Form 3-200-32 Application - Export/Re-export of Plants (CITES)

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

3-200-32 App - CITES Plant Permits 02242023

ePermits Amendment - Export/Re-export of Plants (CITES) (Form 3-200-32) - Private Sector

OMB: 1018-0093

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OMB Control No. 1018-0093
Expires xx/xx/xxxx

FWS Form 3-200-32 (Rev. 02/2023)
U.S. Department of the Interior

Export/Re-Export of Plants and Plant Products (CITES) (including non-commercial American
ginseng exports)
☐New ☐Reissue/Renew ☐Amendment

APPLICATION FORM INSTRUCTIONS

The following instructions pertain to U.S. Fish and Wildlife Service (FWS) permit applications. The General Permit Procedures in 50
CFR 13 address the permitting process. For simplicity, all licenses, permits, registrations, and certificates are referred to as a permit.
If you are an individual, who would be named on the face of the permit, you need to complete the Individual Applicant section of this
application.
If you are an individual seeking permits issued to yourself for activities not associated with your business or institution, you need to
complete the Individual Applicant section as an individual permittee.
If you are an individual associated with a business or institution, and the business or institution’s name would appear on the face of the
permit, you need to complete the Business Applicant section of this application.
If you are a business applying on behalf of an individual, you need to complete the Business Applicant section of this application and
include a limited power of attorney from the person for whom you represent.
A person/entity is qualified to obtain a U.S. Fish and Wildlife Service permit or license when they are "subject to the jurisdiction of the
United States", per 16 USC 1532(13). A foreign person/entity with no permanent physical presence in the United States only qualifies
for an import/export license when they physically enter or exit the U.S. with the wildlife items. The foreign entity is required to designate
a U.S. agent for purposes of record keeping.

GENERAL INSTRUCTIONS:

•

An incomplete application may cause delays in processing or may be returned to the applicant. Be sure you are filling in the
appropriate application form for the proposed activity. Items marked with an asterisk (*) are required fields.

•

Print clearly or type in the information. Illegible applications may cause delays.

•

Sign the application. Faxes or copies of the original signature will not be accepted.

•

If you choose to mail your submission, mail the original application to the address listed below or, if applicable, on the attached
address list. We encourage electronic filing in the ePermits system.

•

Keep a copy of your completed application.

•

Please plan ahead. Unless otherwise indicated, allow at least 60 days for your application to be processed, however, some
applications may take longer than 90 days to process (50 CFR 13.11). Longer processing times will be noted on those applications.

•

Applications are processed in the order they are received.

Individual or Business Applicants:
Individual Applicant. Complete if applying as an individual [do not complete this application if applying for Import/Export License (3-2003) or a Designated Port Exception Permit (3-200-2)]:
•

Enter the information requested. Required fields must be completed. This is used to create your profile and consumer information
in the ePermits system. If you do not have an email address, enter not applicable.

•

Doing business as (dba) / Affiliation: The Division of Management Authority (DMA) and the Office of Law Enforcement (OLE) do
not accept doing business as affiliations for individuals seeking permits on behalf of themselves. “Doing business as” affiliations
apply to individuals seeking permits for a business, agency, Tribe, organizational, or institutional affiliation directly related to the
activity requested in the application. For example, a taxidermist is an individual whose business can directly relate to the requested
activity of exporting taxidermy (dba relevant permit); however, said taxidermist should not apply as a business for permits to nonbusiness related travel with their pet exotic parrot (dba is not relevant to the permit; complete the Business Applicant section).

Business Applicant. Complete if applying as a business, corporation, public agency, Tribe, or institution:

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•

Enter the information requested. Required fields must be completed. This is used to create your contact and account information in
the ePermits system. If you do not have an email address, enter not applicable.

•

If you are applying on behalf of a client, a document evidencing power of attorney must be included with the application.

•

Principal Officer is the person in charge of the listed business, corporation, public agency, Tribe, or institution. The principal
officer is the person responsible for the application and any permitted activities. Often the principal officer is a Director or President.

•

The Contact is the person at the business, corporation, public agency, or institution who will be available to answer questions
about the application or permitted activities. Often this is the preparer of the application. Each person that is associated with the
business that would need to access the business account needs to create their own contact in the ePermits system.

