CONSENT TO HUNT DEER OR TURKEY ON PRIVATE LAND DURING THE CALENDAR YEAR

Name of Last First M.I. State of Connecticut

landowner Department of Energy
listed on and Environmental
deed Protection

Street Town No. of Acres Cross off hunting that is NOT authorized
Location of 1) Deer Hunting
2) Spring Turkey Hunting
property 3) Fall Turkey Hunting
4) Sunday Archery Deer Hunting
Last First M.I. Cross off hunting implements
NOT authorized
Hunter 1) Bow and Arrow/Crossbow
Address 2) Shotgun
information
Town State Zip 3) Muzzleloader (Deer Only)
4) Centerfire Rifle (Deer Only)
Conservation ID Number
5) Revolver (Deer Only)
I know and understand the boundaries of the above I hereby grant the person named above
listed properties, and that this form is valid only during permission to hunt on my property during the
the calendar year for which it was signed by the calendar year indicated. I have also indicated
landowner. I also understand that any person making a the seasons and hunting implements that may
written false statement on this form shall be subject to be used.
arrest as provided for in Section 53A-157 of 1975 Rev. of
C.G.S.

Signature of Permittee Date Signature of Landowner Date

Date

CONSENT TO HUNT DEER OR TURKEY ON PRIVATE LAND DURING THE CALENDAR YEAR

Name of Last First M.I. State of Connecticut

landowner Department of Energy
listed on and Environmental
deed Protection

Street Town No. of Acres Cross off hunting that is NOT authorized
Location of 1) Deer Hunting
2) Spring Turkey Hunting
property 3) Fall Turkey Hunting
4) Sunday Archery Deer Hunting
Last First M.I. Cross off hunting implements
NOT authorized
Hunter 1) Bow and Arrow/Crossbow
Address 2) Shotgun
information
Town State Zip 3) Muzzleloader (Deer Only)
4) Centerfire Rifle (Deer Only)
Conservation ID Number
5) Revolver (Deer Only)
I know and understand the boundaries of the above I hereby grant the person named above
listed properties, and that this form is valid only during permission to hunt on my property during the
the calendar year for which it was signed by the calendar year indicated. I have also indicated
landowner. I also understand that any person making a the seasons and hunting implements that may
written false statement on this form shall be subject to be used.
arrest as provided for in Section 53A-157 of 1975 Rev. of
C.G.S.

Signature of Permittee Date Signature of Landowner Date