Form Pwd 0552 - Application For Texas Resident Lifetime License Page 2
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1
2
3Application for Texas Resident Lifetime License
Send completed application form, supporting documents and proper fee to:
Texas Parks and Wildlife Department, 4200 Smith School Road, Austin, Texas 78744.
For additional information concerning Lifetime Licenses call toll-free 1-800-792-1112, #4820# or direct (512) 389-4820.
Application for:
$1,800.00
980
Resident Lifetime Super Combination Hunting and All-Water Fishing License
981
Resident Lifetime Hunting License
$1,000.00
$1,000.00
982
Resident Lifetime Fishing License
983
Resident Lifetime Hunting License to Combination Upgrade
$800.00
984
Resident Lifetime Fishing License to Combination Upgrade
$800.00
I wish to donate to the Veterans Fund.
$1.00
$5.00
$10.00
$20.00
No Thanks
I wish to help feed hungry Texas families with a donation to Hunters for the Hungry.
$1.00
$5.00
$10.00
$20.00
No Thanks
I wish to make a tax-deductible contribution to the Parks and Wildlife Lifetime License Endowment Fund.
$
Visa
Master Card
Discover
TOTAL
$
Payment by:
Check
Money Order
Credit Card:
Name on Credit Card:
Daytime Phone:
Address:
Street
City
State
Zip Code
Card Number:
Expires:
Month/Year
If paying by credit card please mail completed form and supporting documents to TPWD, 4200 Smith School Road, Austin, TX 78744.
If applicant holds a current year license including the same privileges (hunting, fishing or combination) as being applied for, then the current
year license must be surrendered to Texas Parks and Wildlife Department along with this application. The applicant must have been a resident
of Texas for more than six months immediately before applying for this lifetime license. Applicant understands that lifetime licenses may be
suspended or revoked in accordance with Parks and Wildlife Code 12.501. Additional fees for hunting and/or fishing tags may be required in the
future. Trapper’s license, fur-bearing animal propagation permit, annual public hunting permit, reptile and amphibian endorsement, or federal
duck stamp are not included with lifetime combination or hunting license.
Applicant:
Last
First
Middle
TX
Residence Address:
Street
City
State
Zip Code
TX
Mailing Address:
Street
City
State
Zip Code
Email Address:
Home Telephone Number:
Daytime Telephone Number:
Physical Description:
Male
Feet
Inches
Month
Day
Year
Female
Height
Color of Eyes
Color of Hair
Date of Birth
Applicants 17 years of age or older are required to send a photocopy of their Texas Driver's License or personal identification
card issued by the Texas Department of Public Safety with this application form.
Texas Driver's License Number or
Social Security Number (required by
Personal Identification Number:
federal law if over 13 years of age):
If Gift, Mail License to: Name:
Daytime Telephone Number:
Address:
Street
City
State
Zip Code
If this license includes hunting, please continue on the next page.
PWD 0552 – A0900 (06/17)
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