Form 3-200-42 Application - Import/Transport of Injurious Wildlife

OMB Control No. 1018-0093
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FWS Form 3-200-42 (Rev. 02/2023)
U.S. Department of the Interior

☐New

«Title_of_application»
☐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 (3200-3) 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).

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FWS Form 3-200-42 (Rev. 02/2023)
U.S. Department of the Interior

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

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.

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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FWS Form 3-200-42 (Rev. 02/2023)
U.S. Department of the Interior

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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FWS Form 3-200-42 (Rev. 02/2023)
U.S. Department of the Interior

Certification Statement
Certification: I hereby certify that I have read and am familiar with the regulations
contained in Tittle 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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FWS Form 3-200-42 (Rev. 02/2023)
U.S. Department of the Interior

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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OMB Control No. 1018-0093
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FWS Form 3-200-42 (Rev. 02/2023)
U.S. Department of the Interior

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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FWS Form 3-200-42 (Rev. 02/2023)
U.S. Department of the Interior

IMPORT/TRANSPORT OF INJURIOUS WILDLIFE
Under the Lacey Act (18 U.S.C. 42), any importation of injurious wildlife regulated under 50 CFR 16 into the United States or its
territories or possessions must be authorized under a permit issued by the FWS. In addition, for any injurious specimens listed
in 50 CFR 16, transport between the continental United States, the District of Columbia, Hawaii, the Commonwealth of Puerto
Rico, or any territory or possession of the United States by any means whatsoever must be authorized by the FWS.
If you are requesting authorization for activities that involve a species listed under the Endangered Species Act, you must
complete Form 3-200-37a and include your responses with this application.
Complete all questions on this application. Mark questions that are not applicable with "N/A". If needed, use a separate sheet
of paper. On all attachments or separate sheets you submit, please indicate the application question number you are
addressing. If you are applying for multiple specimens, be sure to indicate which specimen you are addressing in each
response.
When do I need an injurious wildlife permit?

When do I not need an injurious wildlife permit?

New import

Movement between States within the continental United
States for individuals (or progeny) not previously imported
under a permit

Movement between listed jurisdictions (Continental United Acquisition of an injurious wildlife species
States, D.C., Hawaii, Puerto Rico, or any other United
States possession)
Movement between different institutions for animals that
Movement from one facility or exhibit to another within the
were previously permitted for import or progeny of such an same permitted institution within the continental United
individual (documentation required)
States
Importation or transport of dead natural-history specimens of
wildlife or their eggs for museum or scientific collection
(excluding migratory birds or dead game mammals from
Mexico)
Importation or transport of any live wildlife for direct use by a
Federal agency (excluding migratory birds)
Export

•

For transport of injurious wildlife that was previously imported under an injurious wildlife permit, or is progeny of wildlife that
was imported under an injurious wildlife permit, the sending institution applies for the permit.

•

Previous permit conditions, which require permits for any future transport of that animal or its progeny, continue to apply.

•

“Progeny” means ANY animal in the lineage, not just direct descendants.

What is the proposed activity (check appropriate section)?

☐ Importation (other permits may be necessary under CITES, ESA, or both)

☐ Transportation between a facility in the continental United States and the District of Columbia, Hawaii,
Commonwealth of Puerto Rico, or any territory or possession.

the

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FWS Form 3-200-42 (Rev. 02/2023)
U.S. Department of the Interior

OMB Control No. 1018-0093
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Purpose of Activity (check all appropriate choices)

☐ Scientific

☐ Educational
☐ Zoological
☐ Medical

If you have an animal that needs to be permitted, all previous permit conditions still apply:
•

Double escape-proof containment

•

FWS Office of Law Enforcement must be notified within 24 hours if animal or progeny escapes

If there is no evidence that the specimens in question or their ancestors were previously permitted for import or transport
between listed jurisdictions, they are not considered permitted, and conditions do not apply.
For the import of any species in the family Salmonidae, an authorized health certificate is required in lieu of an injurious wildlife
import permit. For more information on how to obtain this certificate, please contact the FWS Fish and Aquatic Resource
Conservation Program at [email protected]
Even if your injurious wildlife no longer requires a permit under the new ruling, we highly recommend that you
continue to use double escape-proof containment to hold and transport.
1. For EACH species or specimen, provide:
a. Scientific name (genus, species, and if applicable, subspecies) and common name;
b. Birth or hatch date (MM/DD/YYYY);
c.

Gender (if known);

d. Description or identification (such as dead, live, studbook number);
2. Current location of specimen(s).
3. Provide a brief description of your proposed activity (i.e., project proposal, education program, etc.).
4. Name and address of your facility where specimens will be housed and maintained.
5. Injurious wildlife must be maintained in double escape-proof enclosures (that is, two separate containment systems to
ensure against escape) at all times. Provide a description, including photos or diagrams (no blueprints) of the following
that identifies how containers and facilities are double escape-proof:
a. All transportation containers that will be used with the species; and
b. All permanent facilities where specimens will be held, including display facilities, off- display holding areas, and
veterinarian or medical facilities where the species might be held.
6. Provide:
a. Qualifications of the individuals who care for or who will care for and handle the animals, including the number of
years of experience with this species or similar species; and
b. The overall experience of the institution in holding and maintaining the species.
7. Provide copies of State authorization(s) required for your facility to possess and maintain injurious wildlife species or
the name and phone number of the State contact person or office for verification that no authorization is required. If
moving animals across State lines for export purposes, you may be required to meet regulatory requirements of each
State. Please indicate what States you will be traveling through and copies of any authorizations required.
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8. For import, provide the name and address of person(s) or institution(s) in the foreign country from whom you will obtain
the specimen(s).
9. For import or transport of live bat species, provide your CDC transport permit. A CDC transport permit is only required
for original imported specimens, not their progeny.
10. For acquiring specimens from within the United States:
a. Provide the name and address of person(s) or institution(s) from whom you will obtain the specimen(s).
b. If the animal(s) was previously imported, specify the name of the importer and permit number under which the
animal(s) was imported; OR
c.

If the animal(s) is the progeny of a previously imported animal, provide the information on the location and date of
birth of the original animal imported under a permit.

11. If maintaining ownership and transporting for educational purposes: Provide a description of your education program
and the materials or script of the program. Please also discuss how the specimen being moved will be maintained in
double escape proof containment throughout the transport and presentation of the specimen.
All international shipment(s) must be through a designated port. A list of designated ports (where a wildlife inspector
is posted) is available. If you wish to use a port not listed, please contact the Office of Law Enforcement for a Designated
Port Exemption Permit (Form 3-200-2).

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FWS Form 3-200-42 (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 (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 to average 45 minutes (electronically) to 1 hour (paperbased), including time for reviewing instructions, gathering and maintaining data and completing and reviewing the form.
Direct comments regarding the burden estimate or any other aspect of the form to the Service Information Clearance
Officer, Fish and Wildlife Service, U.S. Department of the Interior, 5275 Leesburg Pike, MS: PRB (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].

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