Form SFN6071 "Application for Duplicate Resident or Nonresident Lottery/Bow License Tags" - North Dakota

What Is Form SFN6071?

This is a legal form that was released by the North Dakota Game and Fish Department - a government authority operating within North Dakota. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 19, 2019;
  • The latest edition provided by the North Dakota Game and Fish Department;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form SFN6071 by clicking the link below or browse more documents and templates provided by the North Dakota Game and Fish Department.

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Download Form SFN6071 "Application for Duplicate Resident or Nonresident Lottery/Bow License Tags" - North Dakota

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APPLICATION FOR DUPLICATE RESIDENT OR NONRESIDENT
LOTTERY/BOW LICENSE TAGS
MAIL APPLICATION AND FEE TO:
North Dakota Game and Fish Department
Attn: Duplicate
Licensing Section SFN 6071 (06/19/2019)
NDGFD
100 N. Bismarck Expressway
Bismarck, North Dakota 58501-5095
Phone: (701) 328-6335
Please complete ENTIRELY and PRINT legibly.
Full Legal Name:
Date of Birth:
Sex:
Height:
Address:
Weight:
Eye Color:
Hair Color:
City:
State:
ZIP+4:
*Social Security Number (last 4 digits):
Telephone:
Driver’s License No. or Nondriver Photo ID No.: State:
Hunter Education Number:
State Issued:
A Hunter Education course is required by law for all hunters born after December 1961; enter in your certificate number and the
state you passed the course in. If you do not have a number, enter the year you took the course and the state.
I hereby petition the North Dakota Game and Fish Department Director for duplicate lottery/gratis/bow license tag(s) as provided for in
Section 20.1-02-05(21), NDCC. I understand that I may obtain a duplicate North Dakota resident or nonresident lottery/gratis/bow license
tag(s) to replace the lost or destroyed lottery/gratis/bow license tag(s). I will furnish the information requested so that the department
may review the request and check the license records for verification. I will return the original lottery/gratis/bow tag to the Bismarck office
promptly if/when found.
Place original license was purchased: Applicant’s Signature:
Date:____________________
State of:_________________________
County of:________________________
This record was acknowledged before me on ____________ by __________________________
(Date)
(Name of Individual)
Signature of Notarial Officer:___________________________________________________
NOTARY STAMP
*Notary is not required if identity is verified by GNF Staff.
F E E S
YOUTH (UNDER 16)
TAG #
NON-RESIDENT
RESIDENT/GRATIS
RESIDENT/GRATIS
[ X     ]
Application Fee
$2.00
$2.00
$2.00
[
    ]
Deer Bow
$20.00
$4.00
$8.00
Deer Gun
$20.00
$4.00
$8.00
[
    ]
[
    ]
Pronghorn
$20.00
$4.00
$8.00
[
    ]
Wild Turkey
$2.00
$2.00
$2.00
[
    ]
Swan
$3.00
$1.00
$1.00
Moose Elk Sheep (circle)
$4.00
$8.00
TOTAL
$
$
$
North Dakota Game and Fish Department use only:
(Staff/Warden sign below when lottery/gratis/bow license tag(s) has been issued.)
Signature:_____________________________________________________________Date:__________________Badge #:_______
*In compliance with the Federal Privacy Act of 1974, the disclosure of the individual’s social security number on this form is mandatory pursuant to North Dakota Century Code
43-50-02. The individual’s social security number is used for identification purposes and the national database to determine eligibility for licensure and detect violations of law or
regulations. Penalty for the applicant not including the Social Security Number on their application will cause the application to not be processed.
APPLICATION FOR DUPLICATE RESIDENT OR NONRESIDENT
LOTTERY/BOW LICENSE TAGS
MAIL APPLICATION AND FEE TO:
North Dakota Game and Fish Department
Attn: Duplicate
Licensing Section SFN 6071 (06/19/2019)
NDGFD
100 N. Bismarck Expressway
Bismarck, North Dakota 58501-5095
Phone: (701) 328-6335
Please complete ENTIRELY and PRINT legibly.
Full Legal Name:
Date of Birth:
Sex:
Height:
Address:
Weight:
Eye Color:
Hair Color:
City:
State:
ZIP+4:
*Social Security Number (last 4 digits):
Telephone:
Driver’s License No. or Nondriver Photo ID No.: State:
Hunter Education Number:
State Issued:
A Hunter Education course is required by law for all hunters born after December 1961; enter in your certificate number and the
state you passed the course in. If you do not have a number, enter the year you took the course and the state.
I hereby petition the North Dakota Game and Fish Department Director for duplicate lottery/gratis/bow license tag(s) as provided for in
Section 20.1-02-05(21), NDCC. I understand that I may obtain a duplicate North Dakota resident or nonresident lottery/gratis/bow license
tag(s) to replace the lost or destroyed lottery/gratis/bow license tag(s). I will furnish the information requested so that the department
may review the request and check the license records for verification. I will return the original lottery/gratis/bow tag to the Bismarck office
promptly if/when found.
Place original license was purchased: Applicant’s Signature:
Date:____________________
State of:_________________________
County of:________________________
This record was acknowledged before me on ____________ by __________________________
(Date)
(Name of Individual)
Signature of Notarial Officer:___________________________________________________
NOTARY STAMP
*Notary is not required if identity is verified by GNF Staff.
F E E S
YOUTH (UNDER 16)
TAG #
NON-RESIDENT
RESIDENT/GRATIS
RESIDENT/GRATIS
[ X     ]
Application Fee
$2.00
$2.00
$2.00
[
    ]
Deer Bow
$20.00
$4.00
$8.00
Deer Gun
$20.00
$4.00
$8.00
[
    ]
[
    ]
Pronghorn
$20.00
$4.00
$8.00
[
    ]
Wild Turkey
$2.00
$2.00
$2.00
[
    ]
Swan
$3.00
$1.00
$1.00
Moose Elk Sheep (circle)
$4.00
$8.00
TOTAL
$
$
$
North Dakota Game and Fish Department use only:
(Staff/Warden sign below when lottery/gratis/bow license tag(s) has been issued.)
Signature:_____________________________________________________________Date:__________________Badge #:_______
*In compliance with the Federal Privacy Act of 1974, the disclosure of the individual’s social security number on this form is mandatory pursuant to North Dakota Century Code
43-50-02. The individual’s social security number is used for identification purposes and the national database to determine eligibility for licensure and detect violations of law or
regulations. Penalty for the applicant not including the Social Security Number on their application will cause the application to not be processed.