Form 3-200-75 Application - Registration of a Production Facility for

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

FWS Form 3-200-75 (Rev. 02/2023)
U.S. Department of the Interior

Export of Certain Native Species for Single Use and Multiple Use Shipments (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 3-200-75 (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 CFR13. 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 3-200-75 (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” to Question 3, 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.

Page 3 of 12

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

FWS Form 3-200-75 (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.

Page 4 of 12

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

FWS Form 3-200-75 (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

Page 5 of 12

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

FWS Form 3-200-75 (Rev. 02/2023)
U.S. Department of the Interior

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” to Question 3, 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

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

FWS Form 3-200-75 (Rev. 02/2023)
U.S. Department of the Interior

EXPORT OF CERTAIN NATIVE SPECIES FOR SINGLE USE OR MULTIPLE USE SHIPMENTS
This application is to be used by qualified production facilities to establish an annual registration, or master file, to
export certain native species (if requesting authorization for sturgeon or paddlefish, please use form 3-200-76 or 3200-80. A master file will allow the registrant to obtain a number of single-use CITES export documents for
approved species. (Please refer to the fee schedule for the appropriate fees for the activity you are requesting.
This application form may also be used to apply for single-use permits for captive-bred native species. For a single-use
permit for wild native species, please use application form 3-200-27. If you are requesting a single-use permit for nonnative species, please use application form 3-200-24.
The U.S. FWS may not issue CITES documents for the commercial export of Appendix-I specimens, unless the
specimens were obtained from animals produced at a CITES-registered Appendix-I commercial breeding
operation. For more information on registering an Appendix-I commercial breeding operation, contact the Division
of Management Authority at [email protected].
This application can be used to (choose one):
Request an export permit
This application allows you to request a CITES export permit for one shipment, valid for 6 months.
Establish a new Master File
This application allows you to set up a Master File Registration, valid for one year and renewable, for exports of
certain native species under CITES. Once the application is approved, you will need to obtain single-use permits;
valid for 6 months, for each export (50 CFR 13.11).
Renew and/or Amend an Existing Master File, File # __________________
Once your Master File is established, you may request single-use permit using application for 3-200-74.
GENERAL INFORMATION
Review this application carefully and provide complete answers to all 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.
To accommodate the different purposes of this application, please complete the sections that are applicable to your
request as laid out below:
Part I
Part II
Part III

All applicants must complete
Captive-bred species
Wild-collected species
Part I
All Applicants Must Complete

Please respond to each of the following questions and provide all information requested. Mark questions that are not
applicable with “N/A”. If needed, use separate sheets of paper. Please indicate the question number you are addressing
on all attachments or separate sheets you submit. If you are applying for multiple species, be sure to indicate which
species you are addressing in each response.
1. Scientific (genus, species, and if applicable, subspecies) and common name of species to be included in your master
file/permit.
2. Description of all products and/or specimens to be exported (e.g., live, whole carcasses, meat), including source (i.e.,
captive-bred and/or wild-collected). For live exports, include typical description of specimens to be exported, including
age-group (e.g., hatchlings, sub-adults, adults), sex (male, female, unknown), and typical size of each in metric units
(e.g., cm, m).

Page 7 of 12

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

FWS Form 3-200-75 (Rev. 02/2023)
U.S. Department of the Interior

3. Location of farm or production facility (physical address, including county):
Name:
Street Address:
City/County:
State:
Zip Code:
4. Copies of any licenses or permits required for your farm or production facility (e.g., to house, maintain, breed, sell
and/or dispose of these specimens) under Federal, Tribal, State, and/or local laws or regulations. If a license is not
required for your farm or production facility, provide us with the Federal, Tribal, State, and/or local regulatory
exemption(s).
5. Provide labeled photographs depicting the facilities for the specimens described in your application.
6. The transport conditions for live animals 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.
7. If requesting a single-use export permit, provide the name and address of the recipient of the shipment:
Name:
Street Address:
City/County:
State/Province:
Country:
Postal Code:

Part II
Captive-Bred Species:
Please provide the following information for each species in the application.
8. Evidence the animals were captive-bred (e.g., breeder’s records, signed breeder’s statement (questions 20-21),
Species360 Specimen Reports);
9. Evidence that your founder stock was legally harvested and obtained in accordance to CITES and with any Federal,
State and local laws (all original stock used to produce the offspring even if now dead or no longer able to breed).
Examples of documentation include state license and tag number or permit, valid at the time the founder stock was
harvested, authorizing collection from the wild. If no permits or licenses were required at the time of collection, provide
the regulatory exemption under Federal, Tribal, State, or local law or correspondence with a government official that
supports the collection was harvested lawfully;
10. Purpose founder stock was removed from the wild;
11. Where founder stock specimens were removed from the wild (exact location) and by whom (name and address);
12. Date(s) founder stock were removed from the wild;
Page 8 of 12

FWS Form 3-200-75 (Rev. 02/2023)
U.S. Department of the Interior

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

13. Method (including gear if applicable) used to capture/remove founder stock from the wild.
14. Estimate of your production and export of specimens for the coming year. If dealing with more than one type of
specimen, please provide estimates for each.
15. Normal mortality rates (eggs, hatchlings, juveniles, adults, as applicable) at your facility. If you have experienced
unexpected or higher than normal mortality rates, disease outbreaks, or contaminant events at your facility during the
past five years please provide a brief discussion.
If the specimens for export are species listed in Appendix II of CITES, please answer questions 16-21. If the
specimens for export are species listed in Appendix III of CITES, please skip to question 20.
16. Provide information about the breeding facility, including:
a. Size of your breeding facility;
b. Size and type of facility buildings (such as, food prep room and incubation facilities);
c.