Application processing fee:
•

An application processing fee is required at the time of application, unless exempted under 50 CFR 13. The application processing
fee is assessed to partially cover the cost of processing a request. The fee does not guarantee the issuance of a permit, nor
will fees be refunded for applications for which processing has begun. Checks or money orders must be for the exact
amount for each application submitted. If you are making more than one request, you must submit a separate payment
for each request, otherwise your application will be returned.

•

Documentation of fee exempt status is not required for applications submitted by Federal, Tribal, State, or local
government agencies; but must be supplied by those applicants acting on behalf of such agencies. Such applications
must include a letter on agency letterhead and signed by the head of the unit of government for which the applicant is acting on
behalf, confirming that the applicant will be carrying out the permitted activity for the agency.

CERTIFICATION:
•

The individual identified in the Individual Applicant Section, the principal officer named in the Business Applicant Section, or person
with a valid power of attorney (documentation must be included in the application) must sign and date the application. This
signature legally binds the applicant to the statement of certification. You are certifying that you have read and understand the
regulations that apply to the permit. You are also certifying that all information included in the application is true to the best of your
knowledge. Be sure to read the statement and re-read the application and your answers before signing.

ALL APPLICANTS COMPLETE THE QUESTIONS ASSOCIATED WITH YOUR APPLICATION
Please continue to next page. DO NOT RETURN THIS PAGE WITH THE APPLICATION
Mail applications to: U.S. Fish and Wildlife Service; Division of Management Authority; Branch of Permits, MS:IA; 5275 Leesburg
Pike; Falls Church, Virginia 22041-3803 or as directed by specific applications.
If you would like expedited mailing, please enclose a self-addressed, pre-paid, computer-generated, courier service airway bill. If
unspecified, all documents will be mailed via the U.S. Postal Service.
Please refer to the fee schedule for the appropriate fees for the activity you are requesting.

If you are making more than one request, you must submit a separate payment
for each request, otherwise your application will be returned.

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INDIVIDUAL APPLICANTS
*First Name

Middle Name

*Last Name

*Email Address

Telephone Number

*Street Address

*City

*State/Province

*Zip or Postal Code

*Country

If you wish to have your permit mailed to a different address, complete the following:
*Street Address

*State/Province

*City

*Zip or Postal Code

*Country

If you would like expedited mailing, please enclose a self-addressed, pre-paid, computer-generated, courier service
airway bill. If unspecified, all documents will be mailed via the U.S. Postal Service.

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”, 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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Certification Statement
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.

Signature and date

Include a check or money order, payable to the U.S. FISH AND WILDLIFE SERVICE, as
a nonrefundable processing fee [50 CFR 13.11(d)(4)] (see instructions above).
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))
*Required fields. Applications without this information are subject to delays or returns.

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BUSINESS APPLICANTS
*Business Name

doing business as (dba)

*Indicate your business type:
__ Business or other for profit
__ Farm

__ Small business

__ Government (Federal/State/Local/Tribal)

__ Not-for-profit institution

Name that will appear on the permit if you are applying on behalf of an individual/business

*Primary Contact Name

*Primary Contact Email Address

*Business Email Address

*Preferred Contact Method (e.g. phone, email)

*Principal Officer Name

*Principal Officer Title

*Principal Officer Email

Tax ID Number

*Business Phone

Alternate Phone

*Street Address

*State/Province

*City

*Zip or Postal Code

*Country

If you wish to have your permit mailed to a different address, complete the following:
*Street Address

*State/Province

*City

*Zip or Postal Code

*Country

If you would like expedited mailing, please enclose a self-addressed, pre-paid, computer-generated, courier service
airway bill. If unspecified, all documents will be mailed via the U.S. Postal Service.

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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”, 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.

Certification Statement
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.

Signature and date

Include a check or money order, payable to the U.S. FISH AND WILDLIFE SERVICE, as
a nonrefundable processing fee [50 CFR 13.11(d)(4)] (see instructions above).
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))
*Required fields. Applications without this information are subject to delays or returns.

