Waterfowl Merritt Island NWR Application Worksheet

Transcription

1 1. Please print your Customer ID or driver license number or social security number AND date of birth. Customer ID No. Or Driver License No. Or Social Security No. AND Date of Birth 2. Please print your name. MM / DD / YYYY Phase I APPLICATION PERIODS All periods begin at 10:00 a.m. Eastern time and end at 11:59 p.m. Eastern time September 14, September 24, 2018 Permit Pickup Deadline: October 08, 2018 Phase II October 11, January 14, 2019 First Middle Last 3. Please indicate your 4-digit hunt choice(s) (# that appears to the left of each hunt) in the boxes provided. 1st Choice 2nd Choice 3rd Choice 4th Choice 5th Choice 4. You can apply online at (choose 'Apply for Limited Entry/Quota Permits') or you can complete this form and present it to any license agent or tax collector office and they will submit your application for you. Submitting false information or using another person s identity without their consent is considered identity theft and may result in felony charges and the loss of hunting privileges. The Florida Fish and Wildlife Conservation Commission (FWC) collects social security numbers (SSN) for the issuance of recreational and professional fishing or hunting licenses or permits to an individual in accordance with chapter 379 F.S. and 42 USC 666 for the purposes of administration of the Title IV-D program for child support enforcement, use by the Commission, and as otherwise provided by law. FOR AGENT USE ONLY To Submit an Application: INSTRUCTIONS FOR TAX COLLECTOR OFFICES AND LICENSE AGENTS In RLIS, navigate to the Customer Lookup Screen and enter the customer s date of birth and customer ID number, Florida Driver s License number, or the last four digits of the customer s Social Security Number and last name. Under the Customer s Detail section, select Apply for Limited Entry/Quota. Choose the appropriate application and proceed through with prompts according to the customer's requests. Verify all permit choice information before submitting, and print document receipt for the customer.

2 2100 Catfish Creek Impoundment November 17-18, $ Catfish Creek Impoundment November 21-22, $ Catfish Creek Impoundment November 24-25, $ Catfish Creek Impoundment December 8-9, $ Catfish Creek Impoundment December 12, $ Catfish Creek Impoundment December 15-16, $ Catfish Creek Impoundment December 19, $ Catfish Creek Impoundment December 22-23, $ Catfish Creek Impoundment December 25-26, $ Catfish Creek Impoundment December 29-30, $ Catfish Creek Impoundment January 1-2, $ Catfish Creek Impoundment January 5-6, $ Catfish Creek Impoundment January 09, $ Catfish Creek Impoundment January 12-13, $ Catfish Creek Impoundment January 16, $ Catfish Creek Impoundment January 19-20, $ Catfish Creek Impoundment January 23, $ Catfish Creek Impoundment January 26-27, $ Gator Creek Impoundment November 17-18, $ Gator Creek Impoundment November 21-22, $ Gator Creek Impoundment November 24-25, $ Gator Creek Impoundment December 8-9, $ Gator Creek Impoundment December 12, $ Gator Creek Impoundment December 15-16, $ Gator Creek Impoundment December 19, $ Gator Creek Impoundment December 22-23, $ Gator Creek Impoundment December 25-26, $ Gator Creek Impoundment December 29-30, $ Gator Creek Impoundment January 1-2, $ Gator Creek Impoundment January 5-6, $ Gator Creek Impoundment January 09, $ Gator Creek Impoundment January 12-13, $ Gator Creek Impoundment January 16, $ Gator Creek Impoundment January 19-20, $ Gator Creek Impoundment January 23, $ Gator Creek Impoundment January 26-27, $ Peacock's Pocket Impoundment November 17-18, $ Peacock's Pocket Impoundment November 21-22, $ Peacock's Pocket Impoundment November 24-25, $ Peacock's Pocket Impoundment December 8-9, $ Peacock's Pocket Impoundment December 12, $ Peacock's Pocket Impoundment December 15-16, $ Peacock's Pocket Impoundment December 19, $ 27.50

3 2307 Peacock's Pocket Impoundment December 22-23, $ Peacock's Pocket Impoundment December 25-26, $ Peacock's Pocket Impoundment December 29-30, $ Peacock's Pocket Impoundment January 1-2, $ Peacock's Pocket Impoundment January 5-6, $ Peacock's Pocket Impoundment January 09, $ Peacock's Pocket Impoundment January 12-13, $ Peacock's Pocket Impoundment January 16, $ Peacock's Pocket Impoundment January 19-20, $ Peacock's Pocket Impoundment January 23, $ Peacock's Pocket Impoundment January 26-27, $ L Pond Impoundment November 17-18, $ L Pond Impoundment November 21-22, $ L Pond Impoundment November 24-25, $ L Pond Impoundment December 8-9, $ L Pond Impoundment December 12, $ L Pond Impoundment December 15-16, $ L Pond Impoundment December 19, $ L Pond Impoundment December 22-23, $ L Pond Impoundment December 25-26, $ L Pond Impoundment December 29-30, $ L Pond Impoundment January 1-2, $ L Pond Impoundment January 5-6, $ L Pond Impoundment January 09, $ L Pond Impoundment January 12-13, $ L Pond Impoundment January 16, $ L Pond Impoundment January 19-20, $ L Pond Impoundment January 23, $ L Pond Impoundment January 26-27, $ M Pond Impoundment November 17-18, $ M Pond Impoundment November 21-22, $ M Pond Impoundment November 24-25, $ M Pond Impoundment December 8-9, $ M Pond Impoundment December 12, $ M Pond Impoundment December 15-16, $ M Pond Impoundment December 19, $ M Pond Impoundment December 22-23, $ M Pond Impoundment December 25-26, $ M Pond Impoundment December 29-30, $ M Pond Impoundment January 1-2, $ M Pond Impoundment January 5-6, $ M Pond Impoundment January 09, $ M Pond Impoundment January 12-13, $ M Pond Impoundment January 16, $ M Pond Impoundment January 19-20, $ 27.50

