Report Of Unsold Licenses Returned For Year 2000 - Indiana Department Of Natural Resources
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1REPORT OF UNSOLD LICENSES RETURNED FOR
YEAR
Department of Natural Resources
Division of Fish and Wildlife
State Form 37697 (R2/9-00)
2000
Approved by the State Board of Accounts 1990
Date received in
Date posted in
Box number
Agent account number
Received of: (name of agent, county clerk, or state employee)
D/B/A
Street address
City
State
Zip code
KIND OF
NUMBER OF
LICENSES
LICENSE NO. TO LICENSE NO. (inclusive)
LICENSES
LICENSES
TOTAL
AUDIT
GRAND TOTAL
We, the undersigned, hereby certify that we have each counted the above listed licenses and verify the same to be correct.
Signature of clerk, agent or state employee
Date signed (month, day, year)
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