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U.S. Department of the Interior

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Export/Re-Export of Plants and Plant Products (CITES) (including non-commercial American ginseng
exports)
This application covers a wide range of CITES-listed plant specimens, including live or dead specimens, and any
readily recognizable parts, products, or derivatives unless otherwise noted as exempt in the CITES Appendices.
To determine whether a plant species is regulated under CITES, when the species was listed, and whether
exemptions apply to your requested activity and would therefore not require a CITES permit, see CITES
Checklist of Species. If you have any questions regarding your export, contact the Division of Management
Authority at [email protected].
Please review our webpages Wood, Timber, & Other Tree Products, Musical Instruments, and if relevant, What
Can I Do With My Ivory?, for important guidance and information.
Use this application form for exports or re-exports of:
• wild plants, plants produced through assisted production, plant parts, or plant products
• non-commercial shipments of cultivated plants/plant parts or products
• pre-Convention 1 plants/plant parts or products (including commercial shipments of musical instruments)
• commercial shipments of finished products or lumber
• re-exports under an ATA Carnet
• non-commercial shipments as part of a household move or plant society exhibition
This form should NOT be used to:
Request authorization for commercial exports of live plants that are artificially propagated in the United
States. For such exports, applicants should complete form 3-200-33.
• Request authorization for plants listed in the Endangered Species Act. For such exports, applicants
should complete form 3-200-36.
• Request authorization to import Appendix I listed plants. For such imports, applicants should complete
Form 3-200-35.
Single-use Permit: A single-use permit is valid for 6 months from the date of issuance. For re-issuance and/or
amendment of a single use permit, the original permit must be returned with this completed application form:
•

☐ For export: A one-time export of CITES-listed plants or plant products.

☐ For re-export: A one-time export of plants or plant products that were previously imported under a CITES
permit.

☐ For pre-Convention specimens: A one-time export of plants or plant products that were obtained before

the species was listed under CITES. NOTE: No CITES import permit is required for an Appendix-I specimen
that qualifies as pre-Convention.

☐ For personal/household plants: A one-time export of personally-owned, live potted plants or plant
products that are not intended for commercial sale.
Multiple use Permits:

☐ Establish a New Master File: This application form allows you set up a Master File, valid for up to 3 years and

renewable, for plants, plant parts or products that are wild (exports or re-exports), from assisted production (export or
re-export), artificially propagated (re-exports only), or pre-Convention specimens. Once the Master File is approved,
you may obtain partially completed permits, valid for 6 months, for each export (50 CFR 13.11).

1 Specimen was acquired (removed from the wild or held in captivity or a controlled environment) before the date the species was
included in the CITES Appendices. The listing date is found at see CITES Checklist of Species. 50 CFR 23.45(b)(1).
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☐ Amend an established Master File: Allows you to amend a currently valid Master File. You must complete the
relevant sections within this application, provide information on any changes to your facility, operations, species, or
suppliers for the plant specimens that you wish to export.
☐ Renew, or amend and renew an established Master File: Allows you to renew your Master File that has or will

soon expire. You must complete relevant sections within the application, including providing information on
any changes to the quantity, your facility, operations, species, or suppliers for the plant specimens that you wish to
export.
A fee is required for partially-completed permits to accompany each shipment under a Master File: Do
not submit requests for partially completed permits until the Master File is approved. Once approved you may
obtain partially-completed permits, which must accompany each export (50 CFR 13.11). These partiallycompleted permits will be valid for 6 months. For all orders, use FWS Form 3-200-74.

Review this application carefully and provide complete answers to all the questions in the sections relevant
to the activity for which you are requesting authorization. If you are applying for multiple species, be sure to
indicate which species you are addressing in each response. If a question is not applicable, answer with "N/A". If
more space is needed, attach a separate sheet with your responses numbered according to the questions.
For commercial shipments of plants, plant parts, or plant products, you will be required to have a current state nursery
license and/or current U.S. Department of Agriculture (USDA) permit(s). For products that contain both plants and
animal species, you will also need an FWS Import/Export license.

