Section 525.EXHIBIT A Application for Nuisance Wildlife Control Permit

Section 525.EXHIBIT A   Application

for Nuisance Wildlife Control Permit

Part 1.

Personal Data

Name

First

Middle

Initial

Last

Date of Birth

Month

Day

Year

Email Address

Address

Street

City

State

Zip

Code

Phone

-

Area Code

Number

Representing the following

company, organization or governmental body (if applicable):

_________________________________________________________

Part 2.

Type of permit applied for

(check one):

Class A (Commercial −

Mammals and Game Birds)

Class B* (Zoos and Botanical

Gardens or landowners and tenants applying for take of migratory birds on

their property in accordance with a federal permit)

Class C (Governmental – Mammals

and Game Birds Only)

Class D (Commercial –

Migratory Birds)

Class E (Governmental –

Migratory Birds)

*

Zoos and botanical garden must

attach a copy of their Internal Revenue Service tax-exempt status

determination letter, professional accreditation, and a map or legal

description of their properties where wildlife will be controlled; landowners

and tenants desiring to take migratory birds on their property must attach a

copy of their Federal permit.

Part 3.

Work Area (Applicants for

Class A and D Permits only)

A list of

permittees is distributed to District Wildlife  Biologists and Conservation

Police Officers so that they can refer complainants to permittees who service

that area. Please list (in order of preference) up to four counties that you

service. This list will be used strictly for referrals; your activities are

not restricted to this area.

County 1

County 2

County 3

County 4

I certify that all information

provided on this application is true and correct to the best of my

knowledge.

Applicant's

Signature

RETURN COMPLETED APPLICATIONS

TO:

Illinois

Department of Natural Resources

Division of

Wildlife Resources

One

Natural Resources Way

Springfield IL  62702-1271