

BIRD IS:  NONRELEASABLE  RELEASABLE* *Releasable birds must be released to the wild, except that releasable
4 raptors (excluding eagles) may be transferred to falconers permitted to hold the species for falconry.

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ATTACHMENTS (See instructions on the next page to determine which attachments are required and the information that must be
included in each attachment. Check the attachments below that apply.)
 Veterinarian’s statement

 Enclosure information

 Experience information

 Program information

CERTIFICATION. I certify that the information submitted above is true and correct to the best of my knowledge.
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I understand that making a false statement may subject me to the criminal penalties of 18 U.S.C. 1001.
__________________________
__________________________________________________________________________
Signature of permittee/Principal Officer (No stamped signatures. Electronic signatures accepted.) Date of signature (mm/dd/yyyy)

U.S. FISH & WILDLIFE SERVICE APPROVAL / DISAPPROVAL
Approved:

___________________________________
Signature of FWS official

Concurrence: ___________________________________
Signature of FWS official
Denied:

___________________________________
Signature of FWS official

_____________________________________________
Title/Region
Date
______________________________________________
Title/Region
Date
______________________________________________
Title/Region
Date

Facilities/Comments: ________________________________________________________________________________________
__________________________________________________________________________________________________

OMB Control No. 1018-0022
Expires ##/##/####

FWS Form 3-202-12 (Rev. 01/2020)
U.S. Department of the Interior

INSTRUCTIONS
This Acquisition and Transfer Request Form is for the use of holders of Federal Migratory Bird Special Purpose Possession Live
(Education), Eagle Exhibition (Live), Rehabilitation, and Native American Eagle Aviary permits, in requesting authorization to acquire
live migratory birds from other permittees, or to transfer live migratory birds to possession permittees. (Contact your permit office if
your Transfer From/To scenario is not listed below.) This form must be completed and submitted to your Regional Migratory Bird
Permit Office, and it must be approved by the appropriate permit office prior to you receiving or transferring a bird. Allow at
least 30 days from the date the approving permit office receives a complete request.
If this request necessitates amendment of your permit, the completed form will serve as your amendment request. The authorizing
Service official will approve or deny the transaction at the bottom of the form and provide a copy to you for your records. If your
request is approved, you may take possession or transfer the bird once you receive your copy. (You may also require authorization
from your State.) If your request is denied, you may not conduct the requested activity (see 50 CFR 13.29 for reconsideration
procedures).
1. Who completes and signs the Acquisition and Transfer Request form, and where do they submit it?
For a Transfer
From
Rehabilitation
permit

To
Rehabilitation
permit

the 3-202-12 is
submitted by
No transfer form
required

to

include
(attachments)

Comment

NA

NA

Include in annual report

Veterinarian statement,
caging, experience &
education information.

Rehabilitator sends veterinarian
statement to Education/Eagle
Exhibition permittee to submit with
their package to their permit office

Rehabilitation
permit

Education/Eagle
Exhibition
permit

Educator/Eagle
Exhibitor

Educator’s
permit office

Rehabilitation
permit

Native
American Eagle
Aviary permit

Eagle Aviary

Eagle Aviary’s
permit office

Veterinarian statement

Native American Eagle aviaries
have priority for nonreleasable
eagle acquisition.

Rehabilitation
permit

Exempt
Institution

Rehabilitator

Rehabilitator’s
permit office

Veterinarian statement
& caging information

Exempt institution sends caging
information to Rehabilitator to
submit with their package. No
institution is exempt from permit
requirement for eagles

Rehabilitation
permit

Falconry permit

Rehabilitator

Rehabilitator’s
permit office

Copy of State
Falconry permit

Falconry permittee must complete
electronic 3-186A

Education
permit

Education
permit

Both permittees

Their respective
permit office

Veterinarian statement,
caging, experience &
education information.

Sending educator sends vet
statement to Receiving educator to
submit with their package to their
permit office

Education
permit

Educator

Educator’s
permit office

Caging, experience &
education information

Propagator must submit
a completed 3-186A.

Permitted
facility

NA

NA

NA

Transfer of birds from exempt to
permitted facilities is prohibited

Raptor
propagation
permit
Exempt
Institution

2. ATTACHMENTS
This information is required by your permitting office before your permit can be amended to authorize your acquisition and possession of this bird.
a. Veterinarian’s statement –Must be on letterhead and signed by the veterinarian. Must fully describe the injury, illness or other medical or
behavioral condition of the bird, and why it renders the bird non-releasable to the wild. The Service may require an independent evaluation prior to
approving transfers of nonreleasable birds. More detailed instructions and a fillable template are available at
https://www.fws.gov/migratorybirds/pdf/policies-and-regulations/templatevetletter.pdf
b. Enclosure information -- If you are acquiring a bird, attach photographs and diagrams of your permanent facilities/enclosures for housing migratory
birds (both indoor and outdoor). Diagrams must include dimensions (length, width, and height) and a description of interior and exterior construction
materials, such as flooring and netting materials. Indicate the species or type of species that will be housed in each. Also provide a description of the
interior and exterior construction and housing materials, such as flooring, netting, perching, and watering materials.
c. Experience Information -- If you are acquiring a bird that is a new species for you (i.e., your permit does not already authorize possession of
individuals of this species), describe your experience handling this species.
d. Educational program -- If you are acquiring a bird that is a new species for you (i.e., your permit does not already authorize possession of
individuals of this species), provide a brief outline of the educational program you will deliver regarding this species.
3. The permittee/principal officer must sign (in blue ink) and date the form.
4. Mail the completed form and any required attachments to the appropriate Regional Migratory Bird Permit Office indicated in the table above.

OMB Control No. 1018-0022
Expires ##/##/####

FWS Form 3-202-12 (Rev. 01/2020)
U.S. Department of the Interior

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
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. The information the individual provides helps the FWS monitor and report on protected species and assesses 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
In accordance with the Paperwork Reduction Act (44 U.S.C. 3501), the U.S. Fish and Wildlife Service collects information necessary to
monitor take and disposition of migratory birds, under the applicable laws governing the requested activity, for which a permit is
requested, and to respond to requests made under the Freedom of Information Act and the Privacy Act of 1974. 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 above 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. 1018-0022.
ESTIMATED BURDEN STATEMENT
We estimate public reporting for this collection of information averages:
Original submission - paper-based: 1 hour 30 minutes
Original submission - electronic: 1 hour 15 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 (JAO/3W), Falls Church, VA 22041-3803, or via email at
[email protected]. Please do not send your completed form to this address.
FREEDOM OF INFORMATION ACT
For organizations, businesses, or individuals operating as a business (i.e., permittees not covered by the Privacy Act), we request that
you identify any information that should be considered privileged and confidential business information to allow the Service to meet its
responsibilities under FOIA. Confidential business information must be clearly marked "Business Confidential" at the top of the letter or
page and each succeeding page and must be accompanied by a non-confidential summary of the confidential information. The nonconfidential summary and remaining documents may be made available to the public under FOIA [43 CFR 2.26 – 2.33].

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