Form 3-200-15a Federal Fish and Wildlife Permit Application/Order Form

PERMIT APPLICATION / ORDER FORM

Form 3-200-15a (Rev. 12/2025)
U.S. Department of the Interior

OMB Control No. 1018-0167
Expires 07/31/2026

Eagle Parts for Native American Religious Purposes
(Bald and Golden Eagle Protection Act, 50 CFR 22.60)
U.S. Fish and Wildlife Service
National Eagle and Wildlife Property Repository
6550 Gateway Road, Bldg. 128
Commerce City, CO 80022
repository@fws.gov

ALL BOLD FIELDS MARKED WITH AN ASTERISK (*) ARE REQUIRED.
BEFORE FILLING OUT THIS FORM, please see Instructions and Frequently Asked Questions.
Type of Order: (Check ONE)

□ First Order

*Last Name

There is no processing fee for this permit.

□ Reorder (Limited to one pending order at a time)

*First Name

Middle Name

Suffix (Sr., Jr., etc.)

Physical address (Street address; Apartment #, Suite #)
City

State

Zip Code/Postal Code

*State

*Zip Code/Postal Code

*Mailing address (If different than physical address)
*City
*Date of Birth (Must be 18+ years of age)
Primary Phone Number

Permit Number (If known)

Secondary Phone Number

Email Address

Work Phone Number

Contact Person (If you have no phone)

*Full Name of U.S. Federally Recognized Tribe

Phone Number of Contact Person
*Enrollment Number

Inmate Specific Data
Inmate Number
New Incarceration: □ Yes □ No

Institution

DESCRIPTION OF REQUESTED MATERIAL:

Chaplain Name

Chaplain Phone Number

*Species (Select ONE)

*Age (Select ONE)

□ Bald

□ Adult

□ Golden

□ Immature

Section 1: Whole Eagle or Parts Request: (Select ONE of the check boxes below.) If only loose feathers are needed, please fill out Section 2.

□ Whole Eagle Only. (If selected, no additional parts or loose feathers can be added.) (Plumes can be found under the tail feathers.)
□ Wings and Tail only (Plumes included)

□ Wings only

□ Tail only (Plumes included)

Section 2: Loose Feathers Request: (Please select ONE from either category below but not both.) Not to be combined with Section 1 above.

□ 10 Quality (8 wing, 2 tail)

Include plumes? (Maximum quantity: 2) !!!! Yes

□ 20 Miscellaneous (Lower quality, mix of wing and tail feathers)

Include Plumes (Quantity 3-5)
Plumes Only (Quantity 20)

Is this a graduation order

Yes

Section 3: Parts Request: (The following can be ordered separately. Cannot be combined with a whole eagle order.)

□ Head

□ Feet

□ Trunk (body minus the head, feet, wings, and tail)

□ Ulna (Maximum quantity: 2)

□ Other Items not found above: (Please be specific)
I hereby certify that I am requesting eagle items for religious purposes and that the information submitted herein is complete and accurate to the
best of my knowledge. I understand that making a false statement can make me subject to the criminal penalties of 18 U.S.C. 1001.

*Signature:

Date of Signature:

IMPORTANT NOTE – This application is not complete until questions 1 and 2 in Section E (page 2 below) are complete. The Certificate
of Enrollment in a U.S. Federally Recognized Tribe form on page 3 must be signed by the Tribal official who is authorized to certify
that an individual is a duly enrolled member of that Tribe and must be submitted for all first-time applications.
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Form 3-200-15a (Rev. 12/2025)
U.S. Department of the Interior

Eagle Parts for Native American Religious Purposes
(Bald and Golden Eagle Protection Act, 50 CFR 22.60)
U.S. Fish and Wildlife Service
National Eagle and Wildlife Property Repository

OMB Control No. 1018-0167
Expires 07/31/2026

NOTE: A Federal Migratory Bird Eagle Parts and Feathers Request Form will authorize Native Americans to use
eagles, parts, and feathers for religious and cultural purposes, including healing, marriage, and naming ceremonies.
Recognizing the significance of eagles to Native Americans, the U.S. Fish and Wildlife Service (Service) established
the National Eagle Repository (Repository) in the early 1970s to provide Native Americans with the eagles, parts, and
feathers of Bald and Golden eagles for religious purposes.
Applicants should review Title 50 Parts 10, 13, 22.60 of the Code of Federal Regulations (CFR), Morton Policy, DOJ
Eagle Feather Policy, and the Bald and Golden Eagle Protection Act. Applicants are responsible for reviewing and
understanding these regulations before requesting and accepting a permit. Please read “Frequently Asked
Questions” and the pertinent regulations before signing and submit the application.
Please provide the information requested below. If additional information needs to be provided that does not
fit in the designated spaces, add additional sheets to your application submission. You may use as many
additional sheets as needed. Please number pages accordingly using the page number box provided at the
bottom of the sheet, and the corresponding question number.
You should be as thorough and specific as possible in your responses. Incomplete applications will be returned.
SECTION E
Questions:
1) Disqualification factor. Have you, the permittee, or your client (if a broker on behalf of your client):
a. Been assessed a civil penalty or convicted of any criminal provision of any statue or regulation relating to
the activity for which the application is filed )50 CFR 13.21 (b)(1)).
b. 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 (50 CFR 13.21 (c)(1)).
c. Had a permit revoked within the last five years for willfully violating any Federal or State statute or
regulation, or any Indian Tribal Law or regulation, or any law or regulation of any foreign country, which
involves a violation of the conditions of the permit or of the laws or regulations governing the permitted
activity (50 CFR 13.28 (a)(1)) or failing to correct deficiencies that were the cause of a permit suspension
within the 60 days (50 CFR 13.28 (a)(2)).
*Answer “yes” if ANY of the events listed immediately above have occurred. Answer “no” if none of the
events listed immediately above have occurred.

