APPLICATION
Lifetime Hunting & Fishing License for Resident Disabled Veterans
This license shall be issued only to an individual resident of North Carolina who is a fifty percent or more disabled
veteran as determined by the U.S. Department of Veterans Affairs, remaining valid for the lifetime of the individual so long
as the individual remains fifty percent or more disabled. Certification from the Department of Veterans Affairs must be
submitted with this application.
Applicant’s Name:
Telephone # (
First
Middle
)
Last
Resident Address:
Street
City
State
Zip Code
City
State
Zip Code
Mailing Address (if different from above):
Street or PO Box
Birth Date:
NC Driver License #
WRC Customer # (if available)
Email Address:
Are you certified by the Dept. of Veterans Affairs as a 50% or more disabled veteran?
Yes If yes, attached a copy of the Certification.
No
If no, you must obtain this Certification prior to applying.
Incomplete applications and those received without proper VA documentation will be returned. For your convenience, we have attached a
certification form you may take to your local County or State Veterans Service Office for completion.
Check Appropriate Box(s)
Lifetime Disabled Veteran Fishing Only Licenses
Inland Fishing (basic) – Statewide inland fishing. Includes fishing in designated Public Mountain Trout Waters, fishing in trout waters on ...................... $10
game lands, and fishing in joint waters. It does not include fishing in coastal waters.
Coastal Recreational Fishing – Authorizes fishing in coastal and joint waters. It does not authorize fishing in inland waters. .......................................... $10
Lifetime Disabled Veteran Hunting & Fishing Licenses
Hunting/Inland Fishing Combo (basic) – Statewide basic hunting and inland fishing. Includes fishing in designated Public Mountain Trout ............ $10
Waters, fishing in trout waters on game lands, and fishing in joint waters. It does not include fishing in coastal waters.
Sportsman – Statewide hunting and inland fishing. Includes hunting for big game, hunting on game lands, hunting for waterfowl (does not include ........ $100
the bear management e-stamp or federal duck stamp), fishing in designated Public Mountain Trout Waters, fishing in trout waters on game lands,
and fishing in joint waters. It does not include fishing in coastal waters.
Sportsman/Coastal Recreational Fishing – Statewide hunting, inland and coastal recreational fishing. Includes hunting for big game, hunting on........... $110
game lands, hunting for waterfowl (does not include the bear management e-stamp or federal duck stamp), fishing in designated Public Mountain
Trout Waters, fishing in trout waters on game lands, and fishing in joint waters.
Bear Management E-Stamp – This electronic stamp is required to hunt bear. This e-stamp must be purchased annually, if hunting bear. ........................ $10
Federal Duck Stamp – This stamp is required for waterfowl hunters 16 years of age and older. This stamp expires June 30 of each year……………....$26.50
Purchase Subtotal
Plus Transaction Fee
Purchase Total
$
$
$
2.00*
*Transaction fee mandated by NCGS 113-270.1B.
COMPLETE THIS SECTION IF YOU ARE APPLYING FOR A LICENSE WITH HUNTING PRIVILEGES.
Unless otherwise indicated below, a person may not purchase a hunting license or hunt in NC without having a Certificate of Competency for completing a hunter
education course or had a NC hunting license effective prior to July 1, 2013.
Check one of the following:
I have had a North Carolina hunting license effective prior to July 1, 2013.
I have successfully completed a hunter education course. Hunter Education Certificate Number:
I have NOT successfully completed a hunter education course and understand that until I do so, when hunting I must be accompanied by an adult 18 years
of age or older who is properly licensed to hunt in North Carolina. “Accompanied” is defined as maintaining a proximity to the hunter, which enables the
adult to monitor the activities of the hunter by remaining within sight and hearing distance at all times without the use of electronic devices.
I certify that all information provided on this application is true and accurate and understand that providing false information
to obtain a license is a Class 1 misdemeanor. Signature
Date
Mail application and fee (payable to NCWRC) to:
Transactions are not considered final until the check has cleared the bank. Items purchased
with a returned check will be made invalid. A Service Charge of up to $25 will be charged on
returned checks (G.S. 25-3-506).
North Carolina Wildlife Resources Commission
License Section
1707 Mail Service Center
Raleigh, NC 27699-1700
Call for priority mail (UPS, Fed. Ex.) Instructions
Office Location: NCSU Centennial Campus, 1751 Varsity Drive, Raleigh, NC
Website: www.ncwildlife.org
Telephone:
1-888-248-6834
Revised 11/2016
NCDVA - 50
CERTIFICATION
Lifetime Hunting and Fishing License for a
Fifty Percent or More Resident Disabled Veteran
SECTION 1: Veteran’s Information
Veteran’s Name: _____________________________________________ Telephone: (___)__________
First
Middle
Last
Address: ____________________________________________________________________________
Street
City
State
Zip Code
VA File No. : ____________________________ Veteran’s Date of Birth: _______________________
_____________________________________________________________________________________
SECTION 2: North Carolina Division of Veterans Affairs (To be completed by an NCDVA
accredited Veterans Service Officer/Veterans Service Technician)
I certify, according to evidence of record, the above veteran is 50% or more disabled as determined
by the U. S. Department of Veterans Affairs. (GA 113-270.1C[b] [4])
_________________________________________
Printed Name of Service Officer/Technician
____________________
Date
________________________________
VSC/County Location
_________________________________________________________
Signature of NCDVA Accredited Representative