PART I
ALL APPLICANTS MUST COMPLETE
1. For re-exports and wild plant exports, provide labeled photographs of your facility and the plants, plant parts, or
plant products to be exported. Clearly indicate which species are depicted in the photos.
2. Provide copies of receipts/invoices and, for commercial shipments, a valid and current U.S. Department of
Agriculture (USDA) Protected Plant Permit.
3. If requesting a single-use permit, provide foreign recipient information (if shipping to yourself,
include your foreign address):
Name:
Business Name:
Address:
City: State/Province:
Country, Postal Code:

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PART II
WILD PLANTS COLLECTED OR ORIGINATING IN THE UNITED STATES
For each species to be shipped provide:
1. Scientific name (genus, species or subspecies) and common name.
2. Number and age class of specimens collected (e.g., 100 seedlings; 50 mature).
3. Specific location and date of collection or harvest for each specimen.
4. The name and address of who collected the specimens.
5. Dated copies of documents demonstrating legal collection (e.g., collection permits or licenses,
landowner's permission).
6. Collection methods.
7. Estimate the number of plants collected and the number of plants at the location (e.g., whether the specimens were
removed from an area of few to several patches of plants, percentage of specimens removed). Provide photographs of
the collection site(s) where the plants or plant parts were harvested and photos of the plants or plant parts that were
harvested.
8. Estimate the number of plants.
9. If you purchased the plants, seeds, or other plant parts, provide the invoice or other document that shows the name
(person or business) and address of the seller, a telephone number or e-mail address, and the date of purchase for
each specimen (such documentation should trace back to the original collector). If a receipt is not available, provide
a signed and dated seller’s statement that includes the following information:
a. Seller’s contact information (name, telephone number or e-mail, and business, if applicable);
b. Recipient’s name and, if different from the applicant, contact information (telephone number or e-mail, and
business, if applicable);
c.

Species and quantity of plants or plant parts sold;

d. Where the plants or plant parts were wild-collected (if in the U.S., include the County);
e. Date of purchase; and
f.

Signature of seller and date signed.

10. For wild-collected Appendix I plants or plant parts, provide a copy of the CITES import permit issued by the
Management Authority of the destination country to which you plan to export (i.e., country of import).

PART III
PLANTS PRODUCED THROUGH ASSISTED PRODUCTION
This section should be completed to export plants or plant parts obtained through assisted production as defined by
CITES Resolution Conf. 11.11 (Rev. CoP18); on Regulation of trade in plants.
For each species to be shipped, provide:
1. Scientific name (genus, species or subspecies) and common name.
2. Description of the plants to be shipped, including the approximate size, age, and quantity, and the specific location
where plants are grown, and planting density.
3. Provide photographs of and describe the growing environment (e.g., forest, field).
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4. How long have you been growing the plants to be shipped?
5. Type of propagation material (e.g., seeds, cuttings, rhizomes, division).
6. Date(s) propagation material was acquired.
7. For propagation material that was collected, provide:
a.

The name and address of who collected it.

b.

Dated copies of documents demonstrating legal collection (e.g., collection permits or licenses, signed
landowner permission).

c.

Collection methods.

d.

Estimate the amount of propagation material collected and the number of plants at the location.

e.

Provide photographs of the collection site(s) and photos of the propagation material that was harvested.

8. For propagation material that was purchased, provide the invoice or other document that shows the name and
address of the seller, including their telephone number or e-mail address, and the date of purchase. If a receipt is
not available, provide a signed and dated seller’s statement that includes the following information:
a.

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

b.

Recipient’s name and, if different from the applicant, contact information (telephone number or e-mail, and
business, if applicable);

c.

Species and quantity of plants or plant parts sold;

d.

Where the plants or plant parts were grown or collected (if in the U.S., include the County);

e.

Date of purchase; and

f.

Signature of seller and date signed.

9. If propagation material was purchased outside the United States, provide applicable USDA documents,
phytosanitary certificates, and validated copies of CITES documents.
10. For Appendix-I species, provide a copy or the CITES import permit issued by the Management Authority of the
destination country to which you plan to export (country of import)

PART IV
For each specimen to be shipped provide:

TIMBER, LUMBER, OR LIVE PLANTS

1. Scientific name (genus, species, and if applicable, hybrid, or subspecies) and common name.
2. General description, quantity, and size of specimen(s) to be exported/re-exported.
3. Form of product (e.g., live, plywood).
4. Unit description (in metric units), including volume/amount of specimen(s) (if applicable).
5. Country where the plant or specimens were acquired.
6. Source of the specimen (e.g., removed from the wild or cultivated).
7. Receipts documenting your acquisition of the specimens to be exported/re-exported. If a receipt is not available,
provide a signed and dated seller’s statement that includes the following information:
a. Seller’s contact information (name, telephone number or e-mail, and business, if applicable);
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b. Recipient’s name and, if different from the applicant, contact information (telephone number or e-mail, and
business, if applicable);
c.

