Form 3-200-73 Application - Re-Export of Wildlife (CITES)

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

3-200-73 App - CITES Reexport Wildlife 02242023

ePermits Application - Re-Export of Wildlife (CITES) (Form 3-200-73) - Individuals

OMB: 1018-0093

Document [pdf]
Download: pdf | pdf
OMB Control No. 1018-0093
Expires xx/xx/xxxx

FWS Form 3-200-73 (Rev. 02/2023)
U.S. Department of the Interior

Re-Export of Wildlife (CITES)
☐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).

Page 1 of 11

FWS Form 3-200-73 (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.

Page 2 of 12

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

FWS Form 3-200-73 (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
*City

*State/Province

*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.

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
Page 3 of 12

FWS Form 3-200-73 (Rev. 02/2023)
U.S. Department of the Interior

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

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.

Page 4 of 12

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

FWS Form 3-200-73 (Rev. 02/2023)
U.S. Department of the Interior

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

doing business as (dba)

__ 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
*City

*State/Province

*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

Page 5 of 12

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

FWS Form 3-200-73 (Rev. 02/2023)
U.S. Department of the Interior

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.

Page 6 of 12

FWS Form 3-200-73 (Rev. 02/2023)
U.S. Department of the Interior

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

RE-EXPORT OF WILDLIFE (CITES)
NOTE 1: If you are re-exporting CITES Appendix II or III specimens that have not been altered or changed since they
were originally imported into the United States (e.g., python skin boots were imported and are now being re-exported), the
application can be submitted either to the Division of Management Authority (DMA) or the Office of Law Enforcement
(OLE). Applications that are submitted to OLE must be submitted to the office nearest to the applicant’s address (See
page 11 for addresses).
Items that are listed below MUST be submitted to the Division of Management Authority (DMA).
•
•
•
•
•
•

Pre-Convention (removed from the wild before CITES applied to the species);
Have been altered after imported (e.g., tanned python skins converted into boots);
Covered under the Endangered Species Act (ESA);
Covered under the Wild Bird Conservation Act (WBCA);
Covered under the Marine Mammal Protection Act (MMPA); or
Covered under the Migratory Bird Treaty Act (MBTA)

NOTE 2: If you are a Customs broker or a freight forwarder applying on behalf of your client, you must attach
documentation that shows you have Power of Attorney to act on your client’s behalf.
Complete all questions on the application. Mark questions that are not applicable with "N/A". If needed, use separate
sheets of paper. On all attachments or separate sheets you submit, indicate the application question number you are
addressing. If applying for more than one specimen, be sure to indicate which specimen is being addressed in each
response.
1. Indicate the purpose of the re-export (check all that applies):

☐ Commercial
☐ Botanical Garden
☐ Personal
☐ Zoo
☐ Traveling Exhibition
☐ Scientific
☐ Medical (including biomedical research)
☐ Educational
☐ Reintroduction/Introduction

Page 7 of 12

FWS Form 3-200-73 (Rev. 02/2023)
U.S. Department of the Interior

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

2. Provide the following information (you may use the attached corresponding inventory sheet) [Please do NOT include
quarantine, immunization or health records unless they document transfer of ownership].
a. Scientific Name (genus, species, subspecies);
b. Common Name;
c. Source (as listed on the foreign CITES permit used to import the specimen);
d. Quantity;
e. Description (if Live animals, provide a complete list of identifiers e.g. tattoo list, band list, etc);
f. Gender (if Live):
g. Country of origin and CITES export permit number:
h. Country of origin CITES export permit issuance date:
i. Country of last re-export and CITES permit number (if applicable):
j. Country of last re-export CITES permit issuance date (if applicable):
3. What is the current location of specimen(s) __________________________________________
4. Provide:
a. 1 A copy of the validated foreign CITES export or re-export document (cancelled by OLE) issued by the
appropriate CITES office in the country from which the wildlife was imported, and
b. 1 Wildlife Declaration (Form 3-177), stamped cleared by OLE, (provide either a hard copy or electronic release;
not applicable for plants); OR
c. If you did not make the original import, provide a copy of the importer's documents outlined above and the invoice
or other document that shows you acquired the wildlife from the original importer or history of transactions that
demonstrate chain of ownership. NOTE: Redacted documents can only be accepted if the information
redacted is not needed to determine a legal chain of custody (e.g., declared value of wildlife, original
exporter name provided a copy of the cleared form 3-177 is provided and traceable). All other redactions
will not be accepted. For further instructions contact the permit issuing office directly.
d. If protected by the Wild Bird Conservation Act (WBCA), provide a copy of the WBCA import permit.
1 Permits

cannot be issued without the documents being stamped cancelled and cleared by OLE.

