Free Landowner Permit Ct Form – Fill Out and Use This PDF

I hereby make application to hunt deer with a shotgun, muzzleloader, rifle or bow and arrow on my property during the free Landowner Deer Hunting Season for Myself, My Spouse, Lineal Descendents, Parents, Grandparents or Siblings.

Only one landowner permit per person is allowed.

HUNTER INFORMATION:
NAME_____________________________________________________	SOCIAL SECURITY NUMBER __ __ __ - __ __ - __ __ __ __
ADDRESS__________________________________________________	DATE OF BIRTH (M/D/Y) ____ ____ / ____ ____ / ____ ____ ____ ____
CITY______________________________________________________	STATE________________ ZIP CODE___________________________
DAYTIME TELEPHONE NUMBER ___ ___ ___ - ___ ___ ___ - ___ ___ ___ ___	RELATIONSHIP TO OWNER______________________________________
DRIVERS LICENSE NO__________________________________ STATE__________	E-MAIL ADDRESS_______________________________________________

VALID CT HUNTING LICENSE NUMBER ___ - __ ___ ___ ___ ___ ___ AND/OR VALID CT ARCHERY PERMIT NUMBER ___ ___ ___ ___ ___ ___

ãUse “L” to indicate permanent, over 65 license, otherwise leave this first space blank.

I declare under the penalties of false statement as provided for in Sec. 26-90 of the Connecticut General Statutes, that the statements herein made by me are true and correct.

Applicant_____________________________________________________________________		Date________________________
(signature)
LANDOWNER INFORMATION:
NAME__________________________________________________________	ADDRESS_______________________________________________
CITY____________________________________________________________	STATE________________ ZIP CODE_________________________

The permit for which I am herewith making application covers property which I own and is described in the land records in:

Town(s) of	Volume	Page(s)	Acreage
__________________________________________	________________	________________	_______________
__________________________________________	________________	________________	_______________
__________________________________________	________________	________________	_______________
__________________________________________	________________	________________	_______________

Location of property: (All parcels must be listed individually.)
Street	Town
_______________________________________	_______________________________
_______________________________________	_______________________________
_______________________________________	_______________________________
_______________________________________	_______________________________

I declare under the penalties of false statement as provided for in Sec. 26-90 of the Connecticut General Statutes, that the statements herein made by me are true and correct.

Applicant_____________________________________________________________________ Date________________________

(signature)

Note: If the information is not legible, the permit cannot be issued.

TO INSURE MAXIMUM USE OF THE PERMIT, PLEASE SUBMIT YOUR APPLICATION PRIOR TO OCTOBER 1 TO:

D.E.P. LICENSE AND REVENUE UNIT

79 Elm Street

Hartford, CT 06106-5127

SEE PAGE 2 OF FORM FOR INSTRUCTIONS AND REGULATIONS

EPW - 50 Rev 4/01

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INSTRUCTIONS:

−Print name and address clearly in the spaces provided.

-Enter the appropriate VALID (license for year in which you wish to hunt) firearms license and/or archery permit number in the space provided.

−Sign and date the application. If multiple landowners on deed, only one needs to sign application.

REGULATIONS:

-A landowner must own at least 10 acres to qualify for the free permits.

-No landowner, lineal descendant, parent, grandparent or sibling shall be issued more than one free permit in any calendar year, regardless of acreage owned.

-The number of deer taken with each permit shall be limited to two deer. As noted on the permit and on one tag, at least one of the deer taken must be antlerless.

-No landowner shall make more than one application for the same person for such deer permit.

-Persons taking a deer with a Free Landowner permit need not bring the deer to a check station, but are required to send in a kill report card within 24 hours. Deer killed with a landowner permit using archery equipment must be reported on landowner kill report cards, not archery kill report cards.

-Landowners hunting deer on their own property are not required to wear 400 square inches of fluorescent orange clothing. All other relatives hunting with the Landowner Permits are required to wear the fluorescent orange while firearms deer hunting, however this restriction does not apply to archery hunters during the separate archery season.

-To hunt with a firearm, a State Firearms Hunting License is required if landowner does not reside on the qualifying property.

-To hunt with a bow and arrow, a State Archery Permit is required if landowner does not reside on the qualifying property.

−This application is available on the DEP website at: http://dep.state.ct.us/burnatr/wildlife/fguide/fgindex.htm

HUNTING EQUIPMENT:

1.Muzzleloader means a rifle or shotgun (.45 caliber minimum) using a single projectile loaded from the muzzle end. Telescopic sights and shotgun converters are permitted.

2.A capped percussion lock or a flintlock with powder in the pan is considered a loaded firearm.

3.A person may hunt with a 12,16, or 20 gauge shotgun using rifled slug ammunition. Any shotgun used to take deer shall not be capable of holding more than three shells and shall have its magazine plugged with a one-piece filler, incapable of removal without disassembling, so that the total gun capacity does not exceed three shells.

4.A centerfire rifle of at least 6mm or larger may be used during the Free Landowner season.

5.Legal bows and arrows include long, recurved and compound bows capable of propelling a hunting type arrow of not less than 400 grains 150 yards free flight over level ground. The arrowhead must have at least two blades and must be at least 7/8 inch wide at its widest point.

EPW - 50 Rev 4/01

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