Hunting Preserve License Renewal and Annual Report

Hunting Preserve Renewal and Annual Report 2023 Louisiana Department of Wildlife and Fisheries

License Code: 02A
Hunting Preserve License Renewal and Annual Report

Your Hunting Preserve license issued by the Louisiana Department of Wildlife & Fisheries (LDWF) expires June 30th of each calendar year. LDWF regulations require you to renew your Hunting Preserve license prior to October 1st for the upcoming hunting season.

If there are any changes to the operational plan that you will implement for the upcoming hunting season please update the appropriate portions of this form where indicated

If you wish to renew your Hunting Preserve License please complete the renewal form by August 31st.

PAYMENT METHODS: The last step after submitting your renewal form for your Hunting Preserve License will be to pay the $420 annual fee.

You can pay the renewal fee online at https://louisianaoutdoors.com/commercial-license

You will login to the payment page with your current six digit Hunting Preserve License # and the last four digits of the permit holders SSN or Tax ID number.

If you wish to pay by mail you can mail the $420 personal check, money order, or cashier's check made payable to LA Dept of Wildlife and Fisheries. Check can be sent to the address listed below:

LA Dept of Wildlife and Fisheries

Attn: Wildlife Permits Program

2000 Quail Drive

Baton Rouge, LA 70808-9038

If you have any questions or suggestions while completing the application please feel free to send me an email to wildlifepermits@wlf.la.gov Monday through Thursday between the hours of 8:00 AM and 4:30 PM at 225-765-2975 Please leave a voicemail if I do not answer and I will call you back upon my return.

This renewal application will allow you the option to save your progress and continue at a later time if necessary.

Thanks

LDWF Wildlife Permits Program

www.wlf.louisiana.gov
Renew Permit*

YesNo
Application Date*

MonthDayYear
Format MM-DD-YYYY
Are you renewing permit under a business name or as an individual?*

BusinessIndividual
Name*

First NameLast Name
Business or Company Name currently listed on your permit
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parish of Residence*
Phone Number*
Email*
example@example.com
Louisiana Resident*

YesNo
Driver's License Number *
Driver's License State Issued*
Date of Birth*

MonthDayYear
Format MM-DD-YYYY
Last Four Digits of SSN or Tax ID Number if licensed as a business*
LDWF Hunting Preserve License Number (6 digits)
Parish where Hunting Preserve is located*

Legal Release Statement

Game Breeder Permit Renewal and Annual Report
Louisiana Department of Wildlife and Fisheries Hunting Preserve Release Statement.
Legal Release Statement Signature (Hold down the left mouse button to sign)*

Clear
Legal Release Statement Typed Name*

First NameLast Name
Legal Statement Date Signed*

MonthDayYear
Date
By submitting an application for a Louisiana Department of Wildlife and Fisheries Hunting Preserve Permit, I consent to facility and game bird inspections during the duration of the permit period. I understand that an application and inspection does not guarantee the issuance or renewal of a permit.*

AgreeDisagree

Commercial Licensing Disclosure Statement

Game Breeder Permit Renewal and Annual Report
Louisiana Department of Wildlife and Fisheries Commercial License Disclosure

If applying for resident license/permit for an individual:

I qualify for resident licensing rates having complied with all of the residency certification requirements as I hereby attest to the accuracy of the following statements:

1. I have resided in Louisiana continuously for at least the past twelve months.

2. I am registered to vote in Louisiana, or I am not registered to vote anywhere.

3. I am in possession of a valid Louisiana driver’s license, or I am not licensed to drive anywhere.

4. I am in possession of a valid Louisiana Department of Wildlife and Fisheries Basic Hunting and Trapping License.

5. If I intend to control reptiles and/or amphibians, I am in possession of a valid Louisiana Department of Wildlife and Fisheries Basic Fishing License.

6. I am in possession of Louisiana registrations for all vehicles I own within Louisiana, or I do not own any motor vehicles within Louisiana.

7. I have filed a Louisiana state income tax return and complied with state income tax laws and regulations, or I did not earn an income.

If applying for a resident license for a business:

I certify that the corporation or other legal entity for which I am obtaining a license/permit is qualified for resident rates as it is incorporated or otherwise organized under and subject to the laws of Louisiana, and is domiciled in Louisiana and has a permanent physical location of business in Louisiana where records are held in compliance with R.S.56:306.4.

