Non-Resident Landowner's Application
for a Moose Validation Tag 20
Ministry of Natural
Resources and Forestry
Instructions
•
Applications that are incomplete or illegible will not be accepted. Please print.
•
Submit this application along with proof of property ownership to a participating ServiceOntario centre.
•
Refer to the Hunting Regulations Summary - Information for Non-Residents Wishing to Hunt Moose section for information
on submitting this form.
Notice of Collection of Personal Information:
Personal information is collected under the authority of the Fish and Wildlife Conservation Act, 1997, SO 1997 and will be used
for the purposes of identification, enforcement, research, marketing and administration. While personal information may be
stored outside Canada and subject to the laws of the jurisdiction where it is stored, private companies under contract to provide
the licensing services are contractually obligated to comply with Ontario’s Freedom of Information and Protection of Privacy Act
with regard to personal information in their custody. For information about collection practices contact the Outdoors Card Centre
at 1-800-387-7011.
Part A - Personal Information
Outdoors Card Number
Moose Licence Transaction Number
Last Name
Date of Birth (yyyy/mm/dd)
First Name
Unit Number
Street Number
Middle Initial
Street Name
City/Town
PO Box
Province
Postal Code
Part B - Hunting by a Non-Resident Landowner
I am the owner of real property at
in the
Name of place of Municipality
Municipality/County/District
Instrument No.
of
for the
registered in the Land Registry Office for the
Lot No.
Concession or Plan No.
, Ontario, and more particularly described in
Name of City or Town
Municipality/County/District
of
Registry or Land Titles Division
,
Name of City or Town
of
Name of place of Municipality
.
Wildlife Management Unit in which property is located:
Part C - Declaration
I hereby declare that the above information is correct and that I have submitted only one application. I understand that the
submission of more than one application is prohibited and will result in rejection of all applications.
Signature
Date (yyyy/mm/dd)
Print Form
FW1038E (2016/04)
Clear Form
© Queen's Printer for Ontario, 2016
Disponible en français
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