The following instructions pertain to the standard License/Permit Form
3-200 that must be completed as an application for a U.S. Fish and Wildlife
Service permit. Please read the General Permit Procedures (50 CFR 13) sent
with this package.
- Complete all appropriate blocks/lines. Print clearly or type in the
information. A complete application prevents delays!
- Sign the application in ink and send an original to the address on the
top of the application. Faxed copies will not be accepted.
- Applications will be processed in the order they are
received.
Most of the application form is self-explanatory, but
the following provides some further assistance for completing the form.
COMPLETE EITHER BLOCK A OR BLOCK B:
Block A.
"Complete if applying as an individual" - Enter the complete
name of the responsible party who will be the permittee if a permit is
issued. Enter personal information that identifies the applicant. All blocks
must be completed. If you are applying on behalf of a client, the personal
information must pertain to the client. A notarized document stating power
of attorney must be included with the application.
Block B.
"Complete if applying as a business, corporation, public
agency or institution" - Enter the complete name and address of the
business, agency or institution who will be the permittee if a permit is
issued. Give a brief description of the type of business the applicant is
engaged in, the name and phone number of the person in charge, and if the
company is incorporated, the state in which it was incorporated.
ALL APPLICANTS COMPLETE BLOCK C:
Block C.1
"Do you currently have or have had any Federal Fish and
Wildlife license or permits?" - List the number of any FWS or CITES permits.
Block C.2
"Have you obtained any required state or foreign government
approval to conduct the activity you propose?" - If the proposed activity is
regulated, check the appropriate box. If "yes", list the State or foreign
countries involved and type of document required. Include a copy of these
documents with the application. If "no" indicate what steps you have taken
to secure approval (use attachment if necessary). If the proposed activity
is not regulated check "not required".
Block C.3
"Enclose check or money order" - There is a permit
processing fee unless you are fee exempt. Consult the enclosed Application
Processing Fee section or 50 CFR 13.11. Make the check or money order
payable to the U.S. Fish and Wildlife Service and attach it to the
application form. If fee exempt, write "exempt" in this space.
Block C.4
"Attachments" - Consult the regulation. Provide any
required additional information outlined on the supplemental page of the
application form. Be as complete and descriptive as possible. If there is
any doubt as to the information's relevance, include it with the
application. An incomplete or unclear application may cause delays in
processing.
Block C.5
"CERTIFICATION" - The individual applicant in Block A, the
person named in Block B, or person with power of attorney must sign and date
the application in ink. This signature binds that person to the statement of
certification. This means that you certify that you read and understood the
regulations that apply to the permit. You also certify that everything
included in the application is true to the best of your knowledge. Be sure
to read the statement and re-read the application before signing.
Privacy Act and Paperwork Reduction Act -- Notice
In accordance with the Paperwork Reduction Act of 1995 (44 U.S.C. 3501,
et seq.) and the Privacy Act of 1974 (5 U.S.C. 552a) please be advised that:
- The gathering of information on fish and wildlife is authorized by:
(a) Bald and Golden Eagle Act (16 U.S.C. 668a); (b) Endangered Species Act
of 1973 (16 U.S.C. 1539); (c) Migratory Bird Treaty Act (16 U.S.C.
703-711); (d) Marine Mammal Protection Act of 1972 (16 U.S.C. 1371-1383);
(e) Wild Bird Conservation Act (16 U.S.C. 4901-4916); (f) Lacey Act (18
U.S.C. 42 & 44); and, (g) Title 50, Part 13, of the Code of Federal
Regulations.
- Information requested in this form is purely voluntary; however,
submission of information is required in order to process applications for
licenses or permits authorized under the above acts. With the exception of
your social security number, failure to provide all requested information
is sufficient cause for the U.S. Fish and Wildlife Service to deny a
permit. Response is not required unless a currently valid Office of
Management and Budget (OMB) control number is displayed.
- Applications for permits authorized under the Endangered Species Act
of 1973 (16 U.S.C. 1539) and the Marine Mammal Protection Act of 1972 (16
U.S.C. 1371-1383) will be published in the Federal Register as required by
the two acts.
- Routine use disclosures may also be made:
- To the U.S. Department of Justice when related to litigation or
anticipated litigation;
- Of information indicating a violation or potential violation of a
statute, regulation, rule, order or license to appropriate Federal,
State, local or foreign agencies responsible for investigation or
prosecuting the violation or for enforcing or implementing the statute,
rule, regulations, order or license;
- From the record of an individual in response to an inquiry from a
Congressional office made at the request of that individual (42 FR
19083; April 11, 1977);
- To subject matter experts, and State and other Federal agencies, for
the sole purpose of obtaining advice relevant to issuance of the permit.
- For individuals, personal information such as home address and
telephone number, financial data, and personal identifiers (social
security number, birth date, etc.) will be removed prior to any release of
the application.
- For applications for permits under the Migratory Bird Treaty Act and
Bald and Golden Eagle Protection Act: The public reporting burden for this
information collection varies based on the specific activity use being
requested. With the exception of applications for scientific collecting,
special Canada goose, special purpose, and take of golden eagle nest
permits, we estimate it will take you about an hour to read the
instructions and complete the application form. We estimate applications
for special purpose permits will take you about 2.5 hours to read and
complete, and scientific collecting and golden eagle nest permits will
take about 4 hours. This burden estimate includes time for reviewing
instructions, gathering and maintaining data and completing and reviewing
the form. You may direct any comments concerning the burden estimate or
any other aspect of the form, the accuracy of this burden and suggestions
for reducing this burden to the Information Collection Clearance Officer,
Mail Stop 222, Arlington Square, U.S. Fish and Wildlife Service, 1849 C
Street, N.W., Washington, D.C. 20240, and to the Office of Information and
Regulatory Affairs, OMB, Attention: Desk Officer for the Interior
Department (1018-0022), Washington, D.C. 20240.
Freedom of Information Act -- Notice
For organizations, businesses, or individuals operating as a business
(i.e., permittees not covered by the Privacy Act), we request that you
identify any information that should be considered privileged and
confidential business information to allow the Service to meet its
responsibilities under FOIA. Confidential business information must be
clearly marked "Business Confidential" at the top of the letter or page
and each succeeding page, and must be accompanied by a non-confidential
summary of the confidential information. The non-confidential summary and
remaining documents may be made available to the public under FOIA [43 CFR
2.13(c)(4), 43 CFR 2.15(d)(1)(i)].
Application Processing Fee
The fee to process a permit application varies by permit type and is listed on
the permit application under the instructions. Checks are to be
made payable to "U.S. Fish and Wildlife Service". The fee applies to
permit applications and renewals. The processing fee will not be refunded
if the permit is issued, denied or abandoned. There is no application processing fee
for Native Americans to apply for permits related to religious ceremonial use of eagles and eagle parts.
The fee schedule does not apply to any Federal, State, or local
government agency or individual or institution under contract to such
agency for the proposed activities. Proof of such status must accompany the
application (50 CFR 13.11(d)).