Idaho Outfitter Certification Form - Idaho

This "Idaho Outfitter Certification Form" is a document issued by the Idaho Department of Fish and Game specifically for Idaho residents with its latest version released on June 1, 2017.

Download the up-to-date fillable PDF by clicking the link below or find it on the forms website of the Idaho Department of Fish and Game.

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IDAHO OUTFITTER CERTIFICATION
Outfitter Business Name _________________________________________________
Outfitter License No. ____________________________________________________
Address _______________________________________________________________
Telephone No. _________________________________________________________
City/State/Zip _________________________________________________________
I, the undersigned, certify that the following individual(s) have contracted for outfitting services for a big game hunt for license year
(year) ________________________ (Outfitter Signature) _____________________________________________________ and that a deposit fee has been received for the hunt:
*Includes Access/Depredation Fee
Name ________________________________________________________________
License
*Combination .......................... $250.00 o
*Jr. Mentored Hunt .....................$35.75 o
Mailing Address ________________________________________________________
*Adult Hunt 3/Day Fish ........... $164.75 o
begin fish date (mm/dd/yy) _______ /_______/ _______
City ___________________ State______________ Zip ________________________
*Disabled American Veteran1 ..... $35.75 o
Soc. Sec No. _______ -________ -_________(required by law)
begin fish date (mm/dd/yy)______ /_______/ ________
Elk
Gender _______________ Height_______________ Weight ____________________
Adult ........... $416.75 o
Jr. Mentor/DAV....... $39.75 o
Unit No. _________
Zone ________________________________________________________ A o B o
Eye Color ______________ Hair Color _________________
Deer
Date of Birth (mm/dd/yy) ______ / ______ / _____ Telephone (
) ______- _______
Adult ......................................... $301.75
o Regular
o White Tail
Jr. Mentor/DAV ........................ $23.75
o Regular
o White Tail
Archery Education No. ___________________________________________________
Bear
(or previous archery permit or attached signed affidavit)
(intended hunt unit ______________)
Regular $186.00 o
(intended hunt unit ______________)
Reduced $41.75 o
Hunter Education No. ___________________________________________________
(required if born after January 1,1975)
(intended hunt unit ______________)
2nd $41.75 o
(intended hunt unit ______________)
Jr. Mentored/DAV $23.75 o
Driver’s License No. _____________________________________________________
Mt. Lion
(optional information)
(intended hunt unit ______________)
Regular $186.00 o
(intended hunt unit ______________)
Reduced $41.75 o
DL. expire date (mm/dd/yy) ______ /_______ /_______ DL. St. _________________
(intended hunt unit ______________)
2nd $41.75 o
Wolf (# requested up to 5____________)
IDAHO FISH AND GAME OFFICE USE ONLY
(intended hunt unit ______________)
$31.75 o
Permits
License No. Issued ______________________________________
Archery $20.00 o
Muzzleloader $20.00 o
Sage/Sharptail Grouse $4.75 o
Migratory Bird $4.75 o
Tag No.’s Issued ________________________________________
TOTAL AMOUNT OF PURCHASE .................................................. $ ____________
1. 40% or greater service connect Veteran. Documents from VA required.
*Includes Access/Depredation Fee
Name ________________________________________________________________
License
*Combination .......................... $250.00 o
*Jr. Mentored Hunt .....................$35.75 o
Mailing Address ________________________________________________________
*Adult Hunt 3/Day Fish ........... $164.75 o
begin fish date (mm/dd/yy) _______ /_______/ _______
City ___________________ State______________ Zip ________________________
*Disabled American Veteran1 ..... $35.75 o
Soc. Sec No. _______ -________ -_________(required by law)
begin fish date (mm/dd/yy)______ /_______/ ________
