Form 2728 at a glance
What it is: Application for Pioneer License R12-4-201, Arizona Game and Fish Department.
Who signs: Sign on the Applicant's Signature line and enter the Date.
A filled-in Form 2728 example: a Pioneer License application
How to fill out Form 2728, box by box
Name, Date of Birth and Customer ID Number
Print or type the Name, the Date of Birth and the Customer ID Number.
Mailing Address, City, State, Zip and Phone
Enter the Mailing Address, City, State, Zip and Phone.
Gender, Weight, Height, Hair and Eyes
Enter the Gender, Weight, Height, Hair and Eyes.
Resident, Date AZ Residency began and Drivers license or ID card #
Mark Resident, enter the Date AZ Residency began and enter the Drivers license or ID card #.
Physical Address and Email
Enter the Physical Address if different than mailing, and the Email.
Copy of one legal document enclosed
Include a copy of any one of the following legal documents.
Birth Certificate, Driver's License, Motor Vehicle Division ID card or U.S. Passport. Check which one is enclosed.
Applicant's Signature and Date
Sign on the Applicant's Signature line and enter the Date.
By signing this document you affirm that you meet the eligibility requirements of this rule and the information provided on the application is true and accurate. By signing you also affirm that you are 70 years of age or older and have been a resident of AZ for 25 or more consecutive years preceding application for this license. You also affirm that you are not receiving any residency privileges in another state. It is unlawful for any person to obtain by fraud or misrepresentation a license to take wildlife. Any license fraudulently obtained is void from the date of issuance. Si desea hablar con un representante de servicio al cliente bilingüe para obtener información llame al (602) 942-3000 de lunes a viernes de 8:00 a.m. A 5:00 p. Y luego ingrese el número. 5 durante el mensaje grabado.
Common questions about Form 2728
What is a 2728 form?
Application for Pioneer License R12-4-201, Arizona Game and Fish Department. The Arizona Game and Fish Department may issue a complimentary Pioneer License to individuals 70 years of age or older who have been bona fide residents of Arizona for 25 or more consecutive years immediately preceding application for the license. All other stamps and tags must be purchased separately.
Are there fees?
The fee is none. The * on Applicant's Signature: Optional: Hard Plastic permanent card may be purchased for $4.00 (checked October 20, 2026). Card will be mailed within 30 days after application is processed.
Sources
[1] Form 2728 (Revised 8/23), Application for Pioneer License, Arizona Game and Fish Department (the Official source link on this page).