Application For Bird, Fish And Small Game License - Wyoming Game And Fish Department

ADVERTISEMENT

(
ONE HUNDRED PERCENT
100%) DISABLED VETERAN
APPLICATION FOR BIRD, FISH AND SMALL GAME LICENSE
ALL PERSONAL INFORMATION REQUESTED ON THIS FORM IS REQUIRED
X
X
X
X
X
|___________________________________________|________________________|_____|_________||
|
|
| - |
|
| - |
|
|
|
|
Last Name
First Name
MI
Suffix
SOCIAL SECURITY NUMBER (Last 4 digits required)
|_______________________________________________________________|________________________________________|__________|____________|
Mailing Address
City
State
Zip Code
|_______________________________________________________________|________________________________________|__________|____________|
Physical Address
City
State
Zip Code
|________|
|__________|
|_______|
|____-____|
|______/______/_______|
|______|
|__________-___________-____________|
Weight
Eyes
Hair
Height
DOB (MM/DD/YYYY)
Sex
Daytime Phone # (8AM-5PM M-F)
PROOF OF RESIDENCY (REQUIRED TO BE ELIGIBLE FOR A ONE HUNDRED PERCENT (100%) DISABLED VETERAN BIRD, FISH AND
SMALL GAME LICENSE):
WY Driver’s License Number or WY ID Card Number
YRS WY RES.
ONE of the
Complete the PROOF OF
following must
OR
RESIDENCY form
be provided:
ON REVERSE SIDE
Under penalty of prosecution, I swear that the information given by me on this application is true and correct. I swear, under penalty of prosecution,
that I am a United States citizen and have been a resident of Wyoming and domiciled in Wyoming for not less than one (1) year and have not claimed
residency elsewhere for any purpose during that one (1) year period immediately preceding the date of this application or that I am an alien and have
resided continuously in Wyoming for at least one (1) year immediately prior to the date of this application, and that all information contained herein is
true and correct.
Resident Applicant’s Signature
_________________________________________________________
Date_____________
NO LICENSE WILL BE ISSUED WITHOUT THIS APPLICATION AND RESPECTIVE CERTIFICATION LETTER.
LICENSE REQUIREMENTS:
Wyoming State Statutes §23-1-705 (d): The department shall issue without charge lifetime bird, small game and fish licenses
to any disabled veteran who is one hundred percent (100%) disabled as determined by the United States Department of Veteran
Affairs. The license is valid so long as the licensee remains a Wyoming resident.
Wyoming Game and Fish Commission Regulation, Chapter 44, Regulation for Issuance of Licenses, Permits, Stamps, Tags,
Preference Points, and Coupons, Section 14(d): One hundred percent (100%) disabled does not refer to disability
compensation. Valid documentation (official Department of Veterans Affairs or official Armed Forces logo must be present in
the document’s letterhead) must be attached to this application to be considered complete.
One hundred percent (100%) Disabled Veteran Bird, Fish and Small Game licenses are issued only at Wyoming Game and Fish Department Regional
Offices located in JACKSON, PINEDALE, CODY, SHERIDAN, GREEN RIVER, LARAMIE, LANDER, or CASPER. Applications can be mailed to
the headquarters office: License Section, Wyoming Game and Fish Department, 5400 Bishop Boulevard, Cheyenne WY 82006-0001.
FOR DEPARTMENT USE ONLY
LICENSE #: __________________________
DATE ISSUED: _______________________
ISSUED BY: __________________________

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Legal
Go
Page of 2