Species and quantity of plants or plant parts sold;

d. Country where the plants or plant parts were grown or harvested; and
e. Date of purchase; and
f.

Signature of seller and date signed.

8. If the product (or CITES-listed components) were previously imported into the United States, provide copies of
validated CITES documents issued by the country of export. The copies must be endorsed by the foreign country at
the time of export, AND validated by U.S. Customs and Border Protection or USDA Animal and Plant Health
Inspection Service (APHIS) at the time of import; AND
a. If you were not the original importer, provide a copy of the invoice or other documentation that shows how you
acquired the specimens from the original importer. Be sure to correlate each document (CITES permit # and
issuance date) to the corresponding specimen.
b. Date of import for each specimen (of CITES-listed component).
9. For lumber, timber, or plants acquired prior to the date the species was included in the CITES Appendices,
provide documentation, a signed statement, or other evidence that the specimen was harvested/cultivated and/or
imported prior to its CITES listing date (e.g., bill of sale, USDA or foreign phytosanitary certificate). To check dates
species were listed in CITES, please visit CITES Checklist of Species.

PART V
MEDICINAL OR EXTRACT-BASED PRODUCTS (NON-WOOD)
1. For each specimen to be shipped provide, a description in tabular or spreadsheet form of the following information:
a. Scientific Name
b. Product Name
c.

Product Description (e.g., extract, tablet, capsules, powder)

d. Individual Packaging Unit (e.g., bottles, box) *Include size if applicable.
e. Amount of Product Per Package Unit
f.

Number of Packing Units

g. Total Amount of Product to be Shipped
2. Country where the specimens were harvested/cultivated.
3. Country where the specimens were acquired.
4. Receipts documenting the acquisition of the specimens to be exported/re-exported (e.g., bills-of-sale documenting
history of transactions). If a receipt is not available, provide a signed and dated seller’s statement that includes the
following information:
a. Seller’s contact information (name, telephone number or e-mail, and business, if applicable);
b. Recipient’s name and, if different from the applicant, contact information (telephone number or e-mail, and
business, if applicable);
c.

Species and quantity of plants or plant parts sold;

d. Where the plants or plant parts were grown or collected (if in the U.S., include the County);
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e. Date of purchase; and
f.

Signature of seller and date signed.

5. If the product was previously imported into the United States, provide copies of validated CITES documents issued
by the country of export. The copies must be endorsed by the foreign country at the time of export, AND validated
by U.S. Customs and Border Protection or USDA Animal and Plant Health Inspection Service (APHIS) at the time of
import; AND
a. If you were not the original importer, provide a copy of the invoice or other documentation that shows how you
acquired the specimen(s) from the original importer. Be sure to correlate each document (CITES permit # and
issuance date) to the corresponding specimen(s) requested in question 1.
b. Date of import for each specimen.
6. For specimens acquired prior to the date the species was included in the CITES Appendices, provide documents, a
signed statement, or other evidence that shows the specimen(s) was harvested/cultivated and/or imported prior to
its CITES listing date (e.g., bill of sale, USDA or foreign phytosanitary certificate). To check dates species were
listed in CITES, please visit CITES Checklist of Species.

PART VI
MANUFACTURED WOOD PRODUCTS (E.G., ROSEWOOD GUITARS)
1. Please provide a brief overview of your business practices (supply chain, how often you obtain additional stock,
how often you export, and who you typically ship to).
2. Are there multiple CITES listed species in the product to be shipped? ϒ No

ϒ Yes

a. If no, for each species, provide the quantity of products (as requested in Question 4 below).
b. If yes, for each species provide the quantity in cubic meters (as requested in Question 5 below).
3. For each species to be shipped, provide:
a. Scientific name (genus, species, and if applicable, subspecies) and common name.
b. General description of the product to be exported/re-exported (e.g., finished guitar, guitar parts).
c.

