Form SLAP22.41 "Application for Permit for the Release of Live Wildlife" - Nevada

What Is Form SLAP22.41?

This is a legal form that was released by the Nevada Department of Wildlife - a government authority operating within Nevada. Check the official instructions before completing and submitting the form.

Form Details:

  • Released on January 1, 2012;
  • The latest edition provided by the Nevada Department of Wildlife;
  • 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 SLAP22.41 by clicking the link below or browse more documents and templates provided by the Nevada Department of Wildlife.

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Download Form SLAP22.41 "Application for Permit for the Release of Live Wildlife" - Nevada

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___________________________________________________________________________________________________________
APPLICATION
PERMIT FOR THE RELEASE OF LIVE WILDLIFE
Fee: $0
(22.41)
Please PRINT all information except for your signature. Incomplete or illegible applications will be returned.
APPLICANT INFORMATION
SPORTSMAN’S ID or SSN:
TAX ID:
DATE OF BIRTH:
NAME [LAST]
[FIRST]
[MIDDLE]
:
PHYSICAL ADDRESS
:
:
:
CITY
STATE
ZIP
:
MAILING ADDRESS
:
:
:
CITY
STATE
ZIP
:
:
:
HOME PHONE
WORK PHONE
E-MAIL ADDRESS
HEIGHT:
WEIGHT:
HAIR:
EYES:
GENDER:
:
:
DRIVER’S LICENSE NUMBER:
STATE
DATE ISSUED
___________________________________________________
1. What is the purpose for the release?
___________________________________________________________________________
2. List both the common and scientific names of each species, and the approximate number of each that you
are requesting to release.
COMMON NAME
SCIENTIFIC NAME
NUMBER
3. Proposed date(s) for the release: __________________________________________________________
4. Name and telephone number of the owner of the property where the wildlife is to be released:
_________________________________________________________________________________
5. The complete address or legal description of the property where you propose to release the wildlife.
__________________________________________________________________________________
6. The specific source (name, address, phone) from where you have or will obtain the wildlife to be released:
___________________________________________________________________________________________
I, the signator, in signing this application, hereby state that I am entitled to this permit under the laws of the
State of Nevada and that no false information or false statement has been made by me to obtain this license.
_____________________________________________________________
__________________________________
Signature of Applicant
Date
____________________________________________________________________________________________________________
STATE OF NEVADA – Department of Wildlife
SLAP 22.41
Rev. Jan 2012
Page 1 of 2
___________________________________________________________________________________________________________
APPLICATION
PERMIT FOR THE RELEASE OF LIVE WILDLIFE
Fee: $0
(22.41)
Please PRINT all information except for your signature. Incomplete or illegible applications will be returned.
APPLICANT INFORMATION
SPORTSMAN’S ID or SSN:
TAX ID:
DATE OF BIRTH:
NAME [LAST]
[FIRST]
[MIDDLE]
:
PHYSICAL ADDRESS
:
:
:
CITY
STATE
ZIP
:
MAILING ADDRESS
:
:
:
CITY
STATE
ZIP
:
:
:
HOME PHONE
WORK PHONE
E-MAIL ADDRESS
HEIGHT:
WEIGHT:
HAIR:
EYES:
GENDER:
:
:
DRIVER’S LICENSE NUMBER:
STATE
DATE ISSUED
___________________________________________________
1. What is the purpose for the release?
___________________________________________________________________________
2. List both the common and scientific names of each species, and the approximate number of each that you
are requesting to release.
COMMON NAME
SCIENTIFIC NAME
NUMBER
3. Proposed date(s) for the release: __________________________________________________________
4. Name and telephone number of the owner of the property where the wildlife is to be released:
_________________________________________________________________________________
5. The complete address or legal description of the property where you propose to release the wildlife.
__________________________________________________________________________________
6. The specific source (name, address, phone) from where you have or will obtain the wildlife to be released:
___________________________________________________________________________________________
I, the signator, in signing this application, hereby state that I am entitled to this permit under the laws of the
State of Nevada and that no false information or false statement has been made by me to obtain this license.
_____________________________________________________________
__________________________________
Signature of Applicant
Date
____________________________________________________________________________________________________________
STATE OF NEVADA – Department of Wildlife
SLAP 22.41
Rev. Jan 2012
Page 1 of 2
Submit your completed application to the appropriate Department office:
For fish and aquatic species:
For birds and terrestrial species:
Nevada Department of Wildlife
Nevada Department of Wildlife
Fisheries Division
Game Division
1100 Valley Road
1100 Valley Road
Reno, NV 89512
Reno, NV 89512
Phone Numbers:
Western Region (Reno)
(775) 688-1500
Eastern Region (Elko)
(775) 777-2300
Southern Region (Las Vegas)
(702) 486-5127
FOR DEPARTMENT USE ONLY
Date Received: _______________
Date Approved: _______________
Date Returned for Additional Information: ____________________
Date Disapproved: _______________
Department Representative:_______________________________
REASON FOR DISAPPROVAL:
____________________________________________________________________________________________________________
STATE OF NEVADA – Department of Wildlife
SLAP 22.41
Rev. Jan 2012
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