Form Gui - Class-A Assistant Guide Or Assistant Guide Biennial License Renewal - Department Of Commerce, Community, And Economic Development Of Alaska Page 2
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1
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3
4
5The following questions must be answered.
RESIDENCY STATUS
YES
NO
Are you a resident of the State of Alaska as defined by AS 16.05(26)?
(See page 4 for full definition)
SINCE YOUR LAST LICENSE WAS ISSUED:
1. Are you aware of any investigations against you, in any state, jurisdiction or in Canada?
Have you:
2. Have you been convicted of a crime or are you currently charged with committing a crime? For purposes
of this question, “crime” includes but is not limited to a misdemeanor, felony, or a military offense,
Including a conviction involving driving under the influence (DUI) or driving while intoxicated (DWI),
driving without a license, reckless driving, or driving with a suspended or revoked license. “Convicted”
includes having been found guilty by verdict of a judge or jury, having entered a plea of guilty, nolo
contendere or no contest, or having been given probation, a suspended imposition of sentence, or a fine.
3. had a professional license denied, revoked, suspended, or otherwise restricted, conditioned,
or limited or have you surrendered a professional license, been fined, placed on probation,
reprimanded, disciplined, or entered into a settlement with a licensing authority in connection with a
professional license you have held in any jurisdiction including Alaska and including that of any military
authorities or is any such action pending?
4. been convicted of violating a state or federal hunting, guiding, or transportation
services statute or regulation?
5. been convicted of a state or federal hunting, guiding, or transportation services statute or
regulation within the last 12 months, for which you received an unsuspended fine of more
than $2,000?
6. been convicted of a state or federal hunting, guiding, or transportation services statute or
regulation within the last 36 months, for which you received an unsuspended fine of more
than $3,000?
7. been convicted of a state or federal hunting, guiding, or transportation services statute or
regulation within the last 60 months, for which you received an unsuspended fine of more
than $5,000?
8. provided big game commercial services illegally?
9. secured or attempted to secure a license through deceit, fraud, or intentional
misrepresentation?
10. failed to comply with a Board order?
11. continued or attempted to provide big game commercial services after becoming unfit due
to professional incompetence?
12. been a state or federal law enforcement officer engaged in fish and wildlife protection in
the past three months?
If “yes,” state the date of your termination:
13. been employed by the Department of Fish and Game or a federal wildlife management agency as a
game or wildlife biologist within the last 12 months?
If “yes,” state your date of employment and the unit(s) you were employed in:
Hire date:
Termination date:
Game Management Unit(s):
CONTINUED ON NEXT PAGE
08-4209 (Rev. 11/06/13)
Page 2
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