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' "M PERMIT APPLICATION FORM INSTRUCTIONS The following instructions pertain to the standard License/Permit Form 3-200 that must be completed as an applicaton 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 blocksAines. Print cleazly 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 aze received. Most of the application form is self-explanatory, but the following provides some further assistance for completing the form. COMPLETE EITHER BLOCKA OR BLOCK B: B1ockA. "Complete if applying as an individual" - Enter the complete name of theresponsible 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 aze applying on behalf of a client, the personal information must pertain to the client. A notarized document stating power of attomey 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 pemilt 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, fire state in which it was incorporated. ALL APPLICANTS COMPLETE BLOCK C: Block C.1 "Do you currently have or have you had any Federal Fish and Wildlife license orpermit?" -List the number of any FWS or CITES permits. If applying for a renewal, the original permit must be returned with this application. 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 "Attachments" -Consult the fact sheet or regulation. Provide any required additional informafion outlined on the supplemental page(s) (Section D) 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. Y` - Block C.4 "Check or money order (if applicable)" -There is a permit processing fee unless you aze fee exempt. Consult the enclosed APPLICATION PROCESSING FEE information. Make the check or money order payable to the "U.S. Fish and Wildlife Service" and attach if to the application form. If you aze fee exempt, write "exempt" in this space. ~- Block C.5 "CERTIFICATION" -The individual applicant in Block A, the person named in Block $, or a person with power of attomey 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.