I understand that:

1. If the proof shows that a license/permit has been obtained by fraud or subterfuge, the vessels and equipment used under this license/permit shall be forfeited.

2. The privileges granted by the license/permit are subject to change, termination, or modification before its expiration date, which may occur as a result of legislative action, changes in Commission or Department rules, regulations, or license/permit conditions.

3. It is my responsibility to obey all applicable laws and license/permit conditions and to apprise myself of any change to laws, regulation, or license/permit conditions.

4. This license may be modified, canceled, or revoked prior to its expiration as a result of changes in, or violations of laws, regulations, or the terms and conditions of the license/permit itself.

5. It is my responsibility to verify the accuracy of the license/permit issued from this application and immediately notify the Commercial License Section of the Department of Wildlife & Fisheries of any errors contained therein.

6. This application may take up to four weeks for processing if applied for by mail and that I am not legal to begin operation without the required original license/permit(s) in my possession.

7. I must be present when my “nontransferable” license/permit is in use and I am responsible for having all other required license/permit(s), including the appropriate gear license(s) and vessel license(s) as applicable, except when a nontransferable license/permit is issued in a business name, any employee of that company may operate under authority of the license at the location for which the license/permit was issued.

By signature below, applicant attests to the accuracy of the information contained in this application, including residency certification and acknowledgement of responsibility for an understanding of the conditions and requirements on this application. I certify that that the information provided herein is true and correct and I authorize the Louisiana Department of Wildlife and Fisheries to contact the Department of Revenue for Income Tax verification purposes as it relates to the 12 month residency requirement set forth in La.R.S.56:8(16)(a). I further understand that providing any false information subjects me to criminal violations.
Commercial License Disclosure Statement Electronic Signature*

Clear
Commercial License Disclosure Statement Electronic Signature Date*

MonthDayYear

Hunting Preserve 2023-2024 Daily Hunt Log Report

All permit holders regardless of renewal status are required to complete a daily hunt log. You have the option to upload scans of your completed hunt log or enter the requested data in the table below.
Did you hunt during the previous season?*

YesNo
Optional: Upload below your completed 23-24 Hunt Log Files directly your your device

Cancelof

2023-2024 Daily Hunt Log Reporting Manual Input Table (additional column to the right, use tab to move to the adjacent columns during data input or use the slide bar at the bottom of the table) PLACE A ZERO IN ALL COLUMNS OF HUNT 1 ROW IF YOU DID NOT HUNT*

	Date	#Quail Released	#Quail Bagged	#Chukar Released	#Chukar Bagged	#Pheasant Released	#Pheasant Bagged	#Mallards Released	#Mallards Bagged
Hunt 1
Hunt 2
Hunt 3
Hunt 4
Hunt 5
Hunt 6
Hunt 7
Hunt 8
Hunt 9
Hunt 10
Hunt 11
Hunt 12
Hunt 13
Hunt 14
Hunt 15
Hunt 16
Hunt 17
Hunt 18
Hunt 19
Hunt 20
Hunt 21
Hunt 22
Hunt 23
Hunt 24
Hunt 25
Hunt 26
Hunt 27
Hunt 28
Hunt 29
Hunt 30
Hunt 31
Hunt 32
Hunt 33
Hunt 34
Hunt 35
Hunt 36
Hunt 37
Hunt 38
Hunt 39
Hunt 40
Hunt 41
Hunt 42
Hunt 43
Hunt 44
Hunt 45
Hunt 46
Hunt 47
Hunt 48
Hunt 49
Hunt 50
Hunt 51
Hunt 52
Hunt 53
Hunt 54
Hunt 55
Hunt 56
Hunt 57
Hunt 58
Hunt 59
Hunt 60

Hunting Preserve 2023-2024 Bird Purchase Records

* The National Poultry Improvement Plan (NPIP) number should be provided to you by the bird producer. Sometimes the producer is not NPIP certified, but rather, the producer will buy chicks or eggs from an NPIP certified source. This is allowed provided the birds do not come in contact with non-NPIP certified birds. If this is the case, the seller should provide you with the NPIP number of the source of the eggs or chicks. The NPIP certification number should not be confused with a game breeder license number or importation permit number. The NPIP number will look like this: 74-371. The first number (74) indicates the state of the producer, and the second number (371) is assigned to the individual producer. In this example, NPIP certification #74-371can be traced to C.D. Wheeler in Texas.
Did you purchase birds last year?*

