Fole Form 2728 A PDF Details

In the heart of Arizona's vibrant wildlife and hunting culture, the Arizona Game and Fish Department offers a unique opportunity for its senior residents through the Fole 2728 A form, a Pioneer License Application. This complimentary license is a testament to the state's appreciation for individuals who have spent a significant portion of their lives within its borders, specifically targeting those 70 years of age or older who can claim Arizona as their home for 25 or more consecutive years immediately preceding the application. While the license itself is complimentary, it requires that any additional stamps or licenses be purchased separately, allowing holders to tailor their experience to their interests. An optional hard plastic permanent card, offering a more durable alternative to paper, can be acquired for a nominal fee, ensuring that recipients have a lasting memento of their contribution to Arizona's community and wildlife conservation efforts. The process entails submitting personal information along with proof of residency and age, emphasizing the department's commitment to verifying each applicant's eligibility in a manner that respects their privacy and dignity. Notably, the inclusion of one's Social Security Number is voluntary, intended only for use within the Sportsman's Database, underscoring the delicate balance between necessary documentation and the protection of individual rights. With comprehensive guidelines and a straightforward application process, the Fole 2728 A form embodies Arizona's dedication to honoring its long-standing residents by granting them special privileges in acknowledging their enduring relationship with the state's natural heritage.

QuestionAnswer
Form NameFole Form 2728 A
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesarizona fish and game website pioneer license, arizona pioneer fishing license, pioneer fishing license arizona, az game and fish pioneer license application

Form Preview Example

Arizona Game and Fish Department

5000 W. Carefree Hwy. Phoenix, AZ 85086

PIONEER LICENSE APPLICATION azgfd.gov FEE: Complimentary

The Department may issue Pioneer Licenses to people 70 years of age or older who have been bona fide resi- dents of Arizona for 25 or more consecutive years immediately preceding application for the license. All other stamps and/or licenses must be purchased separately.

*Optional: Hard Plastic permanent card may be purchased for $4.00. Customer will be mailed card within 30 days.

**Social Security Number is voluntary (to be used for Sportsman’s Database Only)**

Name

 

 

 

Date of Birth

Phone

 

 

 

 

 

 

 

 

Address

 

 

 

City

State

Zip

 

 

 

 

 

Mailing Address (if different than above)

 

City

State

Zip

 

 

 

 

 

 

 

Department ID/SSN

 

 

 

Email

 

 

 

 

 

 

 

 

 

Gender

Height

 

Weight

Eyes

Hair

Yrs of Resi-

 

 

 

 

 

 

dency

 

 

 

 

 

 

 

AFFIDAVIT: I certify that I have been a resident of this state for 25 or more consecutive years immediately preceding application for this license.

Attachments: Additional information required under R-12-4-201

_____An original or certified copy of the applicant’s birth certificate, driver’s license, Motor Vehicle Division

identification card or U.S. Passport must accompany each application. These items will be returned to the ap- plicant Photocopies are subject to verification.

Applicant Signature*

Date

 

 

*DO NOT SIGN THIS APPLICATION until you are in the presence of a Department employee or a notary public. This application must be notarized if it is not presented in person.

I do hereby certify that on (date) _________ (applicant name)_____________________

Personally appeared before me and made the above declaration. In witness whereof, I have hereunto set my hand and affixed my official seal this (date)____________

(seal)

 

 

Notary Public in and of the county of __________,

 

 

 

State of Arizona. My commission expires_______.

 

 

 

 

 

 

 

ARIZONA GAME AND DEPARTMENT USE ONLY

 

 

 

 

 

 

 

 

 

Date Received

Date Reviewer

PHX

Region

 

Approved

Denied

 

Received

 

 

 

 

 

 

 

 

 

 

 

Date License Issued

Review Complete

PR#

Plastic Card Purchased?

Date Card Issued

Issuer Initials

 

Date

 

Y

N

 

 

 

 

 

 

 

 

 

FOLE_Form 2728-A_Revised 08/15/2011

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