8100-FM-FR0052 6/2014
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF CONSERVATION AND NATURAL RESOURCES
BUREAU OF FORESTRY
REQUEST FOR PERMISSION TO SUB-LET
Date: ___________________________
I hereby apply for permission to sub-let Forest Camp Lease Number: ________________________________to:
_________________________________________________________________________________________
(Print Name and Address of Sub-Tenant)
during the following period:_____________________________ to _________________________________
for the amount of _____________________dollars ($________________)
E
My reason(s) for sub-letting are: _______________________________________________________________
_________________________________________________________________________________________
PL
_________________________________________________________________________________________
(Lessee’s Signature)
M
I, the undersigned, hereby agree that if permission to sub-let Forest Camp Lease Number:______________
is granted by the Department of Conservation and Natural Resources, I shall assume responsibility for the
actions of the members of my party. I am familiar with the Rules and Regulations for the State Forests as well
as the Guidelines for Leased Forest Campsites.
SA
NOTICE TO LESSEE: LESSEE is also responsible for the conduct and actions of any and all guests that use
the aforementioned leased campsite, including those sub-letting this site.
Print Names and addresses of party members:
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
Date: ____________________________________
_________________________________________
(Signature of Sub-Tenant)
Please send completed form directly to the local District Forester sufficiently in advance to permit their
action before the effective dates of sub-letting.
For Department Use Only
The above request has been [Approved / Denied] on ___________________________________________
By: ________________________________
District Forester:_______________________________
Department of Conservation and Natural Resources