Elk
Gender _______________ Height_______________ Weight ____________________
Adult ........... $416.75 o
Jr. Mentor/DAV....... $39.75 o
Unit No. _________
Zone ________________________________________________________ A o B o
Eye Color ______________ Hair Color _________________
Deer
Adult ......................................... $301.75
o Regular
o White Tail
Date of Birth (mm/dd/yy) ______ / ______ / _____ Telephone (
) ______- _______
Jr. Mentor/DAV ........................ $23.75
o Regular
o White Tail
Archery Education No. ___________________________________________________
Bear
(or previous archery permit or attached signed affidavit)
(intended hunt unit ______________)
Regular $186.00 o
(intended hunt unit ______________)
Reduced $41.75 o
Hunter Education No. ___________________________________________________
(required if born after January 1,1975)
(intended hunt unit ______________)
2nd $41.75 o
(intended hunt unit ______________)
Jr. Mentored/DAV $23.75 o
Driver’s License No. _____________________________________________________
Mt. Lion
(optional information)
(intended hunt unit ______________)
Regular $186.00 o
(intended hunt unit ______________)
Reduced $41.75 o
DL. expire date (mm/dd/yy) ______ /_______ /_______ DL. St. _________________
(intended hunt unit ______________)
2nd $41.75 o
Wolf (# requested up to 5____________)
IDAHO FISH AND GAME OFFICE USE ONLY
(intended hunt unit ______________)
$31.75 o
Permits
License No. Issued ______________________________________
Archery $20.00 o
Muzzleloader $20.00 o
Sage/Sharptail Grouse $4.75 o
Migratory Bird $4.75 o
Tag No.’s Issued ________________________________________
TOTAL AMOUNT OF PURCHASE .................................................. $ ____________
1. 40% or greater service connect Veteran. Documents from VA required.
IDAHO FISH AND GAME OFFICE USE ONLY
Date Received (mm/dd/yy) _____________ / _________ / __________
Amount Received Check/Check $ _______________________________
Date Documents Issued (mm/dd/yy) _____________/ __________/ __________
Date Documents Mailed (mm/dd/yy) ____________ /__________ /________
Distribution: Outfitter; Outfitters and Guides Licensing Board; IDFG Regional Office.
REV 6/17
IDAHO OUTFITTER CERTIFICATION
Outfitter Business Name _________________________________________________
Outfitter License No. ____________________________________________________
Address _______________________________________________________________
Telephone No. _________________________________________________________
City/State/Zip _________________________________________________________
I, the undersigned, certify that the following individual(s) have contracted for outfitting services for a big game hunt for license year
(year) ________________________ (Outfitter Signature) _____________________________________________________ and that a deposit fee has been received for the hunt:
*Includes Access/Depredation Fee
Name ________________________________________________________________
License
*Combination .......................... $250.00 o
*Jr. Mentored Hunt .....................$35.75 o
Mailing Address ________________________________________________________
*Adult Hunt 3/Day Fish ........... $164.75 o
begin fish date (mm/dd/yy) _______ /_______/ _______
City ___________________ State______________ Zip ________________________
*Disabled American Veteran1 ..... $35.75 o
Soc. Sec No. _______ -________ -_________(required by law)
begin fish date (mm/dd/yy)______ /_______/ ________
Elk
Gender _______________ Height_______________ Weight ____________________
Adult ........... $416.75 o
Jr. Mentor/DAV....... $39.75 o
Unit No. _________
Zone ________________________________________________________ A o B o
Eye Color ______________ Hair Color _________________
Deer
Date of Birth (mm/dd/yy) ______ / ______ / _____ Telephone (
) ______- _______
Adult ......................................... $301.75
o Regular
o White Tail
Jr. Mentor/DAV ........................ $23.75
o Regular
o White Tail
Archery Education No. ___________________________________________________
Bear
