Ohio Resident Lifetime/Multiyear Hunting and Fishing ...

[Pages:3]Ohio Department of Natural Resources

DIVISION OF WILDLIFE

Ohio Resident Lifetime/Multiyear Hunting and Fishing License Application

DNR 8939 (1021)

PLEASE TYPE OR PRINT LEGIBLY Mail application and check or money order to:

ODNR, DOW-Conservation, 2045 Morse Rd., Columbus, OH 43229

Licenses are only available to those that meet the definition of "Resident" for the purpose of obtaining Ohio hunting and fishing licenses (See back for complete list of documents). Incomplete applications will not be processed.

INSTRUCTIONS FOR LICENSE APPLICATION

1. Complete and sign application.

2. Validate residency and age by presenting required documents at Wildlife Office (locations listed), or if submitting by mail, a notary must certify that required documents were presented. (Do not mail required documents, they will not be returned.)

3. Include correct payment. Verify method of payment is signed as required. (Amount above required total will be donated.)

LICENSEE INFORMATION

CUSTOMER ID#

LAST NAME OHIO DRIVER LICENSE/ID # (see required documents)

FIRST NAME DL STATE

/ /

DATE OF BIRTH (mm/dd/yyyy)

/ /

MI

SOCIAL SECURITY #

HEIGHT

WEIGHT

MAILING ADDRESS (street,apartment, P.O. box, etc.)

CITY

STATE

ZIP

PHYSICAL ADDRESS

CITY

STATE

ZIP

EMAIL ADDRESS (optional)

(

)

TELEPHONE

If over 21 years of age, I certify I have been previously issued a hunting license (not apprentice) or completed a hunter education course from any state.

SIGNATURE OF LICENSEE Note: Licensee's signature attests to the acceptance of the Rules pertaining to this license, and the conditions set forth in ORC 1533.

REQUIRED DOCUMENTS TO VERIFY AGE AND RESIDENCY FOR A LIFETIME OR MULTIYEAR LICENSE

Regular and Senior Licenses

? Valid Ohio Driver License or ID (BMV issued)

? If no Ohio Driver License or ID, verify residency by presenting 2 of the following documents in the applicant's name (mark documents presented):

Home utility bill

Rent/mortgage receipt

Current voter registration card

State income tax (full-time resident)

Motor vehicle registration

Vehicle/home insurance

Notarized statement from employer on business letterhead

Income source (pay stub, social security check)

Youth License ? Valid Ohio Driver License or ID (BMV issued) ? If no Ohio Driver License or ID:

Verify residency of Parent/Guardian (see above options) and

A birth certificate with parent/guardian listed on residency documents.

AGE

less than

16

16-66

FISHING

LICENSE TYPE

COST

TOTAL

Less than 16 years (Ohio ID, or if none, present birth certificate and Parent/Guardian Driver License to verify age and residency)

Youth lifetime fishing license (includes Ohio Conservation Card) . . . . . . . . . . . . . . . . . . $430.56 ____________

16 years but less than 66 years (Ohio Driver License/ID, or eligible supporting documents to verify age and residency)

Adult 3-year fishing license . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $72.11 ____________ Adult 5-year fishing license . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $120.18 ____________ Adult 10-year fishing license . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $240.36 ____________ Adult Lifetime fishing license (includes Ohio Conservation Card) . . . . . . . . . . . . . . . . . $599.04 ____________

66+

66 years and older (Ohio Driver License/ID, or eligible supporting documents to verify age and residency)

Senior 3-year fishing license . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $27.04 ____________ Senior 5-year fishing license . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $45.07 ____________ Senior Lifetime fishing license (includes Ohio Conservation Card) . . . . . . . . . . . . . . . . . $84.24 ____________

AGE

less than

18

18-66

66+

HUNTING

LICENSE TYPE

COST

TOTAL

Less than 18 years (Ohio Driver License/ID, or birth certificate and Parent/Guardian Driver License to verify age and residency)

Youth 3-year hunting license . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $27.04 ____________

Youth 5-year hunting license . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $45.07 ____________

Youth 10-year hunting license . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $90.14 ____________

Youth Lifetime hunting license (includes Ohio Conservation Card) . . . . . . . . . . . . . . . . . $430.56 ____________

18 years but less than 66 years (Ohio Driver License/ID, or eligible supporting documents to verify age and residency)

Adult 3-year hunting license . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $54.08 ____________ Adult 5-year hunting license . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $90.14 ____________ Adult 10-year hunting license . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $180.27 ____________ Adult Lifetime hunting license (includes Ohio Conservation Card) . . . . . . . . . . . . . . . . . $449.28 ____________

