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LANDOWNER PERMISSION FORM


This certifies that _____________________________________________ (and ____ guests) is/are authorized
(full name)

to enter upon the property of _________________________________________________ for the purpose of


(landowner/lessee)

__________________________________________________________________________________________
__________________________________________________________________________________________
_________________________________________________________________________________________.
Permission is valid for the dates _________ to _________.

______________________

____________________________________

Date

Signature of landowner/lessee

The N.C. Wildlife Resources Commission provides this form as a public


service for landowner/lessee and sportsmen use. Landowners/lessees are
not required to use this form, but are encouraged to provide at least the
information above when granting written permission.

_(______)____________________________
Contact number

Revised 7/13/11

LANDOWNER PERMISSION FORM


This certifies that _____________________________________________ (and ____ guests) is/are authorized
(full name)

to enter upon the property of _________________________________________________ for the purpose of


(landowner/lessee)

__________________________________________________________________________________________
__________________________________________________________________________________________
_________________________________________________________________________________________.
Permission is valid for the dates _________ to _________.

______________________

____________________________________

Date

Signature of landowner/lessee

The N.C. Wildlife Resources Commission provides this form as a public


service for landowner/lessee and sportsmen use. Landowners/lessees are
not required to use this form, but are encouraged to provide at least the
information above when granting written permission.

_(______)____________________________
Contact number

Revised 7/13/11

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