Lifetime License Application - N.c. Wildlife Resources Commission

Lifetime License Application

N.C. Wildlife Resources Commission

Side 1

Revised 08/2015

Applicant Information:

Complete and mail with payment to: NCWRC, License Section, 1707 Mail Service Center, Raleigh, NC 27699-1700.

Name of Applicant

Telephone # (

)

Mailing Address

City

State

Zip

Resident Address

City

State

Zip

Date of Birth

County of Residence

NCDL #

Email

Is this license a gift?

Yes

No If yes, mail license to

Donor or

Applicant. If mailed to donor, please complete the below information.

License Donor’s Name

Donor’s Telephone # (

)

Donor’s Mailing Address

City

State

Zip

I certify that all information provided on this application is true and accurate and understand that providing false information to obtain a license is a Class

1 misdemeanor. Signature

Date

Refer To The Reverse Side Of This Application For A List Of Privileges Associated With Each License.

Infant (under 1 year of age) and Youth (age 1-11) Licenses: Infant and youth applications must be received at WRC Headquarters or processed at

st

th

a Wildlife Service Agent no later than the day before the child turns 1 or 12 years of age. Applications received on or after the child’s 1

or 12

birthday CANNOT be processed as an infant or youth license. A copy of the birth certificate must accompany applications for infant and youth

licenses. Birth certificate documentation cannot be returned.

1

Sportsman Infant

.............................................................................................................................................................................................................................. $200

4

Unified Sportsman/Coastal Recreational Fishing Infant

.................................................................................................................................................................... $275

5

Coastal Recreational Fishing Infant

.................................................................................................................................................................................................. $100

1

Sportsman Youth

.............................................................................................................................................................................................................................. $350

4

Unified Sportsman/Coastal Recreational Fishing Youth

.................................................................................................................................................................... $450

5

Coastal Recreational Fishing Youth

.................................................................................................................................................................................................. $150

Adult (age 12 or older) Licenses:

1

Resident Sportsman

......................................................................................................................................................................................................................... $500

1

Nonresident Sportsman

..................................................................................................................................................................................................................$1200

1 *

Resident Senior Sportsman

(this license is not eligible for personalization) ...................................................................................................................................... $15

2

Resident Comprehensive Hunting

.................................................................................................................................................................................................... $250

3

Resident Comprehensive Inland Fishing

........................................................................................................................................................................................... $250

3 *

Resident Senior Comprehensive Inland Fishing

(this license is not eligible for personalization) ........................................................................................................ $15

4

Resident Unified Sportsman/Coastal Recreational Fishing

............................................................................................................................................................... $675

4

Nonresident Unified Sportsman/Coastal Recreational Fishing

........................................................................................................................................................$1550

4 *

Resident Unified Senior Sportsman/Coastal Recreational Fishing

(this license is not eligible for license personalization) ................................................................ $30

5

Resident Coastal Recreational Fishing

............................................................................................................................................................................................. $250

5

Nonresident Coastal Recreational Fishing

........................................................................................................................................................................................ $500

5 *

Resident Senior Coastal Recreational Fishing

(this license is not eligible for personalization) .......................................................................................................... $15

6

Resident Unified Inland/Coastal Recreational Fishing

....................................................................................................................................................................... $450

Bear Management E-Stamp – This electronic stamp is required to hunt bear. This e-stamp must be purchased annually, if hunting bear.… ..................................... ...$10

Federal Duck Stamp – This stamp is required for waterfowl hunters 16 years of age and older. This stamp expires June 30 of each year…………………………....$26.50

Must Complete This Section If Purchasing A License With Hunting Privileges: Unless otherwise indicated below, a person may not purchase a hunting license

or hunt in NC without having a Certificate of Competency for completing a hunter education course or had a NC hunting license effective prior to July 1, 2013.

Check one of the following:

Minor, has not taken hunter education course (before the license holder can utilize the hunting portion of this license without being accompanied by a properly licensed

adult, they must have completed a hunter education course).

I have had a North Carolina hunting license effective prior to July 1, 2013.

I have successfully completed a hunter education course. Hunter Education Certificate Number:

I have NOT successfully completed a hunter education course and understand that until I do so, when hunting I must be accompanied by an adult 18 years of age or

older who is properly licensed to hunt in North Carolina. “Accompanied” is defined as maintaining a proximity to the hunter, which enables the adult to monitor the

activities of the hunter by remaining within sight and hearing distance at all times without the use of electronic devices.

License Personalization –

Not available for the senior lifetime licenses.

Personalization (Additional $5.00 Fee): Complete the following information if you wish to add a personalized message to this license.

$5

1)

Indicate your personal message including letters, numbers, dashes, periods, commas and/or blanks up to 21 spaces:

2)

In addition to the 21-digit message, you have the option to include a 6-digit personalization which is included with the

$5 fee and appears on the license separate from the above message. If interested, indicate your selection of letters,

Purchase Subtotal

$

numbers, dashes, periods, commas and/or blanks up to 6 spaces:

Plus Transaction Fee $

2.00*

Purchase Total

$

*Transaction fee mandated by NCGS 113-270.1B.

Method of Payment:

Check

(made payable to NCWRC)

Transactions are not considered final until the check has cleared the bank. Items purchased with a returned

check will be made invalid. A service charge of up to $25 will be charged on returned checks (G.S. 25-3-506).

VISA

MasterCard

Print name exactly as it appears on credit card:

Acct. #

Exp.

CCV #

Signature

Date

Office Location: NCSU Centennial Campus, 1751 Varsity Drive, Raleigh, NC

Telephone: 1-888-248-6834

Website: