Iowa Department of Natural Resources
|[pic] | |IOWA DEPARTMENT OF NATURAL RESOURCES |
| | |Licensing Section |
| | |502 E 9th St, Des Moines, IA 50319-0034 |
| | |(515) 725-8200 |
REGISTRATION FOR RESIDENT LANDOWNER/TENANT DEER & TURKEY LICENSES
Provide ALL of the following information:
Please print clearly (If we cannot read your writing we will return this form unprocessed.)
|Applicant Information |
|Last Name: | |First Name: | |
|Mailing Address: | |
|City: | |State: | |Zip: | |
|Phone #: | |Email: | |
|Date of Birth: | |Gender: | Male Female |
|Height: | |Weight: | |Eye Color: | | |
| |
|Provide at least TWO (2) of the three number listed below: |
|Iowa DNR # | |Social Security #*: | |Driver’s License # and State:| |
|(if known): | | | | | |
|*The Iowa Department of Natural Resources is required to collect social security numbers from all persons obtaining a hunting, fishing or other recreational |
|license under section 252J.8 of the Code of Iowa and 42 US Code 666(a)(13). You social security number will serve as your principal identification number to |
|determine your eligibility for licenses. It will be provided to law enforcement agencies and the Iowa Child Support Collection Unity to establish, modify, and |
|enforce child support obligations and to collect liabilities owed to the state or a state agency. It WILL NOT appear on your license. |
| |
|*SSN required if your do not know your DNR Number or have never purchased an Iowa hunting/fishing license. |
|I am registering as a (Check ONLY ONE, either I or II): |
|I |Landowner, |II |Tenant, |
| |Spouse of Landowner, or | |Spouse of Tenant, or |
| |Child of Landowner | |Child of Tenant |
|(If selected, complete Sections A and C only) |(If selected, complete Sections B and C only) |
|Section A |
|I attest that I am eligible for free and reduced-fee deer and wild turkey hunting licenses because I meet one of the following criteria: (If registering as a |
|landowner or family member of a landowner, you MUST CHECK ONLY ONE box for 1, 2, or 3.) |
|1 |LANDOWNER: I am a resident of Iowa and I own at least 2 contiguous acres of qualifying agricultural land. I do not use a third party, such as a farm |
| |management company, to make annual farm operating decisions. |
| |(If you checked Box 1, you MUST CHECK AT LEAST ONE box for a-e below.) |
| | I am the farm operator on that farmland, or |
| |I make annual decisions about the farm operations that are carried out by renters, laborers, or custom applicators, or |
| |I raise specialty crops (orchards, nurseries, trees, etc.), listed below, on that land, or |
| | | | |
| | All or part of my land is enrolled in the conservation reserve program, or |
| |I rent my farm to my adult child who operates the farm. |
|2 |LANDOWNER SPOUSE: I am the spouse of a landowner who qualifies for free licenses as described in Statement 1, I reside with that landowner, and the |
| |county number and parcel identification number listed in Section C are for qualifying land owned by that landowner. |
|3 |LANDOWNER CHILD: I am the child of a landowner who qualifies for free licenses as described in Statement 1, I reside with that landowner, and the county |
| |number and parcel identification number listed in Section C are for qualifying land owned by that landowner (If you checked Box 3, you MUST CHECK ONLY |
| |ONE box for f or g below.) |
| | I am under 18 years old, or |
| |I am 18 or 19 years old and I am enrolled in high school or a GED program. |
|GO TO SECTION C |
|Section B |
|I attest that I am eligible for free and reduced-fee deer and wild turkey hunting licenses because I meet one of the following criteria: (If registering as a |
|tenant or family member of a tenant, you MUST CHECK ONLY ONE box for 4, 5, or 6.) |
|4 |TENANT: I am a resident of Iowa and I rent and actively farm agricultural land owned by another person. |
|5 |TENANT SPOUSE: I am the spouse of a tenant who qualifies for free licenses as described in Statement 4, I reside with that tenant, and the county number |
| |and parcel identification number listed in Section C are for qualifying land rented by that tenant. |
|6 |TENANT CHILD: I am the child of a tenant who qualifies for free licenses as described in Statement 4, I reside with that tenant, and the county number |
| |and parcel identification number listed in Section C are for qualifying land rented by that tenant. (If you checked Box 6, you MUST CHECK ONLY ONE box |
| |for h or i below.) |
| | I am under 18 years old, or |
| |I am 18 or 19 years old and I am enrolled in high school or a GED program. |
|7 |Provide the NAME, ADDRESS, and TELEPHONE NUMBER of the landowner who owns the parcel of agricultural land that you rent. The person listed below must be |
| |the owner of the parcel of land that you list for number 8 in Section C below. |
|Landowner Last Name: | |Landowner First Name: | |
|Landowner Mailing Address: | |
|Landowner City: | |Landowner State: | |Landowner Zip: | |
|Landowner Phone #: | | |
|GO TO SECTION C |
|Section C |
|8 |Provide the COUNTY NUMBER and PARCEL IDENTIFICATION NUMBER for ONE parcel of agricultural land that qualifies you for a Landowner/Tenant License. See |
| |“INSTRUCTIONS” for locating the parcel number. Tenants must get this number from the landowner who rents qualifying land to them. The DISTRICT NUMBER** is |
| |also required for Keokuk County. |
| |IMPORTANT: A landowner and all of his/her qualifying family members must register using the same County # and the same Parcel Identification Number. |
| |Likewise, a tenant and all of his/her qualifying family members must register using the same County # and Parcel Identification Number. The same District |
| |Number must also be used, when applicable.* |
|County # | |District #** | |Parcel Identification Number |
| |
|9 |Provide the full legal name of the landowner, as it appears on the deed, who owns the parcel of land listed in number 8 above. If the property is named |
| |under a trust, business, corporation, LLC, etc; that name must be provided for verification purposes. You may use both the First Name and Last Name text |
| |boxes if necessary. Also, if land is owned by more than one individual or a corporation, you must also include a list of all individual owners and their |
| |home address. |
|Landowner Last Name: | |Landowner First Name: | |
|10 |By signing this affidavit, I attest that all of the information provided is true. I understand that I may be subject to conviction of a misdemeanor and |
| |loss of hunting privileges if the information I have provided is proven to be false under Iowa Code 714.8(4). |
| | | |
|Signature | |Date |
WARNING: Incomplete or illegible application will delay the registration process.
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related searches
- iowa department of licensure
- importance of natural resources ppt
- importance of natural resources pdf
- secretary of natural resources california
- iowa department of revenue registration
- iowa department of education licensure
- iowa department of education
- iowa department of education examiners
- types of natural resources pdf
- conservation of natural resources ppt
- iowa department of education directory
- misuse of natural resources examples