4 2516 M Pond Impoundment January 23, $ M Pond Impoundment January 26-27, $ Shiloh 1 Impoundment November 17-18, $ Shiloh 1 Impoundment November 21-22, $ Shiloh 1 Impoundment November 24-25, $ Shiloh 1 Impoundment December 8-9, $ Shiloh 1 Impoundment December 12, $ Shiloh 1 Impoundment December 15-16, $ Shiloh 1 Impoundment December 19, $ Shiloh 1 Impoundment December 22-23, $ Shiloh 1 Impoundment December 25-26, $ Shiloh 1 Impoundment December 29-30, $ Shiloh 1 Impoundment January 1-2, $ Shiloh 1 Impoundment January 5-6, $ Shiloh 1 Impoundment January 09, $ Shiloh 1 Impoundment January 12-13, $ Shiloh 1 Impoundment January 16, $ Shiloh 1 Impoundment January 19-20, $ Shiloh 1 Impoundment January 23, $ Shiloh 1 Impoundment January 26-27, $ Shiloh 2 Impoundment November 17-18, $ Shiloh 2 Impoundment November 21-22, $ Shiloh 2 Impoundment November 24-25, $ Shiloh 2 Impoundment December 8-9, $ Shiloh 2 Impoundment December 12, $ Shiloh 2 Impoundment December 15-16, $ Shiloh 2 Impoundment December 19, $ Shiloh 2 Impoundment December 22-23, $ Shiloh 2 Impoundment December 25-26, $ Shiloh 2 Impoundment December 29-30, $ Shiloh 2 Impoundment January 1-2, $ Shiloh 2 Impoundment January 5-6, $ Shiloh 2 Impoundment January 09, $ Shiloh 2 Impoundment January 12-13, $ Shiloh 2 Impoundment January 16, $ Shiloh 2 Impoundment January 19-20, $ Shiloh 2 Impoundment January 23, $ Shiloh 2 Impoundment January 26-27, $ Shiloh 3 Impoundment November 17-18, $ Shiloh 3 Impoundment November 21-22, $ Shiloh 3 Impoundment November 24-25, $ Shiloh 3 Impoundment December 8-9, $ Shiloh 3 Impoundment December 12, $ Shiloh 3 Impoundment December 15-16, $ Shiloh 3 Impoundment December 19, $ 27.50

5 2807 Shiloh 3 Impoundment December 22-23, $ Shiloh 3 Impoundment December 25-26, $ Shiloh 3 Impoundment December 29-30, $ Shiloh 3 Impoundment January 1-2, $ Shiloh 3 Impoundment January 5-6, $ Shiloh 3 Impoundment January 09, $ Shiloh 3 Impoundment January 12-13, $ Shiloh 3 Impoundment January 16, $ Shiloh 3 Impoundment January 19-20, $ Shiloh 3 Impoundment January 23, $ Shiloh 3 Impoundment January 26-27, $ Shiloh 5 Impoundment November 17-18, $ Shiloh 5 Impoundment November 21-22, $ Shiloh 5 Impoundment November 24-25, $ Shiloh 5 Impoundment December 8-9, $ Shiloh 5 Impoundment December 12, $ Shiloh 5 Impoundment December 15-16, $ Shiloh 5 Impoundment December 19, $ Shiloh 5 Impoundment December 22-23, $ Shiloh 5 Impoundment December 25-26, $ Shiloh 5 Impoundment December 29-30, $ Shiloh 5 Impoundment January 1-2, $ Shiloh 5 Impoundment January 5-6, $ Shiloh 5 Impoundment January 09, $ Shiloh 5 Impoundment January 12-13, $ Shiloh 5 Impoundment January 16, $ Shiloh 5 Impoundment January 19-20, $ Shiloh 5 Impoundment January 23, $ Shiloh 5 Impoundment January 26-27, $ East Gator Creek Impoundment November 17-18, $ East Gator Creek Impoundment November 21-22, $ East Gator Creek Impoundment November 24-25, $ East Gator Creek Impoundment December 8-9, $ East Gator Creek Impoundment December 12, $ East Gator Creek Impoundment December 15-16, $ East Gator Creek Impoundment December 19, $ East Gator Creek Impoundment December 22-23, $ East Gator Creek Impoundment December 25-26, $ East Gator Creek Impoundment December 29-30, $ East Gator Creek Impoundment January 1-2, $ East Gator Creek Impoundment January 5-6, $ East Gator Creek Impoundment January 09, $ East Gator Creek Impoundment January 12-13, $ East Gator Creek Impoundment January 16, $ East Gator Creek Impoundment January 19-20, $ 27.50

6 3116 East Gator Creek Impoundment January 23, $ East Gator Creek Impoundment January 26-27, $ 27.50