Size and type of cage or enclosure used to house juveniles, adults, hatchlings, as appropriate;

d. Are the cages or enclosures indoors or outdoors?
e. How many cages and enclosures does the facility provide?
f.

Whether the location is secured (i.e., fence, guard dog, electric wire, etc.) from theft, natural disaster,
predators, and introduction of wild specimens. If so, please describe;

g. Whether the animals are uniquely identified (pit tags, leg bands, notching, photos). If so, please
describe;
h. Describe your record-keeping process and its maintenance.
17. Describe the ease/difficulty of breeding the species at your facility.
18. Please describe your capability of reliably producing offspring of second or subsequent generations (F2 or greater) at
your facility, by responding to the following questions:
a. How long has the breeder bred the species?
b. How many generations has the breeder produced (F1, F2, F3 etc.)?
c.

How many breeding females and breeding males are currently maintained? How many represent original
founder stock? How many represent offspring held back from previous breeding? If available, please
provide pedigrees for your breeding stock and including identification (name or number) of specimens,
born/hatched date, location born/hatched, and sex.

d. What is the estimated annual production (eggs, hatchlings, live births, as applicable) for each year?

19. Describe any future plans for supplementing breeding stock (e.g., source, how often you do/plan to supplement), if
necessary, especially as they pertain to introducing wild-origin stock?

20. As the Breeder, sign (in ink or electronically) the following statement:
I hereby certify that the animal(s) submitted on this application to be exported were bred and born/hatched from
parental stock at my facility listed below. (Additional information on the parental stock may be requested upon
Page 9 of 12

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

FWS Form 3-200-75 (Rev. 02/2023)
U.S. Department of the Interior

receipt of your application). If you have more than one facility address for your production or location of parental
stock, please include a separate attachment with those locations.
Name and address of your facility where the animals were bred and born/hatched:
Name:
Street Address:
City/Province:
State, Zip Code:

Current location of parental stock:
Name:
Street Address:
City/Providence:
State Zip Code:

Signature: _______________________________

Date: _________________

21. If you are NOT the breeder of the specimen(s), provide copies of documentation showing that you acquired the
animal(s) from the breeder, or documentation demonstrating the history of transactions (chain of ownership of each
animal) and a signed statement from the breeder or breeder's record that includes:
a.

That the animal was bred and born/hatched at his/her facility;

b.

Birth/hatch date, and, if applicable, band/tag number, or other identifiers;

c.

Sex of each specimen he/she bred;

d.

Location (name, street address, city, state) of parental stock;

e.

Complete name and address of the breeder's facility;

f.

Labeled photographs depicting the facilities for the referred specimens.

g.

Provide evidence that the breeder’s founder stock was legally harvested and obtained in accordance to CITES
and with any Federal, State and local laws (all original stock used to produce the offspring even if now dead or
no longer able to breed). Examples of documentation include state license and tag number or permit, valid at
the time the founder stock was harvested, authorizing collection from the wild. If no permits or licenses were
required at the time of collection, provide the regulatory exemption under Federal, Tribal, State, or local law or
correspondence with a government official that supports the collection was harvested lawfully.

Page 10 of 12

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

FWS Form 3-200-75 (Rev. 02/2023)
U.S. Department of the Interior

Part III
Wild-Collected Species
22. For specimens taken from the wild, provide:
a.

Evidence that the specimens will be/were legally taken (e.g., State license, collection permits). If no permits or
licenses will be/were required at the time of collection, provide the regulatory exemption under Federal, Tribal,
State, or local law or correspondence with a government official that supports the collection was harvested
lawfully.

b.

Purpose for removal from the wild

c.

Location where specimens will be/were removed from the wild (including State and county/parish)

d.

Date(s) specimens will be/were removed from the wild

e.

Method (including gear if applicable) used to capture/remove specimens from the wild

23. Provide a description of your production facility (e.g., whether you remove specimens from the wild for immediate
export; whether you maintain specimens until they are a large size; whether you sell live animals, skins, or meat).
Additional information about your facility may be requested upon receipt of your application.
24. The export of some CITES species require that skins be tagged before being exported. If that is the case with your
specimens, we will either request a list of tags while we are processing your application or, if approved, have you
incorporate the list on the face of the permit that we issue.
All exports and re-exports must be through a designated port. A list of designated ports (where an 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 11 of 12

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

FWS Form 3-200-75 (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:
Original submission - paper-based: 2.5 hours
Original submission - electronically: 2.25 hours
Amended submission - paper-based: 2.5 hours
Amended submission - paper-based: 2.25 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: 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