Form 3-200-50 Application - Approval of Sustainable Use Management Pla

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

FWS Form 3-200-50 (Rev. 02/2023)
U.S. Department of the Interior

Approval of Sustainable-Use Management Plan (WBCA)
☐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 (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 3-200-50 (Rev. 02/2023)
U.S. Department of the Interior

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

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.
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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OMB Control No. 1018-0093
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FWS Form 3-200-50 (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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OMB Control No. 1018-0093
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FWS Form 3-200-50 (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 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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OMB Control No. 1018-0093
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FWS Form 3-200-50 (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
Expires xx/xx/xxxx

FWS Form 3-200-50 (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 3-200-50 (Rev. 02/2023)
U.S. Department of the Interior

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

APPROVAL OF SUSTAINABLE USE MANAGEMENT PLAN UNDER WBCA
NOTE 1: This application is for approval of a scientifically based sustainable use management plan that must be
granted before wild-caught species can be imported from the approved exporting country. Birds from an approved
program can be imported into the U.S. without a Wild Bird Conservation Act permit. Sustainable use management plans
developed by the country of export should be submitted for species, which breed in the country of export. If the species
does not breed in the country of export, the Service will consider sustainable use management plans only when the plan
is scientifically valid and nesting (breeding) information can be provided from countries in which the species breeds.
NOTE 2: Complete all questions on the application. Mark questions that are not applicable with "N/A". Given the length of
many of your responses, use separate sheets of paper to respond to the application questions. On all attachments or
separate sheets you are submitting, indicate the number of the application question you are addressing.
1. Background Information, including:
a. Scientific and common name of the species to be covered under the plan;
b. Letters from the country of export's Management and Scientific Authorities transmitting the management plan of
this species;
c.

A summary of the country of export's legislation related to this species and legislation implementing CITES and
where appropriate, a summary of implementing regulations;

d. A summary, from the country of export's Management Authority, on the infrastructure, law enforcement, and
monitoring mechanisms to ensure both enforcement and compliance with the requirements of the management
plan, and that the number of birds removed from the wild or exported will be consistent with the management
plan;
e. Recent information on the distribution of the species within the country of export including scientific references
and maps, and historical information on distributions, if relevant; and
f.

The species' status and its current population trend in the country of export, including scientific references and
copies of the most recent non-detriment findings made by the exporting country's Scientific Authority.

2. Habitat information, including:
a. A general description of habitats used by the species for each portion of the life cycle completed within the
country of export;
b. Recent information on the size and distribution of these habitats throughout the country of export and in each area
or region of take, including scientific references and maps. The approximate location of any reserves that provide
protection for this species should be indicated on the accompanying map(s), along with a brief description of how
reserves are protected and how that protection is enforced;
c.

Status and trends of the important habitats used by the species in the country of export as a whole whenever
available and within each area or region of take, including scientific references;

d. Factors, including management activities, favoring or threatening the species' habitat in the foreseeable future
within each area or region of take (and throughout the country of export whenever available), including scientific
references; and
e. A list of management plans that have been or are being planned, developed, or implemented for the species'
important habitats, if any.

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FWS Form 3-200-50 (Rev. 02/2023)
U.S. Department of the Interior

3.

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Information on the role of the species in its ecosystem, including:
a. A description of the part(s) of the species' life cycle completed within the country of export;
b. A description of nest sites and/or plant communities that are most frequently used for placement of nests, and, if
applicable, nesting habits;
c.

A general description of the species' diet and where the species forages (aerial feeder, tree canopy, tree trunk,
mid-story, under-story, open water, or other), and seasonal changes in foraging habits (include, when available,
scientific references); and

d. Information on any species or plant community which is dependent on the occurrence of the exotic bird species.
4. Information on population dynamics of the species, including:
a. Recent population data for the population of the species in the country of export, as derived from indices of
relative abundance or population estimates, along with documentation for each estimate;
b. Within each area or region of take, documentation for recent population data or estimates, conducted for at least
3 separate years or 1 year with a description of survey plans for future years. These population assessments
should have been conducted during the same season (breeding or non-breeding) of each year for which
documentation is submitted (i.e., be methodologically comparable - both temporally and spatially);
c.

Within each area or region of take, a scientific assessment (with documentation) of recent reproductive (nesting)
success. This assessment should include information on the number of young produced per egg-laying female
per year or per nesting pair, or if scientifically appropriate for the species to be exported, estimates on the number
of young produced per year from pre-breeding and post-breeding surveys conducted within the same annual
cycle;

d. Within each area or region of take, estimation (with documentation) of annual mortality or loss including natural
mortality and take for subsistence use, export trade, and domestic trade in each area of take; or
e. When appropriate, information (with documentation) on the number of young, which can be taken from the area,
as a result of a conservation enhancement program.
5. Information on the determination of biologically sustainable use including:
a. Estimation of the number exported from the country during the past 2 years, and the number of birds removed
from the wild for export, domestic trade, illegal trade, subsistence use, and other purposes (specify) for the
country of export during the past 2 years;
b. The estimated number of birds that will be removed from the wild from each area of take each year for all
purposes (export trade, domestic trade, illegal trade, and subsistence use), including a description of age-classes
(nestlings, fledglings, sub-adults, adults, all classes), when applicable;
c.

For the projected take addressed in the management plan, a description of the removal process, including, but
not limited to, locations, time of year, capture methods, means of transport, and pre-export conditioning;

d. Documentation of how each projected level of take was determined;
e. Explanation of infrastructure and law enforcement and monitoring mechanisms that ensure compliance with the
methodology in the management plan and that the species will be removed at a level that ensures sustainable
use; and
f.

Description of how species in each area or region of take will be monitored in order to determine whether the
number and age classes of birds taken are sustainable.

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FWS Form 3-200-50 (Rev. 02/2023)
U.S. Department of the Interior

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6. Information on species value including:
a. For species that are considered "pests" in the country of origin: documentation that such a species is a pest,
including a description of the type of pest, (e.g., agricultural, disease carrier); a description of the damage the pest
species causes to its ecosystem; and a description of how the sustainable use management plan controls
population levels of the pest species; or
b. For non-pest species: a description of how the sustainable use management plan promotes the value of the
species and its habitats. Incentives for conservation may be generated by environmental education, cooperative
efforts or projects, development of cooperative management units, and/or activities involving local communities.
7. Supplemental information including:
a. Description of any existing enhancement activities developed for the species, including, but not limited to, annual
banding programs, nest watching/guarding, and nest improvement;
b. Description, including photographs and diagrams, of the shipping methods and enclosures proposed to be used
to transport the exotic birds, including but not limited to feeding and care during transport, densities of birds in
shipping enclosures, and estimated consignment sizes; and
c.

Any other information that may be appropriate to the evaluation of this plan.

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FWS Form 3-200-50 (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 9 hours (electronically) to 10 hours (paper-based),
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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