Office use only.

Application number

APPLICATION FOR PADDLEFISH PERMIT

Fees:
Resident $21
Nonresident $41

Paddlefish Archery Permit Paddlefish Snagging Permit

First name Middle initial Last name

Address - Street / P.O. Box / Rural Route and Box Number

City State ZIP

Daytime Telephone Social Security Number (last 4 digits)

Date of birth - Month: Day: Year: Sex:

Hair color: Eye color: Height: ft. in. Weight:

Buddy permit (attach second application form along with fee and enclose in same envelope)

E-mail address

VISA MasterCard Card number:

Card Expiration Date/Verification #

Ü see illustration
3-digit card
verification No.
on back of card

Please note that the applicant must be 12 years old by the second Saturday of July to apply for an archery tag and by
Oct. 1 to apply for a snagging permit. The application fee is refunded if applicant is unsuccessful in the draw.

Send this application with appropriate fee to:

Nebraska Game and Parks Commission
2200 N 33rd St. P.O. Box 30370
Lincoln, NE 68503-0370