□ Yes
□ No
If you answered “Yes”, provide a) the individual’s name; b) date of conviction, civil penalty assessment or
revocation; c) change(s), or reason(s) for revocation; d) location of incident; e) court ticket (if applicable,
federal/state/Tribal court etc.); and f) legal action taken for each violation (i.e. fine, incarceration, probation…).
Please be aware that a “Yes” response does not automatically disqualify you from getting a permit.

2) I acknowledge that I have read the form Instructions and Frequently Asked Questions and will forward all
necessary documentation to the National Eagle and Wildlife Property Repository, 6550 Gateway Road, Bldg. 128,
Commerce City, CO 80022. I have also filled out all fields and questions in this application.
*Check this box to acknowledge:

□

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Form 3-200-15a (Rev. 12/2025)
U.S. Department of the Interior

PERMIT APPLICATION / ORDER FORM

OMB Control No. 1018-0167
Expires 07/31/2026

Eagle Parts for Native American Religious Purposes
(Bald and Golden Eagle Protection Act, 50 CFR 22.60)
U.S. Fish and Wildlife Service
National Eagle and Wildlife Property Repository

Note: The completed Certificate of Enrollment must be attached to process new applications or if
enrollment information has changed. ALL BOLD FIELDS MARKED WITH AN ASTERISK (*) ARE REQUIRED.
EAGLE PERMIT APPLICANT: (Please print)
*Name:
*Address:
*Telephone Number:
NOTE TO CERTIFYING OFFICIAL: Please expedite this completed Certification of Enrollment to the applicant at
the above address.
APPLICANT: Attach this completed certification to your Eagle Permit application and mail all pages to the U.S. Fish
and Wildlife Service, National Eagle Repository.
The U.S. Fish and Wildlife Service administers the Bald and Golden Eagle Protection Act, the Federal
law protecting eagles. This law provides for Native American use of eagle feathers for religious purposes.
Eagles and eagle feathers are accumulated by the Service’s National Eagle Repository and made available
to Native Americans.
Application for a permit to acquire eagle feathers requires certification that the requesting individual is an enrolled
member of an Indian Tribe that is federally recognized under the Federally Recognized Tribal List Act of 1994, 25
U.S.C. 479a-1, 108 Stat. 4791 (1994). The certificate must be signed by the Tribal official who is authorized to
certify that an individual is a duly enrolled member of that Tribe and must include the printed name and official title
of that certifying official. (50 CFR 22.60).

*This section should be completed by the Tribal official who is authorized to certify that an individual
is a duly enrolled member of that Tribe.

- - - - - - - - - - - - -

I certify that
*(Printed Full Name of Applicant)

*(Full Name of U.S. Federally Recognized Tribe)

is an enrolled member of the
, *Enrollment #

I understand that making a false statement can make me subject to the criminal penalties of 18 U.S.C. 1001.

*Printed name of Certifying Official:
*Signature of Certifying Official:
Title:

*Date:
Office phone no.

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OMB Control No. 1018-0167
Expires 07/31/2026

Form 3-200-15a (Rev. 12/2025)
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 22.60; 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 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
that affect protected species. The information the individual provides helps the 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
In accordance with the Paperwork Reduction Act (44 U.S.C. 3501 et seq.), the U.S. Fish and Wildlife Service
collects information necessary to monitor take and disposition of migratory birds, under the applicable laws
governing the requested activity, for which a permit is requested, and to respond to requests made under the
Freedom of Information Act and the Privacy Act of 1974. Information requested in this form is purely voluntary.
However, submission of requested information is required to process applications for permits authorized under
the above 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. 1018-0167.
ESTIMATED BURDEN STATEMENT
We estimate public reporting for this collection of information averages:
Original submission - paper-based: 1 hour 30 minutes (reporting) and 30 minutes (recordkeeping)
Original submission - electronic: 2 hours 30 minutes (reporting) and 30 minutes (recordkeeping)
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 Info_Coll@fws.gov. Please do not send your
completed form to this address.
FREEDOM OF INFORMATION ACT
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 2.26 – 2.33].

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