Hunting And Fishing License Template

							Revised: 07/07                                                                                                           Section III – N . 2
       DEPARTMENT OF CONSERVATION AND NATURAL RESOURCES
       Wildlife and Freshwater Fisheries Division
                                       LIFETIME HUNTING & FISHING LICENSE
                                                                    Application
       PRINT OR TYPE ONLY - INCOMPLETE APPLICATIONS WILL BE RETURNED

       Name: ______________________________________________________________
       (1)
         Social Security #: ______ - ____ - ______ Driver’s License # _________________
       Date of Birth: ______________ Height: ______________ Weight: ______________
       Eyes: ____________________ Hair: ________________ Sex: ________________
       Home Address: ________________________________________________________
       County: ________________ City: _______________ State: _______ Zip: _______
       Phone: Hm (___) _____-_______ Wk (___) _____-_______ Cl (___) _____-_______
       ** Enter Hunter Education ID Number: ______________________________________

       License Privilege (by age)                 Under 2         2 – 1112 – 49      50 & over New          Upgrade
     Freshwater Fishing*                              $150   $200         $250          $150
     Hunting*                                         $300   $400         $500          $300
     Saltwater Fishing                                $250   $300         $350          $250
     Hunting & Freshwater Fishing*                    $450   $500         $700          $450
     Hunting & Saltwater Fishing*                     $550   $700         $850          $550
     Freshwater & Saltwater Fishing*                  $400   $500         $600          $400
     Hunting, Fresh & Saltwater Fishing*              $700   $800         $1,050        $700
     Wildlife Heritage**                              $200   $200         $200          $200                    N/A
     Replacement Lifetime License                     $ 5   $5 fee if old card not returned. No charge if old license
                                                          returned. Enter license Number: ____________________
                 *Freshwater Fishing and Hunting Lifetime License include the Wildlife Heritage Privileges
             ** The Wildlife Heritage License includes: fishing in freshwater statewide with hook and line from the bank; fishing in WFF
             operated Public Fishing Lakes (daily lake permits required); hunting small game, except waterfowl, on WFF WMA (WMA
             map/permit required); and shooting on WFF managed shooting ranges.

                            Upgrading Privilege: Enter current lifetime license number ____________________
                                      If school age child, provide proof of enrollment in an Alabama school.

       This is to certify under penalty of law, that applicant named above is a bonafide Alabama resident having resided continuously in
       Alabama a minimum of 90 days immediately preceding this date as required by State Law. NOTE: It is a violation of Alabama law
       for any nonresident to attempt to purchase an Alabama lifetime hunting / fishing license.

       Submit: (1) completed application, (2) check or money order, and (3) drivers license copy to: Dept. of
       Conservation and Natural Resources, Attn: Lifetime License, PO Box 301450, Montgomery, AL 36130-1450,
       or by walk-in or express mail requests: 64 N Union Street, Ste 457, 36104. Questions: (334) 242-3832 or
       dcnr.license@dcnr.alabama.gov
       License can also be issued by any WFF District Office, County Probate Office/License Commissioner, electronic
       license agents (which includes most sporting good and bait & tackle shops in Alabama), our website
       www.outdooralabama.gov or by calling 1-888-848-6887.

       Applicant’s Signature: ______________________________ Date: _______________
                                     To be excluded from any list of names sold by ADCNR, please check this box [ ]

                                                                 FOR OFFICE USE ONLY

       License Number: _______________________________________ Amount Received: _________ Date Issued: ______________

                    (1)
                          DCNR IS NOW REQUIRED BY SECTION 30-3-194(A) CODE OF ALABAMA 1975 TO COLLECT
                          SOCIAL SECURITY NUMBERS ON ALL RECREATIONAL LICENSES BEING ISSUED/RENEWED.