FWS Form 3-200-27 "Federal Fish and Wildlife Permit Application Form - Export of Wildlife Removed From the Wild (Live/ Samples/Parts/Products) Under the Convention on International Trade in Endangered Species (Cites)"

What Is FWS Form 3-200-27?

This is a legal form that was released by the U.S. Department of the Interior - Fish and Wildlife Service on August 1, 2017 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on August 1, 2017;
  • The latest available edition released by the U.S. Department of the Interior - Fish and Wildlife Service;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of FWS Form 3-200-27 by clicking the link below or browse more documents and templates provided by the U.S. Department of the Interior - Fish and Wildlife Service.

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Download FWS Form 3-200-27 "Federal Fish and Wildlife Permit Application Form - Export of Wildlife Removed From the Wild (Live/ Samples/Parts/Products) Under the Convention on International Trade in Endangered Species (Cites)"

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Form 3-200-27
OMB Control No. 1018-0093
Expires 08/31/2020
Department of Interior
U.S. Fish and Wildlife Service
Federal Fish and Wildlife Permit Application Form
Type of Activity
U.S. Fish and Wildlife Service
EXPORT OF WILDLIFE REMOVED FROM THE WILD (LIVE/
Division of Management Authority
Branch of Permits, MS: IA
SAMPLES/PARTS/PRODUCTS) under the Convention on
5275 Leesburg Pike
International Trade in Endangered Species (CITES)
Falls Church, VA 22041-3803
1-800-358-2104 or 703-358-2104
Complete Sections A or B, and C, D, and E of this application. U.S. address may be required in Section C, see instructions for details.
Instructions on how to make your application complete and help avoid unnecessary delays are attached.
Section A: Complete if applying as an individual
1.a. Last Name
1.b. First Name
1.c. Middle Name/Initial
1.d. Suffix
2. Date of Birth (mm/dd/yyyy)
3. Telephone Number
3.a. Alternate Telephone Number
4. E-mail address
Section B: Complete if applying on behalf of a business, corporation, public agency, Tribe, or institution
1.a. Name of business, agency, Tribe, or institution
1.b. Doing business as (DBA)
2. Tax identification no.
3. Description of business, agency, Tribe, or institution
4.a. Principal officer Last name
4.b. Principal officer First Name
4.c. Principal officer Middle name/initial
4.d. Suffix
5. Principal officer title
6. Primary contact name
7.a. Business telephone number
7.b. Alternate telephone number
7.c. Business fax number
7.d. Business e-mail address
Section C: All applicants complete address information
1.a. Physical address (Street address; Apartment #, Suite #, or Room #; no P.O. Boxes)
1.b. City
1.c. State
1.d. Zip code/Postal code
1.e. County/Province
1.f. Country
2.a. Mailing address (include if different than physical address; include name of contact person if applicable)
2.b. City
2.c. State
2.d. Zip code/Postal code
2.e. County/Province
2.f.Country
Section D: All applicants MUST complete
Attach the nonrefundable application processing fee in the form of a check or money order payable to the U.S. FISH AND WILDLIFE SERVICE in the
1.
amount of $100. 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)].
2.
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 of applicant/Principal Officer for permit (No photocopied or stamped signatures) Date of signature (mm/dd/yyyy)
Please continue to next page
Rev. 8/2017
Page 1 of 8
Form 3-200-27
OMB Control No. 1018-0093
Expires 08/31/2020
Department of Interior
U.S. Fish and Wildlife Service
Federal Fish and Wildlife Permit Application Form
Type of Activity
U.S. Fish and Wildlife Service
EXPORT OF WILDLIFE REMOVED FROM THE WILD (LIVE/
Division of Management Authority
Branch of Permits, MS: IA
SAMPLES/PARTS/PRODUCTS) under the Convention on
5275 Leesburg Pike
International Trade in Endangered Species (CITES)
Falls Church, VA 22041-3803
1-800-358-2104 or 703-358-2104
Complete Sections A or B, and C, D, and E of this application. U.S. address may be required in Section C, see instructions for details.
Instructions on how to make your application complete and help avoid unnecessary delays are attached.
Section A: Complete if applying as an individual
1.a. Last Name
1.b. First Name
1.c. Middle Name/Initial
1.d. Suffix
2. Date of Birth (mm/dd/yyyy)
3. Telephone Number
3.a. Alternate Telephone Number
4. E-mail address
Section B: Complete if applying on behalf of a business, corporation, public agency, Tribe, or institution
1.a. Name of business, agency, Tribe, or institution
1.b. Doing business as (DBA)
2. Tax identification no.
3. Description of business, agency, Tribe, or institution
4.a. Principal officer Last name
4.b. Principal officer First Name
4.c. Principal officer Middle name/initial
4.d. Suffix
5. Principal officer title
6. Primary contact name
7.a. Business telephone number
7.b. Alternate telephone number
7.c. Business fax number
7.d. Business e-mail address
Section C: All applicants complete address information
1.a. Physical address (Street address; Apartment #, Suite #, or Room #; no P.O. Boxes)
1.b. City
1.c. State
1.d. Zip code/Postal code
1.e. County/Province
1.f. Country
2.a. Mailing address (include if different than physical address; include name of contact person if applicable)
2.b. City
2.c. State
2.d. Zip code/Postal code
2.e. County/Province
2.f.Country
Section D: All applicants MUST complete
Attach the nonrefundable application processing fee in the form of a check or money order payable to the U.S. FISH AND WILDLIFE SERVICE in the
1.
amount of $100. 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)].
2.
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 of applicant/Principal Officer for permit (No photocopied or stamped signatures) Date of signature (mm/dd/yyyy)
Please continue to next page
Rev. 8/2017
Page 1 of 8
Form 3-200-27
OMB Control No. 1018-0093
Expires 08/31/2020
E.
E
W
R
W
(L
/S
/P
/P
) (CITES)
XPORT OF
ILDLIFE
EMOVED FROM THE
ILD
IVE
AMPLES
ARTS
RODUCTS
Note 1:
If you are requesting to re-export wildlife, submit form 3-200-73.
Export pre-Convention wildlife; submit form 3-200-23.
Export live captive-born animals; submit form 3-200-24.
Export/Re-export of Wildlife Sample and/or Biomedical Samples (CITES); submit form 3-200-29.