YesNo
Optional: Upload Files or scans of your 23-24 Bird Purchase Records

Cancelof

2023-2024 Hunting Preserve Bird Purchase Records PLACE A ZERO IN ALL COLUMNS OF PURCHASE 1 ROW IF YOU DID NOT PURCHASE BIRDS*

	Supplier Name and Address	Supplier NPIP #	#Quail Purchased	#Chukar Purchased	#Pheasant Purchased	#Mallards Purchased
Purchase 1
Purchase 2
Purchase 3
Purchase 4
Purchase 5
Purchase 6
Purchase 7
Purchase 8
Purchase 9
Purchase 10
Purchase 11
Purchase 12
Purchase 13
Purchase 14
Purchase 15
Purchase 16
Purchase 17
Purchase 18
Purchase 19
Purchase 20
Purchase 21
Purchase 22
Purchase 23
Purchase 24
Purchase 25
Purchase 26
Purchase 27
Purchase 28
Purchase 29
Purchase 30

Download your 2024 Daily Log and Purchase Log Files Below:

Please download your daily and purchase logs below for use during the 2024-2025 hunting season.
Hunting Preserve Daily Log File Download
Hunting Preserve Purchase Log File Download

Hunting Preserve Operational Plan Changes

Please update any necessary portions of your previous operational plan below. If you do not have any changes please disregard the remaining questions of the renewal.
Do you have any changes to your operational plan from the previous license year?*

YesNo
Hunting Preserve Name*
Access type?*

Private Preserve onlyOpen to the public for hunting opportunities
Type of birds that will be released*

QuailChukarPheasantMallards (restricted in the coastal zone)
Description of the hunting activities that will occur on the preserve area:*
Detailed description of your bird release methods:*
How long before the each hunt will the birds be released?*
When will the birds be banded?*
Will there be any other type of hunting on your property other than the preserve game bird hunts? If so, what type of hunting will occur?*
Generally describe the land use and hunting activity on property surrounding your preserve (types of agriculture, fields, pasture, residential, deer hunting, duck hunting, etc.)*
Property Map*

Cancelof

For Preserves Using Ducks Only

If you are not using ducks the remaining questions will not be relevant.
Methods used to train your ducks to fly towards the shooters:
Method to recapture any surviving ducks after the hunt:
Distance from release point to shooter blinds:
Distance from holding/flight pens to shooting blinds if the actual release point is in a different location from the duck pens:
What is the size and average depth of the shooting pond or ponds?
If appropriate upload an updated map or diagram showing the location of blinds, duck release sites, and water sources on your property. Mark blinds with a “B”, release sites with “RS”, permanent ponds with “PP” Areas subject to seasonal flooding by rainfall or overflow from creeks, rivers, etc. with “SF”, and managed water (areas where water may be pumped or flooding and water level can be controlled) with “MW”.

Acceptable file types pdf, doc, docx, xls, xlsx, csv, txt, rtf, html, zip, mp3, wma, mpg, flv, avi, jpg, jpeg, png, gif
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Are there any new permanent ponds, seasonally flooded areas, or managed water adjacent to or nearby (within 2 miles) of the property? If so, please indicate such on a map or diagram in the manner described in the previous question.

Acceptable file types pdf, doc, docx, xls, xlsx, csv, txt, rtf, html, zip, mp3, wma, mpg, flv, avi, jpg, jpeg, png, gif
Cancelof
If the answer to the question above is yes, what is the distance from your shooting pond to the nearest site where the hunting of wild ducks is likely to occur?
If you offer public hunting opportunities on your hunting preserve and would like to be listed on the LDWF website to allow inquiring hunters to locate your hunt opportunities, please list your information such as Preserve Name, Location, Primary Contact Information, Website, and or types of hunts available below:
Should be Empty:

Hunting Preserve Renewal and Annual Report 2023 Louisiana Department of Wildlife and Fisheries

Legal Release Statement

Commercial Licensing Disclosure Statement

Hunting Preserve 2023-2024 Daily Hunt Log Report

Hunting Preserve 2023-2024 Bird Purchase Records

Download your 2024 Daily Log and Purchase Log Files Below:

Hunting Preserve Operational Plan Changes

For Preserves Using Ducks Only