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DEPARTMENT OF GAME AND INLAND FISHERIES …

DEPARTMENT OF GAME AND INLAND FISHERIES . LIFETIME LICENSE SALES. BOX 2978. HENRICO, VA 23228-9700. 866-721-6911. (Hearing impaired call TDD# 804-367-1278). Commonwealth of Virginia Resident Application for Lifetime Hunting and Fishing Licenses Instructions and Lifetime License Information on page 2: (Please allow up to 45 days for processing). All fields with an asterisk * are required: *Are you a United States Citizen? Yes No If No, Provide your Visa/Green Card #: _____. *Applicant's Name: _____ *Gender: Male Female First Middle Initial Last Name *Virginia Driver's or DMV ID last 4 digits: _____ *Last 4 digits of Social Security No: _____. *Mailing Address: _____.

LTL-RESAGE-0716 . Instructions Page. INSTRUCTIONS (Please allow up to 45 days for processing.) • Print and complete the Lifetime License Application form.

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Transcription of DEPARTMENT OF GAME AND INLAND FISHERIES …

1 DEPARTMENT OF GAME AND INLAND FISHERIES . LIFETIME LICENSE SALES. BOX 2978. HENRICO, VA 23228-9700. 866-721-6911. (Hearing impaired call TDD# 804-367-1278). Commonwealth of Virginia Resident Application for Lifetime Hunting and Fishing Licenses Instructions and Lifetime License Information on page 2: (Please allow up to 45 days for processing). All fields with an asterisk * are required: *Are you a United States Citizen? Yes No If No, Provide your Visa/Green Card #: _____. *Applicant's Name: _____ *Gender: Male Female First Middle Initial Last Name *Virginia Driver's or DMV ID last 4 digits: _____ *Last 4 digits of Social Security No: _____. *Mailing Address: _____.

2 *City: _____ State: _____Zip: _____+ _____. *Physical Address (if different from mailing): _____. *Telephone (Cell, Home, Work, Other): _____- _____-_____ *Date of Birth: _____/_____/_____. E-mail Address: _____. Please check the license(s) you are applying for: Your Current Age: *Hunting Freshwater Trout *Saltwater Trapping Total Resident Junior (age 2 thru 11) $ N/A N/A N/A N/A $. Resident 44 and Under $ $ $ $ N/A $. Resident 45 to 50 $ $ $ $ N/A $. Resident 51 to 55 $ $ $ $ N/A $. Resident 56 to 60 $ $ $ $ N/A $. Resident 61 to 64 $ $ $ $ N/A $. Resident 65 and Older $ $ $ **$ $ $. Upgrade your lifetime license to a Premium Hard Durable Plastic card: $ $. Contribution to Hunters for the Hungry : $ $ $ $ $ $.

3 *For License information refer to page 2 TOTAL AMOUNT DUE $. *Hunting Lifetime License Qualification Must have at least one to qualify for the hunting lifetime license: I have a Hunter Education Certificate: Required for persons between the ages of 12 and 16 old and those that had never held a hunting license after the age of 18: Provide Certificate State, Date and Number: _____. _____. I have previously been issued a hunting license I am under the age of 12 and exempt from Hunter Education requirements until age 12. (Note: The Apprentice license does not qualify as a hunting license.). Proof of Virginia Residency and Age Requirement; submit a readable photocopy of one of the documents listed below: Valid Virginia driver's license Valid DMV ID card Applicant's Certification By signing this application, I certify that the above information is true and correct.

4 Any person who knowingly makes a false statement in order to secure a license shall be guilty of a Class 2 misdemeanor, punishable by up to six months in jail, a fine of up to $1,000 or both. Signature: _____ Date: _____. LTL-RESAGE-0818 Instructions on second page. INSTRUCTIONS (Please allow up to 45 days for processing.). Print and complete the Lifetime License application form . If purchasing this license as a gift the purchaser must complete the application with the applicant's information and send to us along with a completed and signed Certification of Applicant form . The Certification of Applicant form can be found by clicking on the hyperlink or visiting.

5 The applicant must qualify and supply proof of Virginia residency to buy a resident license. This license is valid for the lifetime of the license holder even if the license holder becomes a nonresident of the Commonwealth subsequent to the purchase of the license. The Agency will accept proof of residency from one of the following: a copy of a valid Virginia driver's license or a valid Virginia DMV identification card. When purchasing a Junior Lifetime Hunting License or if the applicant is under 16 years of age complete and submit a Certification of Applicant form along with a completed application. All applicants must meet Hunter Education requirements if applying for a lifetime hunting license.

6 (Not applicable on the Junior Hunting License see below.) Persons age 12 thru 15 receiving a hunting license must submit a copy of their Hunter Education Certificate with the application. The Junior Lifetime Hunting License will be valid for hunting when a child is accompanied and directly supervised by a properly licensed adult. Upon the child's 12th birthday, this license shall become invalid and shall remain invalid until certification of completion in hunter education is received. To request a new validated card, please submit the Youth Hunter Education Compliance form . All lifetime licensees are required to obtain all additional state and local licenses, permits and stamps as required by law.

7 The lifetime hunting represents the basic state small game license. See the hunting and fishing regulations which are available where licenses are sold or on our web site at Select the license(s) you wish to purchase. Verify that you submit copies of all required documents. Sign and date the application. The application must be signed by the applicant unless it is a gift. Include a PERSONAL CHECK, MONEY ORDER or CASHIER'S CHECK made payable to the TREASURER OF VIRGINIA. Return this application with all supporting documents and payment to: DEPARTMENT of Game and INLAND FISHERIES Attention: Lifetime License Sales Box 2978. Henrico, VA 23228-9700. LIFETIME LICENSE INFORMATION.

8 There is an option on the application to upgrade this lifetime license request to new premium hard durable plastic card for a $ fee. The Hunting lifetime license is the state resident hunting license and is valid for small game only. You are still REQUIRED to obtain any additional licenses or permits in addition to the lifetime hunting if you participate in these activities: Which may include for the hunting season bear, deer and turkey license, archery license, muzzleloader license, bonus deer permit, state or national forest permit, and migratory stamps. The Saltwater lifetime licenses is sold in cooperation with Virginia Marine Resources Commission (MRC). Residents 65 and older: You are not required to buy a Saltwater Fishing License, but you are required to register annually with the Fisherman Identification Program (FIP) by visiting You have the option of purchasing the above lifetime saltwater license for $ to avoid the annual FIP registration process.

9 For further questions on the FIP program please call (757) 247-2200. Visit for purchasing of additional annual licenses if needed. LTL-RESAGE-0818 Instructions Pag


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