66 years and older (Ohio Driver License/ID, or eligible supporting documents to verify age and residency)

Senior 3-year hunting license . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $27.04 ____________ Senior 5-year hunting license . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $45.07 ____________ Senior Lifetime hunting license (includes Ohio Conservation Card) . . . . . . . . . . . . . . . . . $84.24 ____________

OHIO CONSERVATION CARD

LICENSE TYPE

COST

Ohio Conservation Card (please allow up to 45 days for delivery) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $4.00

TOTAL ____________

Grand Total $ ______________

Any payment amount greater than the required total cost will be considered a donation to the Division of Wildlife.

SIGNATURE REQUIRED

Incomplete applications will be returned.

I affirm that I am not under suspension for any natural resources violation and I am eligible to apply for, hold and use the above ODNR licenses and permits and that the information provided above is true and correct.

SIGNATURE OF APPLICANT

DATE

If Mailed, A Notary must certify residency by marking the documents presented and validate age. Sworn to and subscribed before me this _______ day of ________________, year_________. Notary ________________________________________________________ (seal required) DNR 8939 (0918)

AMOUNT OF CHECK $

DEFINITIONS: 1. Resident: A lifetime license or multiyear license may only be issued to an Ohio resident. If proof of residency cannot

be verified, the license application will be denied. For purposes of this license, a resident is defined as any individual who has resided in Ohio for at least six months preceding the application date. A person may only be a resident of one state. 2. Apprentice status: Allows hunters to sample the experience of hunting under the mentorship of a hunter-education certified and licensed adult, 21 years old or older. 3. Youth status: For youth multiyear and lifetime licenses, a copy or of the birth certificate must be presented at the time of application if the youth has not been issued an Ohio driver license or Ohio ID. A youth hunter with a multiyear or lifetime license is qualified to participate in youth hunts until the day of his or her 18th birthday..

FACTS: REFUNDS/TRANSFERS: License fees paid for a lifetime license or multiyear license are nonrefundable and are not transferrable.

SOCIAL SECURITY NUMBER: Federal law requires that a licensee must provide a Social Security Number when purchasing a hunting license or fishing license, regardless of age. If the licensee does not have a Social Security Number, he or she must provide a certification verifying the customer does not have an active number.

IF RESIDENCY CHANGES, THE LICENSE REMAINS VALID: Lifetime licenses and multiyear licenses remain valid for those privileges purchased in Ohio regardless of a change in residency. Permits are issued based upon current residency status.

LICENSE APPLICATION: Application must be completed, signed, and all requested information presented at a wildlife office or if mailed, certified by a notary to be true and accurate. Mailed applications should be sent to ODNR Division of Wildlife headquarters.

ODNR Division of Wildlife offices: Headquarters: 2045 Morse Road, Columbus, OH 43229 Central Ohio: 1500 Dublin Road, Columbus, OH 43215 Northwest Ohio: 952 Lima Avenue, Findlay, OH 45840 Northeast Ohio: 912 Portage Lakes Drive, Akron, OH 44319 Southeast Ohio: 360 E. State Street, Athens, OH 45701 Southwest Ohio: 1076 Old Springfield Pike, Xenia, OH 45385

OHIO CONSERVATION CARD: An Ohio conservation card will be issued to all individuals who purchase a lifetime license. For apprentice hunters who successfully complete hunter education in Ohio, a free updated card will be provided upon completion of an approved course. The card is an optional $4.00 purchase for multiyear licenses. Please allow 45 days for delivery of the card.

HUNTER EDUCATION: Successful completion of a hunter education course is required to hunt without supervision. Until a licensee is hunter-education certified, that person must be accompanied by a certified hunter, 21 years or older.

HUNTER EDUCATION CERTIFIED: In order for a hunting license to indicate hunter education certified (HC), the licensee must complete a certified course. If 21 years or older, the licensee can attest to having previously been issued a hunting license (HA). If the licensee has not taken a hunter education course and cannot attest, the license will indicate apprentice status (AP). At any time in the future, if you would like for your license to reflect your certified status, you can apply for a duplicate card.

GIFT: If the lifetime license or multiyear license is a gift, the applicant must present all required documents, and the purchaser can sign the application.

VALIDITY: Lifetime licenses and multiyear licenses grant the privileges accorded by the rules of the ODNR Division of Wildlife for the year in which the licensed activity is being performed.

DNR 8939 (0918)

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download