Application For 100 % Permanent Disability Fishing/combination License Page 2

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Rhode Island Harvest Information Program (HIP)
Migratory Bird Permit Application
Check off appropriate categories completely. Indicate which birds you hunted last season and the
number bagged.
DIDN’T
HUNT
NONE
1-10
11-30
31+
DUCKS
_____
_____
_____
_____
_____
SEA DUCKS
_____
_____
_____
_____
_____
GEESE/BRANT
_____
_____
_____
_____
_____
DOVES
_____
_____
_____
_____
_____
WOODCOCK
_____
_____
_____
_____
_____
COOTS/SNIPE
_____
_____
_____
_____
_____
RAILS
_____
_____
_____
_____
_____
Name:________________________________________________________________________________
Last
First
Middle
Jr./Sr./etc
Address:_____________________________________________/________________________________
Street
Town or City
State:_______________
Zip Code_______________ DOB_______________
**WARNING
Rhode Island General Law 20-13-5 PROHIBITS the following persons from PURCHASING or POSSESSING a Hunting
License:
·
Persons convicted of a crime of violence*
·
Fugitives from Justice
·
Anyone declared Mentally Incompetent
·
Drug Addicts
·
Habitual Drunkards
* “Crime of Violence” shall mean and include any of the following crimes or an attempt to commit any of them; murder,
manslaughter, rape, first or second degree sexual assault, first or second degree child molestation, kidnapping, first and
second degree arson, mayhem, robbery, burglary, breaking and entering, any felony involving the illegal manufacture,
sale or delivery of a controlled substance classified in schedule I or schedule II of 21-28-2.08, any violation21-28-4.1 or
21-28-4.01.2 or conspiracy to commit any violation of these statutes, assault with a dangerous weapon, assault or battery
involving grave
bodily injury, and or assault with intent to commit any offense punishable as a felony; upon conviction of an offense
punishable as a felony offense under 12-29-5 (domestic violence).
Penalty is a misdemeanor, punishable by a fine not more than five-hundred dollars ($500.00) or imprisonment for up to
ninety (90) days or both.

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