/ IOWA DEPARTMENT OF NATURAL RESOURCES
Licensing Section
502 E 9th St, Des Moines, IA 50319-0034
(515) 725-8200
REGISTRATION FOR RESIDENT LANDOWNER/TENANT
DEER & TURKEY LICENSES

Provide ALL of the following information:

Please print clearly (If we cannot read your writing we will return this form unprocessed.)

Applicant Information
Last Name: / First Name:
Mailing Address:
City: / State: / Zip:
Date of Birth: / Phone #:
Height: / Weight: / Eye Color: / Gender: / Male Female
Provide at least TWO (2) of the three number listed below:
Iowa DNR #
(if known): / Social Security #*: / Driver’s License # and State:
*The Iowa Department of Natural Resources is required to collect social security numbers from all persons obtaining a hunting, fishing or other recreational license under section 252J.8 of the Code of Iowa and 42 US Code 666(a)(13).You social security number will serve as your principal identification number to determine your eligibility for licenses.It will be provided to law enforcement agencies and the Iowa Child Support Collection Unity to establish, modify, and enforce child support obligations and to collect liabilities owed to the state or a state agency.It WILL NOT appear on your license.
SSN required if your do not know your DNR Number or have never purchased an Iowa hunting/fishing licnese.
I am registering as a (Check ONLY ONE, either I or II):
I / Landowner,
Spouse of Landowner, or
Child of Landowner / II / Tenant,
Spouse of Tenant, or
Child of Tenant
(If selected, complete Sections A and C only) / (If selected, complete Sections B and C only)
Section A
I attest that I am eligible for free and reduced-fee deer and wild turkey hunting licenses because I meet one of the following criteria: (If registering as a landowner or family member of a landowner, you MUST CHECK ONLY ONE box for 1, 2, or 3.)
1 / LANDOWNER: I am a resident of Iowa and I own at least 2 contiguous acres of qualifying agricultural land.I do not use a third party, such as a farm management company, to make annual farm operating decisions.
(If you checked Box 1, you MUST CHECK AT LEAST ONE box for a-e below.)
a) I am the farm operator on that farmland, or
b) I make annual decisions about the farm operations that are carried out by renters, laborers, or custom applicators, or
c) I raise specialty crops (orchards, nurseries, garden crops, trees, etc.) on that land, or
d) All or part of my land is enrolled in the conservation reserve program, or
e) I rent my farm to my adult child who operates the farm.
2 / LANDOWNER SPOUSE: I am the spouse of a landowner who qualifies for free licenses as described in Statement 1, I reside with that landowner, and the county number and parcel identification number listed in Section C are for qualifying land owned by that landowner.
3 / LANDOWNER CHILD: I am the child of a landowner who qualifies for free licenses as described in Statement 1, I reside with that landowner, and the county number and parcel identification number listed in Section C are for qualifying land owned by that landowner (If you checked Box 3, you MUST CHECK ONLY ONE box for f or g below.)
f) I am under 18 years old, or
g) I am 18 or 19 years old and I am enrolled in high school or a GED program.
GO TO SECTION C

05/2015 cmcPlease remit application to the address at the top of page 1.DNR Form 542-8070

Section B
I attest that I am eligible for free and reduced-fee deer and wild turkey hunting licenses because I meet one of the following criteria: (If registering as a tenant or family member of a tenant, you MUST CHECK ONLY ONE box for 4, 5, or 6.)
4 / TENANT: I am a resident of Iowa and I rent and actively farm agricultural land owned by another person.
5 / TENANT SPOUSE: I am the spouse of a tenant who qualifies for free licenses as described in Statement 4, I reside with that tenant, and the county number and parcel identification number listed in Section C are for qualifying land rented by that tenant.
6 / TENANT CHILD: I am the child of a tenant who qualifies for free licenses as described in Statement 4, I reside with that tenant, and the county number and parcel identification number listed in Section C are for qualifying land rented by that tenant. (If you checked Box 6, you MUST CHECK ONLY ONE box for h or i below.)
a)
b)
c)
d)
e)
f)
g)
h) I am under 18 years old, or
i) I am 18 or 19 years old and I am enrolled in high school or a GED program.
7 / Provide the NAME, ADDRESS, and TELEPHONE NUMBER of the landowner who owns the parcel of agricultural land that you rent.The person listed below must be the owner of the parcel of land that you list for number 8 in Section C below.
Landowner
Last Name: / Landowner First Name:
Landowner
Mailing Address:
Landowner
City: / Landowner
State: / Landowner
Zip:
Landowner Phone #:
GO TO SECTION C
Section C
8 / Provide the COUNTY NUMBER and PARCEL IDENTIFICATION NUMBER for ONE parcel of agricultural land that qualifies you for a Landowner/Tenant License.See “INSTRUCTIONS” for locating the parcel number.Tenants must get this number from the landowner who rents qualifying land to them.The DISTRICT NUMBER* is also required for counties that have duplicate parcel identification numbers (see list below).
IMPORTANT: A landowner and lal of his/her qualifying family members must register using the same County # and the same Parcel Identification Number.Likewise, a tenant and all of his/her qualifying family members must register using the same County # and Parcel Identification Number.The same District Number must also be used, when applicable.*
County # / District #** / Parcel Identification Number
**District number is required for parcels in the following counties:
Crawford, Keokuk, or Union
9 / Provide the full legal name of the landowner, as it appears on the deed, who owns the parcel of land listed in number 8 above.If the property is named under a trust, business, corporation, LLC, etc; that name must be provided for verification purposes.You may use both the First Name and Last Name text boxes if necessary.Also, if land is owned by more than one individual or a corporation, you must also include a list of all individual owners and their home address.
Landowner
Last Name: / Landowner First Name:
10 / By signing this affidavit, I attest that all of the information provided is true.I understand that I may be subject to conviction of a misdemeanor and loss of hunting privileges if the information I have provided is proven to be false under Iowa Code 714.8(4).
Signature / Date

WARNING: Incomplete or illegible application will delay the registration process.

05/2015 cmcPlease remit application to the address at the top of page 1.DNR Form 542-8070