Application For Fishing License -Wyoming Game And Fish Department
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1
2(
FIFTY PERCENT
50%) DISABLED VETERAN
APPLICATION FOR FISHING LICENSE
ALL PERSONAL INFORMATION REQUESTED ON THIS FORM IS REQUIRED
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Last Name
First Name
MI
Suffix
SOCIAL SECURITY NUMBER (Last 4 digits required)
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Mailing Address
City
State
Zip Code
|_______________________________________________________________|________________________________________|__________|____________|
Physical Address
City
State
Zip Code
|________|
|__________|
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Weight
Eyes
Hair
Height
DOB (MM/DD/YYYY)
Sex
Daytime Phone # (8AM-5PM M-F)
PROOF OF RESIDENCY (REQUIRED TO BE ELIGIBLE FOR A FIFTY PERCENT (50%) DISABLED VETERAN FISHING LICENSE):
WY Driver’s License Number or WY ID Card Number
YRS WY RES.
ONE of the
Complete the PROOF OF
following must
OR
RESIDENCY form
be provided:
ON REVERSE SIDE
Under penalty of prosecution, I swear that the information given by me on this application is true and correct. I swear, under penalty of prosecution,
that I am a United States citizen and have been a resident of Wyoming and domiciled in Wyoming for not less than one (1) year and have not claimed
residency elsewhere for any purpose during that one (1) year period immediately preceding the date of this application or that I am an alien and have
resided continuously in Wyoming for at least one (1) year immediately prior to the date of this application, and that all information contained herein is
true and correct.
Resident Applicant’s Signature
_________________________________________________________
Date_____________
NO LICENSE WILL BE ISSUED WITHOUT THIS APPLICATION AND RESPECTIVE CERTIFICATION LETTER.
LICENSE REQUIREMENTS (Wyoming State Statutes §23-2-201 (f)):
Any resident disabled veteran who receives fifty percent (50%) or more service connected disability compensation from the United
States Department of Veterans Affairs may apply to the department for a resident disabled veteran's lifetime fishing license. The license
entitles the resident disabled veteran to take any fish within Wyoming at the time, in a place, in a manner and in an amount as provided
by law and the orders of the commission. Valid documentation (official Department of Veterans Affairs or official Armed Forces logo
must be present in the document’s letterhead) must be attached to this application to be considered complete.
Fifty percent (50%) Disabled Veteran Fishing licenses are issued only at Wyoming Game and Fish Department Regional Offices located in JACKSON,
PINEDALE, CODY, SHERIDAN, GREEN RIVER, LARAMIE, LANDER, or CASPER. Applications can be mailed to the headquarters office:
License Section, Wyoming Game and Fish Department, 5400 Bishop Boulevard, Cheyenne WY 82006-0001.
FOR DEPARTMENT USE ONLY
LICENSE #: __________________________
DATE ISSUED: _______________________
ISSUED BY: __________________________
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