For those of you who may not know, on April 15th the IRS released a new (and much anticipated) form - Form 3600 162. This new form is designed to help taxpayers accurately report their qualified business income (QBI) and any related deductions. Given that the deadline for filing taxes is just around the corner, now is a good time to take a closer look at this new form and learn how it can be used to your advantage. So, what exactly is Form 3600 162, and what can it do for you? Keep reading to find out!
| Question | Answer |
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| Form Name | Form 3600 162 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | 3600162 dnr service center application form # 3600 162 |
State of Wisconsin |
Fish or Troll With Electric Motor Permit Application |
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Department of Natural Resources |
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dnr.wi.gov |
Form |
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Check here if renewal. |
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An initial Class A permit is valid for the |
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LEAVE |
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Permit Number |
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Date Issued |
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Upon renewal, a Class A permit is valid for the |
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Expiration Date |
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Issued By |
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Notice: Use of this form is required by the DNR for any application filed pursuant to s.29.193,
Wis. Stats. The DNR will not consider your application unless you complete and submit this
form. Personally identifiable information provided may be used to determine identity of the applicant, participation in natural resources surveys, eligibility for approvals and other enforcement purposes.
SECTION I - TO BE COMPLETED BY APPLICANT (Type or print legibly)
Customer ID Number
Applicant Name |
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Driver's License Number |
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Street or Route |
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Home Phone Number (incl area code) |
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City, State, ZIP Code |
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County of Residence |
Previous Permit Number |
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Date of Birth (Mo. - Day - Year) |
Color Eyes |
Color Hair |
Weight |
Height |
Sex |
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Male |
Female |
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I hereby certify that the above information is true and correct, and I hereby authorize the Department of Natural Ressources sto examinne all medical records regarding my disability.
Applicant Signature
Date Signed
29.193(1) DISABLED PERSONS:TROLLING PERMITS
(a)After proper application, the Department shall, after due investigation and without charging a fee, issue a trolling permit to any person who meets the requirements under s. 29.193(2)(c) or ss. 29.171(4)(a)2. 3 or 4, Wis Stats.
(b)A person holding a current fishing license and a trolling permit, or a Class A, B or C permit, may fish or troll in the waters of this state using an electric motor, notwithstanding any municipal ordinances or local regulations adopted under s. 30.77(3), Wis Stats., that prohibit the use of motor boats on navigable waters, or subject to rules promulgated by the department.
SECTION II - TO BE COMPLETED BY LICENSED PHYSICIAN OR CHIROPRACTOR
1.s.29.171(4)(a)2. Has an amputation or other loss of one or more arms above the wrist.
2.s.29.171(4)(a)4. Has a permanent substantial loss of function in one or both arms or one or both hands and fails to meet the minimum standards of any one of the following standards tests, administered under the direction of a licensed physician or chiropractor:
Yes (Attach brief description)
Yes (Attach test results)
No
No
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Upper extremity pinch |
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b. |
Grip |
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c. |
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Name of Physician or Chiropractor (Please Print) |
Medical License Number |
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Date Signed |
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Signature of Physician or Chiropractor |
Phone Number (include area code) |
Fax Number (incl area code) |
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Address |
Mail Application To: |
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Department of Natural Resources |
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Disabled Permit Applications - CS 1 |
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City, State, ZIP Code |
PO Box 7924 |
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Madison, WI 53707 |
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(please allow 6 weeks for review and processing) |
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