Export or Interstate Take of Animals (Live/Samples/Parts/Products) (ESA and/or CITES); submit form 3-200-37.
Export of caviar; submit form 3-200-76.
Registration of a production facility for certain native species, submit form 3-200-75.
Export of hunting trophies; submit form
3-200-28
(All
forms
are available on our website.)
Note 2: Be aware that the U.S. FWS may not be able to issue CITES documents for the commercial export of Appendix-I
species.
Provide the following information. Complete all questions on the 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, indicate the
application question number you are addressing. If applying for more than one specimen, be sure to answer all relevant
questions for each specimen.
Electronic submission of inventories, photographs, and receipts: Some applications contain extensive inventories and/or a
large number of photographs or receipts. You may provide electronic versions of the documents. Such a submission will
assist in expediting the processing of your application since it may reduce data entry by the U.S. Fish and Wildlife Service.
If you wish to provide information electronically, please either include a disk containing your information or, once you have
received an application number via the e-mailed acknowledgment letter, e-mail your information to Permits@fws.gov. Be
sure to include the application number provided in the acknowledgment e-mail that will be sent to you when we receive
your application.
I will be submitting documents electronically.
1. Name and address where you wish the permit to be mailed, if different from page 1. If you would like
expedited shipping, please enclose a self-addressed, pre-paid, computer-generated, courier service airway
bill. If unspecified, all documents will be mailed via regular mail through the U.S. Postal Service.
2. Whom should we contact if we have questions about the application (name, phone number, and e-mail)?
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Page 2 of 8
Form 3-200-27
OMB Control No. 1018-0093
Expires 08/31/2020
3. Disqualification factor. A conviction, or entry of 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 disqualifies any such
person from receiving or exercising the privileges of a permit, unless such disqualification has been expressly
waived by the Service Director in response to a written petition. (50 CFR 13.21(c)) Have you or any of the
owners of the business, if applying as a business, been convicted, or entered a plea of guilty or nolo contendere,
forfeited collateral, or are currently under charges for any violations 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.
4. What is the purpose of the export?
Commercial
Personal
Exhibition
Scientific
Breeding
Other (specify: _____________________________)
5. 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.
Name:
Street Address:
City:
State/Province, Country, Postal Code:
6. For EACH animal or specimen to be exported, provide (a form is provided on page 6 for your convenience):
a.
Scientific name (genus, species, and, if applicable, subspecies) and common name
b.
Birth or hatch date or approximate age
c.
Gender, if known
d.
Description (e.g., live or dead, tattoo#, band #, ISIS #, studbook #, size, weight, skull, mount; for
parts/products – type, quantity, and container)
e.
Specific location of where, when, and by whom (name and address) the animal or specimen was
removed from the wild;
f.
Describe the method of removal from the wild;
g.
Purpose of removal and, if alive, length or approximate length of time held in captivity;
h.
Copy of any permits, licenses, or other documents from the State or local wildlife authorities required
to remove the specimen(s) from the wild;
i.
Documentation showing that the specimens were legally obtained by the applicant (e.g., transfer
documents, sales receipts); and
j.
Copies of any applicable State permits or licenses that are required to house, maintain, breed, and/or
sell these specimens (contact your State for information).
k.
For Alaskan native handicrafts, provide the name of the artist and Tribal affiliation.
Rev. 8/2017
Page 3 of 8
Form 3-200-27
OMB Control No. 1018-0093
Expires 08/31/2020
If your specimen is American alligator or furbearer skin that must be tagged with a CITES tag, provide a list of the
complete CITES Tag numbers [e.g. FL MIS 0712345] or replacement tag numbers [e.g. FWS REPL 0123456].
Tags must be inserted through the skins and permanently locked in place at the time of export.
Note: Replacement tags must be obtained before submitting your application (broken tags must be surrendered
at the time of requesting replacement tags)
[See 50 §
23.69(c)].
Note: When products made from skins are exported, you may be requested to surrender the tags from the skins
used in manufacture; therefore, do not destroy or dispose of tags until after the application process is complete.
7. Current location of specimen(s) (address - street, city, state/province, country):
8. Is this shipment is a sample collection being exported for temporary exhibition or display purposes and is
accompanied by a valid U.S. ATA carnet number?
No
Yes; provide ATA carnet document number _________________
9. Provide the name and address of person/facility receiving the shipment (if self, provide address abroad).
Name:
Street Address:
City:
State/Province, Country, Postal Code:
10. For the export of migratory birds, their parts, nests, or eggs (50 § 10.13), provide copies of the Federal and
State permits or licenses authorizing possession, acquisition, or disposition of such birds, their parts, nests, or
eggs.
11. 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.
Rev. 8/2017
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Form 3-200-27
OMB Control No. 1018-0093
Expires 08/31/2020
12. For the non-commercial export of 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.
13. If you are a CITES-Registered Commercial Operation for Appendix I wildlife, no CITES import is required.
Please provide the name and registration number of the operation:
____________________________________
**All international shipment(s) 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).
Rev. 8/2017
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