Ohio Resident Lifetime/Multiyear Hunting and Fishing ...

1 Ohio Department of Natural ResourcesDIVISION OF WILDLIFEPLEASE TYPE OR PRINT LEGIBLYMail 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 Resident Lifetime/Multiyear Hunting and Fishing License ApplicationDNR 8939 (1021)INSTRUCTIONS FOR LICENSE APPLICATION1. Complete and sign 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.)

2 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 FIRST NAME MI SOCIAL SECURITY #

3 / / OHIO DRIVER LICENSE/ID # (see required documents) DL STATE DATE OF BIRTH (mm/dd/yyyy) HEIGHT WEIGHT MAILING ADDRESS (street,apartment, box, etc.) CITY STATE ZIP PHYSICAL ADDRESS CITY STATE ZIP

4 ( ) EMAIL ADDRESS (optional) TELEPHONEIf 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 LICENSEENote: Licensee s signature attests to the acceptance of the Rules pertaining to this license, and the conditions set forth in ORC DOCUMENTS TO VERIFY AGE AND RESIDENCY FOR A LIFETIME OR MULTIYEAR LICENSER egular 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).

5 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 TYPECOSTTOTAL less than16 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).

6 $ 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 ..$ Adult 5-year Fishing license ..$ Adult 10-year Fishing license ..$ Adult Lifetime Fishing license (includes Ohio Conservation Card) ..$ + 66 years and older (Ohio Driver License/ID, or eligible supporting documents to verify age and residency) Senior 3-year Fishing license ..$ Senior 5-year Fishing license ..$ Senior Lifetime Fishing license (includes Ohio Conservation Card) ..$ TYPECOSTTOTAL less than18 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 ..$ Youth 5-year Hunting license.

7 $ Youth 10-year Hunting license ..$ Youth Lifetime Hunting license (includes Ohio Conservation Card) ..$ 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 ..$ Adult 5-year Hunting license ..$ Adult 10-year Hunting license ..$ Adult Lifetime Hunting license (includes Ohio Conservation Card) ..$ + 66 years and older (Ohio Driver License/ID, or eligible supporting documents to verify age and residency) Senior 3-year Hunting license ..$ Senior 5-year Hunting license ..$ Senior Lifetime Hunting license (includes Ohio Conservation Card) ..$ TYPECOSTTOTAL Ohio Conservation Card (please allow up to 45 days for delivery) ..$ Total $ _____Any payment amount greater than the required total cost will be considered a donation to the Division of REQUIRED Incomplete applications will be 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.

8 AMOUNT OF CHECK $ SIGNATURE OF APPLICANT DATEIf Mailed, A Notary must certify residency by marking the documents presented and validate to and subscribed before me this _____ day of _____, _____ (seal required)DNR 8939 (0918)FISHINGOHIO CONSERVATION CARDHUNTINGDEFINITIONS: 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.

9 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 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.

10 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 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 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.