Home : Licenses & Permits : Mallard Control Permit : Application

THIS IS A FREE PERMIT.
(Chapter 68A, Florida Administrative Code)

 

Mallard Control Permit
Florida Fish and Wildlife Conservation Commission
Division of Hunting and Game Management

620 S. Meridian St., Tallahassee, Florida 32399-1600
Ph: 850-488-5878 * Fax: 850-488-5884


First Name     Last Name  
Date of Birth (mm/dd/yyyy)                         

Name of business, agency, or association (if applicable): (special characters are not allowed, !@#$%&*)

Type of business or association

Address

City     State     Zip

Phone number     Alternate phone number    Fax number

Email address
    (we are requesting your email address in order to contact you regarding permit reporting deadlines)
Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing.


Have you ever been convicted or found guilty, of any criminal or non-criminal violation, regardless of adjudication, or plea entered, of any fisheries or wildlife violation (including a violation of Chapters 379, 370, 372, F.S.; rules of the Commission; similar laws or rules in another jurisdiction)?
Yes No  

If yes, please explain and list the type(s) of violation(s) cited and the county/state where the violation occurred: 
 

Have you ever had a fisheries or wildlife related permit suspended or revoked?
  Yes  No

If yes, please explain:
 

Certification: I hereby swear and affirm by signature that the information submitted in this application and supporting documents is complete and accurate to the best of my knowledge and belief. I understand that any false statement herein may subject me to criminal penalties. I further state that I will abide by all applicable State, Federal, and local laws.  Any false statements or misrepresentations when applying for this license may result in felony charges and will result in revocation of this license. By signing this document, I also agree to comply with the reporting and notification requirements outlined in the provisions of the permit.

Yes, I certify this information is complete and accurate to the best of my knowledge.