Oklahoma Resident Lifetime License Application Form - Oklahoma

This "Oklahoma Resident Lifetime License Application Form" is a part of the paperwork released by the Oklahoma Department of Wildlife Conservation specifically for Oklahoma residents.

The latest fillable version of the document was released on July 1, 2014 and can be downloaded through the link below or found through the department's forms library.

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th
Street Address:
2145 NE 36
St
Mailing address:
P.O. Box 53465
Oklahoma City, OK 73111
Oklahoma City, OK 73152
(
405) 521-3852
OKLAHOMA RESIDENT LIFETIME LICENSE APPLICATION
Attn: Veterans who are certified as disabled by the V.A., please contact ODWC for a different application.
[ ] COMBINATION $775.00
Lifetime licenses are available only by mail or in person at ODWC headquarters in Oklahoma City. For
mail-in orders, please allow up to three weeks for processing. License may be purchased with a money order,
[ ] HUNTING $625.00
cashier’s check, credit card, or personal check. If you pay with a personal check, the LICENSE WILL BE HELD
[ ] FISHING $225.00
FOR THREE WEEKS. ** The Payment Plan Option is available to sportsmen under 18, with the first and last
payments requiring residency approval. Minimum payments are $25 and the balance of the license is due 12
[ ] Under Age 18 Payment Plan**
months from the date of the first payment. After 12 months, any prior payments will be forfeited.
Please Print or Type. Complete All Sections. Incomplete Applications will be returned.
FULL LEGAL NAME ___________________________________________________________________________________________________________________
Last Name
First Name
Middle Name
CURRENT ADDRESS __________________________________________________________________________________________________________________
CITY _________________________________________________ STATE ________ ZIP CODE _______________ COUNTY ______________________________
PERMANENT ADDRESS (if different than above) ____________________________________________________________________________________________
CITY _________________________________________________ STATE ________ ZIP CODE _______________ COUNTY ______________________________
YEARS AT CURRENT ADDRESS _____________
MILITARY VETERAN (Check One) ______ YES ______ NO
SOCIAL SECURITY NUMBER (REQUIRED) ______________________________________ DATE OF BIRTH (MM/DD/YYYY) ________/________/________
DRIVER’S LICENSE NUMBER ____________________________________ STATE ________ EXPIRATION DATE ____________ ISSUE DATE____________
HUNTER EDUCATION NUMBER ______________________________________
STATE CERTIFIED __________
(Required if age 30 or under for combination/hunting, or license will be issued with apprentice designation
(If other than Oklahoma, provide photocopy of certificate or card.)
.)
TELEPHONE NUMBER (__________) ____________________________ EMAIL ADDRESS ________________________________________________________
PREVIOUS ADDRESS __________________________________________ CITY ___________________________ STATE __________ ZIP CODE ____________
DID YOU FILE OKLAHOMA INCOME TAXES LAST YEAR? (Check One) ______ YES ______ NO
IF NO, WHAT STATE? ________________________
OCCUPATION _________________________________________________________________ YEARS AT CURRENT EMPLOYER ________________________
EMPLOYER ___________________________________________________________________________________________________________________________
Name
Address
Telephone
*ANY FALSE STATEMENT OR FALSE INFORMATION MAY CONSTITUTE A MISDEMEANOR, FELONY OR OTHER BREACH OF LAW*
I certify under penalty of perjury under the laws of the state of Oklahoma that the above information is true and correct and that I, or the above applicant, has
been a bonafide permanent resident of Oklahoma, as defined in Title 29 of the Oklahoma State statutes, for six months immediately preceding the date of this
application and that the applicant intends to make Oklahoma his/her permanent place of residence.
X__________________________________________________
X___________________________________________________
Signature of Applicant or Preparer (if other than applicant) / Date
Signature of Authorized Department Employee / ID # / Date
Applicant must contact the County Game Warden or authorized Department of Wildlife employee for residency verification and domiciliary intent before mailing
application to Oklahoma City. To prove residency, please provide the following documents: Oklahoma Driver's License and Hunter Education card (if you are 30 years of
age or under). For those individuals who do not drive, residency can be approved with an Oklahoma ID card that is at least 6 months old. If you are under sixteen years of
age, a report card from an Oklahoma school or the parent’s latest Oklahoma tax return listing the child as a dependent will provide the required proof of residency.
*****************************************************************************************************************************
To charge this purchase to your Visa or MasterCard, complete the section below:
For Office Use Only – Resident Lifetime
___ VISA
___ MASTERCARD
___ DISCOVER
License #: _______________
Issued By: ________
Card Number: ________-________-________-________ Exp. Date: ____/____
Card Holder Name: ________________________________________________
