Form SLAP22.43 "Wildlife Depredation Permit Application Form" - Nevada

What Is Form SLAP22.43?

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

Form Details:

  • Released on October 1, 2010;
  • 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 SLAP22.43 by clicking the link below or browse more documents and templates provided by the Nevada Department of Wildlife.

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Download Form SLAP22.43 "Wildlife Depredation Permit Application Form" - Nevada

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____________________________________________________________________________________________________________
APPLICATION
WILDLIFE DEPREDATION PERMIT
Fee:
$0
(22.43)
Please PRINT all information except for your signature. Incomplete or illegible applications will be returned.
I hereby make application for a Wildlife Depredation Permit.
APPLICANT INFORMATION
TAX ID:
SPORTSMAN’S ID or SSN:
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
:
OCCUPATION
EMPLOYER:
1. Species of wildlife causing damage: ________________________________________________________
2. The nature of the crops or other property being injured: _________________________________________
_____________________________________________________________________________________
3. The extent of the injury or damage: ________________________________________________________
________________________________________________________________________________________
4. Location of the land or property that is being damaged or destroyed on in immediate danger of being
damaged.
______________________________________________________________________________________
5. Method recommended to control or eradicate problem animals: __________________________________
________________________________________________________________________________________
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 22.43
Rev. Oct 2010
Page 1 of 2
____________________________________________________________________________________________________________
APPLICATION
WILDLIFE DEPREDATION PERMIT
Fee:
$0
(22.43)
Please PRINT all information except for your signature. Incomplete or illegible applications will be returned.
I hereby make application for a Wildlife Depredation Permit.
APPLICANT INFORMATION
TAX ID:
SPORTSMAN’S ID or SSN:
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
:
OCCUPATION
EMPLOYER:
1. Species of wildlife causing damage: ________________________________________________________
2. The nature of the crops or other property being injured: _________________________________________
_____________________________________________________________________________________
3. The extent of the injury or damage: ________________________________________________________
________________________________________________________________________________________
4. Location of the land or property that is being damaged or destroyed on in immediate danger of being
damaged.
______________________________________________________________________________________
5. Method recommended to control or eradicate problem animals: __________________________________
________________________________________________________________________________________
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 22.43
Rev. Oct 2010
Page 1 of 2
Submit your completed application to the appropriate office below:
Western Region
Southern Region
Nevada Department of Wildlife
Nevada Department of Wildlife
Special Licenses and Permits
4747 Vegas Dr.; Las Vegas, NV 89108
1100 Valley Rd, Reno, NV 89512
Telephone: (702) 486-5127
Telephone: (775) 688-1500
Counties: Clark, Esmeralda, Lincoln, Nye
Counties: Carson City, Churchill, Douglas,
Humboldt, Lyon, Mineral, Pershing, Storey,
Washoe
Eastern Region
Nevada Department of Wildlife
60 Youth Center Road; Elko, NV 89801
Telephone: (775) 777-2300
Counties: Elko, Eureka, Lander, White Pine
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 22.43
Rev. Oct 2010
Page 2 of 2
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