5. Is this shipment a sample collection being exported for temporary exhibition or display purposes and accompanied by
a valid ATA carnet? (Application must be processed by DMA, see address on page 6)

☐ NO
☐ YES; provide ATA carnet document number ______________________
6. Provide the name and address of person or facility receiving the shipment (if self, provide your address abroad).
Name:
Address:
City:
State/Province:
Country, Postal Code:

Page 8 of 12

FWS Form 3-200-73 (Rev. 02/2023)
U.S. Department of the Interior

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

7. For applicants residing or located outside the United States conducting commercial activities. The name,
physical address and telephone number of your agent that is located in the United States who will maintain your
records for five (5) years from the expiration of the permit. (50 § 13.12 and 13.46 requires this information).
U.S. address (not a P.O. Box) for foreign applicant. (50 § 13.12 requires this information for issuance).
Name:
Address:
City:
State, Zip Code:
8. For live animals, the transport conditions must comply with the CITES Guidelines for Transport of Live Animals or,
in the case of air transport, with the International Air Transport Association (IATA) live animal regulations (contact
airline for information). As such, describe:
a. The type, size, and construction of any shipping container; and
b. The arrangements for watering or otherwise caring for the wildlife during transport.
For the non-commercial export of CITES Appendix-I species, provide a copy of the CITES import permit or evidence one
will be issued by the Management Authority of the country to which you plan to export the specimen(s). In accordance
with Article III of the CITES treaty, it is required that import permits are issued before the corresponding export permit.
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).

Page 9 of 12

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

FWS Form 3-200-73 (Rev. 02/2023)
U.S. Department of the Interior

Re-export of Wildlife (CITES)
Inventory Page
a. Scientific Name
(genus, species,
subspecies)

b. Common
Name

EXAMPLE: Caiman
crocodilus fusus

brown
caiman

c. Source Code
Listed on
Country of Origin
Permit

d. Unit of
Measure &
Quantity

e. Description
of Specimen
(include
tattoo/band
lists if
applicable)

f. Gender
(Y/N)

C

NO/1

watch straps

N

g. Country of
Origin and
Country of Origin
Permit Number

h. Country of
Origin Export
Permit
Issuance Date

i. CITES Country of
Last Re-export and
Re-export Permit
No. (If applicable)

j. Last Re-export
Certificate
Issuance Date (If
applicable)

Columbia CO/123345

07/05/1998

Switzerland CH/89076

07/05/2000

Enter column
totals for #
animals/products
etc.

Page 10 of 12

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

FWS Form 3-200-73 (Rev. 02/2023)
U.S. Department of the Interior

CITES Permit Offices
NOTE: The application must be submitted to Division of Management Authority or to the Office of Law Enforcement in the
region where the applicant is located.
Division of Management Authority (DMA)
5275 Leesburg Pike, MS-IA
Falls Church, VA 22041-3803
Office of Law Enforcement (OLE)
Anchorage, AK
U.S. Fish & Wildlife Service
Office of Law Enforcement
P.O. Box 190045
Anchorage, AK 99519
Phone: (907) 271-6198
Fax: (907) 271-6199
Courier Services Only
4600 Postmark Drive, Suite NB207
Anchorage, AK 99519
Atlanta, GA
U.S. Fish & Wildlife Service
Office of Law Enforcement
4341 International Parkway, Suite #104
Atlanta, GA 30354
Phone: (404) 763-7959
Fax: (404) 366-7031
Chicago, IL
U.S. Fish & Wildlife Service
Office of Law Enforcement
10255 W. Higgins Road, Suite 350
Rosemont, IL 60018
Phone: (847) 298-3250 Ext. 30110
Fax: (847) 298-7669
Denver, CO
U.S. Fish & Wildlife Service
Office of Law Enforcement
Denver International Airport
P.O. Box 492098
Denver, CO 80249
Phone: (303) 342-7430
Fax: (303) 342-7433
Guam
U.S. Fish & Wildlife
Service Office of Law
Enforcement
415 Chalan San Antonio Road, Suite 209
Tamuning, Guam 96913-3620
Phone: (671) 647-6064
Fax: (671) 647-6068

Honolulu, HI
U.S. Fish & Wildlife
Service Office of Law
Enforcement 3375
Koapaka St., #B296
Honolulu, HI 968191867
Phone: (808) 861-8525
Fax: (808) 861-8515
Miami, FL
U.S. Fish & Wildlife
Service Office of Law
Enforcement 3701 NW
82nd Avenue, Ste #1
Doral, Florida 33166
Phone: (305) 526-2994 or 2620
Fax: (305) 526-7480
New Orleans, LA
U.S. Fish & Wildlife
Service Office of Law
Enforcement 2424
Edenborn, Room 100
Metairie, LA 70001
Phone: (504) 219-8870
Fax: (504) 219-8868
Seattle, WA
U.S. Fish & Wildlife Service
Office of Law Enforcement
17930 International Blvd. Suite 500
Seatac WA 98188
Phone: (206) 241-0191
Fax: (206) 241-1760
Valley Stream, NY
U.S. Fish & Wildlife Service
Office of Law Enforcement
70 E. Sunrise Hwy, Suite 419
Valley Stream, NY 11580
Phone: (516) 825-3950
Fax: (516) 825-3597

Page 11 of 12

FWS Form 3-200-73 (Rev. 02/2023)
U.S. Department of the Interior

NOTICES
PRIVACY ACT STATEMENT

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

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:
Original submission - paper-based: 1.5 hours
Original submission - electronically: 1.25 hours
Amended submission - paper-based: 1.5 hours
Amended submission - electronically: 1.25 hours
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: 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 12 of 12


File Typeapplication/pdf
AuthorHarlow, Caroline I
File Modified2023-02-24
File Created2023-01-27

© 2024 OMB.report | Privacy Policy