|
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.
|