(or previous archery permit or attached signed affidavit)
(intended hunt unit ______________)
Regular $186.00 o
(intended hunt unit ______________)
Reduced $41.75 o
Hunter Education No. ___________________________________________________
(required if born after January 1,1975)
(intended hunt unit ______________)
2nd $41.75 o
(intended hunt unit ______________)
Jr. Mentored/DAV $23.75 o
Driver’s License No. _____________________________________________________
Mt. Lion
(optional information)
(intended hunt unit ______________)
Regular $186.00 o
(intended hunt unit ______________)
Reduced $41.75 o
DL. expire date (mm/dd/yy) ______ /_______ /_______ DL. St. _________________
(intended hunt unit ______________)
2nd $41.75 o
Wolf (# requested up to 5____________)
IDAHO FISH AND GAME OFFICE USE ONLY
(intended hunt unit ______________)
$31.75 o
Permits
License No. Issued ______________________________________
Archery $20.00 o
Muzzleloader $20.00 o
Sage/Sharptail Grouse $4.75 o
Migratory Bird $4.75 o
Tag No.’s Issued ________________________________________
TOTAL AMOUNT OF PURCHASE .................................................. $ ____________
1. 40% or greater service connect Veteran. Documents from VA required.
*Includes Access/Depredation Fee
Name ________________________________________________________________
License
*Combination .......................... $250.00 o
*Jr. Mentored Hunt .....................$35.75 o
Mailing Address ________________________________________________________
*Adult Hunt 3/Day Fish ........... $164.75 o
begin fish date (mm/dd/yy) _______ /_______/ _______
City ___________________ State______________ Zip ________________________
*Disabled American Veteran1 ..... $35.75 o
Soc. Sec No. _______ -________ -_________(required by law)
begin fish date (mm/dd/yy)______ /_______/ ________
Elk
Gender _______________ Height_______________ Weight ____________________
Adult ........... $416.75 o
Jr. Mentor/DAV....... $39.75 o
Unit No. _________
Zone ________________________________________________________ A o B o
Eye Color ______________ Hair Color _________________
Deer
Adult ......................................... $301.75
o Regular
o White Tail
Date of Birth (mm/dd/yy) ______ / ______ / _____ Telephone (
) ______- _______
Jr. Mentor/DAV ........................ $23.75
o Regular
o White Tail
Archery Education No. ___________________________________________________
Bear
(or previous archery permit or attached signed affidavit)
(intended hunt unit ______________)
Regular $186.00 o
(intended hunt unit ______________)
Reduced $41.75 o
Hunter Education No. ___________________________________________________
(required if born after January 1,1975)
(intended hunt unit ______________)
2nd $41.75 o
(intended hunt unit ______________)
Jr. Mentored/DAV $23.75 o
Driver’s License No. _____________________________________________________
Mt. Lion
(optional information)
(intended hunt unit ______________)
Regular $186.00 o
(intended hunt unit ______________)
Reduced $41.75 o
DL. expire date (mm/dd/yy) ______ /_______ /_______ DL. St. _________________
(intended hunt unit ______________)
2nd $41.75 o
Wolf (# requested up to 5____________)
IDAHO FISH AND GAME OFFICE USE ONLY
(intended hunt unit ______________)
$31.75 o
Permits
License No. Issued ______________________________________
Archery $20.00 o
Muzzleloader $20.00 o
Sage/Sharptail Grouse $4.75 o
Migratory Bird $4.75 o
Tag No.’s Issued ________________________________________
TOTAL AMOUNT OF PURCHASE .................................................. $ ____________
1. 40% or greater service connect Veteran. Documents from VA required.
IDAHO FISH AND GAME OFFICE USE ONLY
Date Received (mm/dd/yy) _____________ / _________ / __________
Amount Received Check/Check $ _______________________________
Date Documents Issued (mm/dd/yy) _____________/ __________/ __________
Date Documents Mailed (mm/dd/yy) ____________ /__________ /________
Distribution: Outfitter; Outfitters and Guides Licensing Board; IDFG Regional Office.
REV 6/17

Download Idaho Outfitter Certification Form - Idaho

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