Card Holder Address: _______________________________________________
Signature: ________________________________________________________
Rev. 07/2014
th
Street Address:
2145 NE 36
St
Mailing address:
P.O. Box 53465
Oklahoma City, OK 73111
Oklahoma City, OK 73152
(
405) 521-3852
OKLAHOMA RESIDENT LIFETIME LICENSE APPLICATION
Attn: Veterans who are certified as disabled by the V.A., please contact ODWC for a different application.
[ ] COMBINATION $775.00
Lifetime licenses are available only by mail or in person at ODWC headquarters in Oklahoma City. For
mail-in orders, please allow up to three weeks for processing. License may be purchased with a money order,
[ ] HUNTING $625.00
cashier’s check, credit card, or personal check. If you pay with a personal check, the LICENSE WILL BE HELD
[ ] FISHING $225.00
FOR THREE WEEKS. ** The Payment Plan Option is available to sportsmen under 18, with the first and last
payments requiring residency approval. Minimum payments are $25 and the balance of the license is due 12
[ ] Under Age 18 Payment Plan**
months from the date of the first payment. After 12 months, any prior payments will be forfeited.
Please Print or Type. Complete All Sections. Incomplete Applications will be returned.
FULL LEGAL NAME ___________________________________________________________________________________________________________________
Last Name
First Name
Middle Name
CURRENT ADDRESS __________________________________________________________________________________________________________________
CITY _________________________________________________ STATE ________ ZIP CODE _______________ COUNTY ______________________________
PERMANENT ADDRESS (if different than above) ____________________________________________________________________________________________
CITY _________________________________________________ STATE ________ ZIP CODE _______________ COUNTY ______________________________
YEARS AT CURRENT ADDRESS _____________
MILITARY VETERAN (Check One) ______ YES ______ NO
SOCIAL SECURITY NUMBER (REQUIRED) ______________________________________ DATE OF BIRTH (MM/DD/YYYY) ________/________/________
DRIVER’S LICENSE NUMBER ____________________________________ STATE ________ EXPIRATION DATE ____________ ISSUE DATE____________
HUNTER EDUCATION NUMBER ______________________________________
STATE CERTIFIED __________
(Required if age 30 or under for combination/hunting, or license will be issued with apprentice designation
(If other than Oklahoma, provide photocopy of certificate or card.)
.)
TELEPHONE NUMBER (__________) ____________________________ EMAIL ADDRESS ________________________________________________________
PREVIOUS ADDRESS __________________________________________ CITY ___________________________ STATE __________ ZIP CODE ____________
DID YOU FILE OKLAHOMA INCOME TAXES LAST YEAR? (Check One) ______ YES ______ NO
IF NO, WHAT STATE? ________________________
OCCUPATION _________________________________________________________________ YEARS AT CURRENT EMPLOYER ________________________
EMPLOYER ___________________________________________________________________________________________________________________________
Name
Address
Telephone
*ANY FALSE STATEMENT OR FALSE INFORMATION MAY CONSTITUTE A MISDEMEANOR, FELONY OR OTHER BREACH OF LAW*
I certify under penalty of perjury under the laws of the state of Oklahoma that the above information is true and correct and that I, or the above applicant, has
been a bonafide permanent resident of Oklahoma, as defined in Title 29 of the Oklahoma State statutes, for six months immediately preceding the date of this
application and that the applicant intends to make Oklahoma his/her permanent place of residence.
X__________________________________________________
X___________________________________________________
Signature of Applicant or Preparer (if other than applicant) / Date
Signature of Authorized Department Employee / ID # / Date
Applicant must contact the County Game Warden or authorized Department of Wildlife employee for residency verification and domiciliary intent before mailing
application to Oklahoma City. To prove residency, please provide the following documents: Oklahoma Driver's License and Hunter Education card (if you are 30 years of
age or under). For those individuals who do not drive, residency can be approved with an Oklahoma ID card that is at least 6 months old. If you are under sixteen years of
age, a report card from an Oklahoma school or the parent’s latest Oklahoma tax return listing the child as a dependent will provide the required proof of residency.
*****************************************************************************************************************************
To charge this purchase to your Visa or MasterCard, complete the section below:
For Office Use Only – Resident Lifetime
___ VISA
___ MASTERCARD
___ DISCOVER
License #: _______________
Issued By: ________
Card Number: ________-________-________-________ Exp. Date: ____/____
Card Holder Name: ________________________________________________
Card Holder Address: _______________________________________________
Signature: ________________________________________________________
Rev. 07/2014

Download Oklahoma Resident Lifetime License Application Form - Oklahoma

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