Quantity and size (in metric units) of product(s) (e.g., 1 table, 220 x 84 cm).

d. Country and year that the wood was harvested.
e. Country where you acquired the specimen/product.
4. Provide receipts documenting your acquisition of the wood to be exported/re-exported (e.g., bills-of-sale
documenting history of transactions).
5. Provide copies of validated CITES documents issued by the country of export for specimens/wood of CITES listed
species previously imported into the United States. The copies must be endorsed by the foreign country at the
time of export, AND validated by U.S. Customs and Border Protection or USDA Animal and Plant Health
Inspection Service (APHIS) at the time at import; AND
a. If you were not the original importer, provide a copy of the invoice or other document that shows how you
acquired the product from the original importer. Be sure to correlate each document (CITES permit # and
issuance date) to the corresponding product.
b. Date of import for each product (of CITES-listed species).
6. WHERE APPLICABLE, if requesting to export finished wood products manufactured prior to their CITES listing
date (for example, Dalbergia retusa; December 6, 2013*), complete and sign the following statement. This would
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include brokers requesting to export finished products not yet in your possession at the time of submitting this
application. *To find the effective date of the CITES listing, see CITES Checklist of Species.
7. I certify that all the products to be exported under my Master File were manufactured from
__________________________________________ [scientific name, (Genus species)] wood, harvested prior to
the effective date of the CITES listing _________________________ [date, (month/date/year)]. The
manufacture date of each product will be documented by a serial number. The manufacture date of each
product is prior to the CITES listing date. If requested by the U. S. Fish and Wildlife Service, I am willing to
report the number of products, product descriptions, the product serial numbers, and any other data relevant to
exports under my Master File when I request additional partially completed CITES documents under my Master
File.
Applicant's signature:
Printed Name:

Date:
____________________________________

PART VII
EXHIBITION BY PLANT SOCIETY AND TRADE SHOWS (NON-COMMERCIAL)
For each specimen to be shipped provide:
1. Scientific name (genus, species, and if applicable, hybrid, or subspecies) and common name.
2. A general description (quantity, size, and plant part) or each (e.g., 100 live flowering plants).
3. Provide documentation or a signed statement of how, from whom, where, and when the plants were acquired.
4. The names, dates, and countries of the shows/events you are participating in.
5. Approximate date of re-import into the United States.
6. Provide a signed statement certifying that none of the specimens to be exported will be sold/traded and all of the
specimens will be returned to the United States through a CITES designated port upon conclusion of the show.
7. Will the shipment be exported for temporary exhibition or display purposes and accompanied by a valid ATA
carnet (for single use permits only)?
ϒ No

ϒ Yes; provide ATA carnet document number _______________________.

PART VIII
PERSONAL, HOUSEHOLD PLANTS (NON-COMMERCIAL)
For each specimen to be shipped provide:
1. Scientific Name (genus, species, and if applicable, hybrid, or subspecies) and common name;
2. A general description (quantity, size, and plant part) or each (e.g., 1 12-inch potted plant);
3. If known, provide the source of the specimen (e.g., removed from the wild or cultivated);
4. Receipts documenting the acquisition of the specimens to be exported/re-exported OR a signed statement
regarding the source of your plants, when you obtained them and how and where you obtained them.
Page 13 of 14

OMB Control No. 1018-0093
Expires xx/xx/xxxx

FWS Form 3-200-32 (Rev. 02/2023)
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 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 (PRA; 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 PRA, 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 for individuals and 1 hour for private sector and government
Amended submission - paper-based: 1 hour 45 minutes for individuals 45 minutes for private sector and government
Original submission - electronic: 1 hour 45 minutes for individuals and 1 hour 45 minutes for private sector and government
Amended submission - electronic: 1 hour 30 minutes for individuals and 1 hour 30 minutes for private sector and government
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.
Questions regarding permits from Management Authority should be sent to [email protected].

Page 14 of 14


File Typeapplication/pdf
AuthorHarlow, Caroline I
File Modified2023-02-24
File Created2023-01-25

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