OKLAHOMA DEPARTMENT OF WILDLIFE CONSERVATION

Physical Address:                                                Mailing address:

1801 N. Lincoln                                                  P.O. Box 53465

Oklahoma City, OK 73105                              Oklahoma City, OK 73152

(405) 521-3851

APPLICATION TO REPLACE AN ANNUAL LICENSE

In order for the Department of Wildlife to issue a replacement for a lost or destroyed license, this application must be completed, signed by the license holder, and returned to the Department of Wildlife with the $1.50 replacement fee.

RESIDENCY:     RESIDENT        NONRESIDENT

LICENSE TO BE REPLACED:      FISHING           HUNTING         COMBINATION

                                                                 DEER       TURKEY      LAKE TEXOMA

                                                                 OTHER _____________________________________________________

STORE WHERE PURCHASED _______________________________________________________________

ADDRESS __________________________________________________________________________________

PLEASE PRINT OR TYPE:

NAME ______________________________________________________________________________

                                Last Name                                               First Name                                                              Middle Initial

ADDRESS ___________________________________________________________________________

CITY ________________________________     STATE _______      ZIP CODE __________ - _______

DRIVER’S LICENSE NUMBER _______ - ______ - _______     DATE OF BIRTH _____/_____/_____

                                                                                    REQUIRED                                                                      REQUIRED

LICENSE NUMBER _______________     ISSUE DATE _____/_____/_____

                                                    If Known                                                          If Known

HUNTER EDUCATION NUMBER _________________________

I do hereby swear that the above license has been destroyed or lost. It is not now in my possession, nor has it been transferred to another individual. If the above mentioned license is found after the issuance of a replacement, I swear that I will forward it to the Department of Wildlife at the above address.

_____________________________________________                  (_______) _______ - __________

Signature of License Holder                                                                                    Phone Number