Transcription of Application for Replacement License (PWD 341)
1 Texas Parks and Wildlife Department4200 Smith School Road, Austin, TX 78744 (800) 792-1112 Application FOR Replacement LICENSEl *111 Resident Super Combo $10l *117 Resident Senior Super Combo $10l *503, *504, *505 Res. Comb. Hunt/Fish Pkgs. $10l *506, *507, *508 Res. Comb. Senior Hunt/Fish Pkgs. $10l *101 Resident Hunting License $10l *102 Senior Resident Hunting License $6l *105 General Non-Resident Hunting License $10l *118 Non-Resident Spring Turkey Hunting License $10l *169 Youth Hunting License $6l 231, *232, *233 Resident Fishing Packages $10l 234, *235, *236 Senior Resident Fishing Packages $10l 250, *251, *252 Non-Resident Fishing Packages $10l *502 Disabled Veteran Super Combo FREEl *990, *991, *992 Lifetime License Tags $10l *237 Resident Year-from-Purchase All Water Pkg.
2 $10l *510, *511, *512 Resident Active Military Licenses FREEl 157 Non-Resident 5-day Special Hunting License $10l 107 Non-Resident Special Hunting (Small Game) $10l 173 Annual Public Hunting Permit $10l 175 Limited Public Use Permit $10l 106 Resident trapper $3l 208 Lake Texoma Fishing $10l 167 Upland Game Bird Endorsement $3l 168 Migratory Game Bird Endorsement $3l 135 Archery Hunting Endorsement $3l 211 Saltwater Fishing Endorsement $3l 256 Freshwater Fishing Endorsement $3 Last Name: _____ First Name: _____Driver s License /ID: State _____ No.: _____ Date of Birth: _____/_____/_____Address: _____City: _____ State: _____ Zip: _____Telephone: (_____) _____I certify that I purchased the item(s) checked below.
3 The item has been lost/destroyed and I request a Replacement be issued.* I certify the following status of tags at the time my original License above was understand that under Texas Penal Code , it is a felony to make a false statement on this form. 1 l Used l Not Used Rio Grande Turkey ONLY in county with bag limit of 1 or 4 turkeys NOT VALID IN EAST TEXAS 2 l Used l Not Used Rio Grande Turkey ONLY in county with bag limit of 1 or 4 turkeys NOT VALID IN EAST TEXAS 3 l Used l Not Used Rio Grande Turkey ONLY in county with bag limit of 1 or 4 turkeys NOT VALID IN EAST TEXAS 4 l Used l Not Used Eastern OR Rio Grande Turkey in any county with bag limit of 1 or 4 turkeys 5 l Used l Not Used White-tailed Deer Antlerless Only 6 l Used l Not Used White-tailed Deer Antlerless Only 7 l Used l Not Used White-tailed Deer Buck OR Antlerless 8 l Used l Not Used White-tailed Deer Buck OR Antlerless 9 l Used l Not Used
4 White-tailed Deer Buck OR Antlerless 10 l Used l Not Used Mule Deer Antlerless Only 11 l Used l Not Used Mule Deer Buck OR Antlerless l Used l Not Used Red Drum Tagl Other: Item Type: _____ Item Name: _____Signature of Applicant: _____ Date: _____License Agent #: _____ Agent Name: _____ Mail completed form(s) on a monthly basis to: TPWD, Attn: License Section, 4200 Smith School Road, Austin, TX Texas Parks and Wildlife Department maintains the information collected through this form. With few exceptions, you are entitled to be informed about the information we collect. Under Sections and of the Texas Government Code, you are also entitled to receive and review the information. Under Section , you are also entitled to have this information corrected.
5 PWD 341 A0900 (5/19)
