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Indiana Department of Natural Resources
INDIANA SPORT RECREATION LICENSE
Mitchell E. Daniels, Jr., Governor
Kyle J. Hupfer, Director, Dept. of Natural Resources
Glen Salmon, Director, Div. of Fish and Wildlife
Sport ID:  500D2C3418 License No:  0506070236175

DATE:  06/07/2005
TIME:  1:05:57 PM

ISSUED TO:
  Christopher Person
13579 Odd number Rd. 
Apt: 2468
Huntingburg, IN 47715
BIRTH DATE:  08/07/1972
SEX:   Male
HEIGHT:  6' 4"
WEIGHT:  225
EYE COLOR:  Green
HAIR COLOR:  Brown
BLOOD TYPE:  
EXEMPTION:  

This license is non-transferable and non-refundable.
PRIVILEGES ISSUED

LICENSE TYPE VALID PERIOD FEE
Trout/Salmon Stamp 01/01/2005 - 02/28/2006 $9.25
Res. Deer Firearm 01/01/2005 - 02/28/2006 $24.00
Migratory Waterfowl Stamp 01/01/2005 - 02/28/2006 $6.75
Res. Hunt/Fish 01/01/2005 - 02/28/2006 $20.75
-------------------------------------- -------------Total Fees (4): $60.75
NOT A REAL LICENSE XXXXXXX test XXXXX XXXXX
NOT A REAL LICENSE XXXXXXX test XXXXX XXXXX
NOT A REAL LICENSE XXXXXXX test XXXXX XXXXX
NOT A REAL LICENSE XXXXXXX test XXXXX XXXXX
NOT A REAL LICENSE XXXXXXX test XXXXX XXXXX

 
HUNTER ED NUMBER HIP NUMBER

X
  SIGNATURE
THIS IS NOT A REAL LICENSE - It was created on test
I swear and affirm under the penalties of perjury found in IC 35-44-2-1 (Class "D" Felony) that the information contained in this document is true and correct.
 
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Store of Purchase:   Test Store
  123 store st
indy, IN  46000

Name & Address:   Christopher Roach
  13579 Odd number Rd. 
Apt: 2468
Huntingburg, IN 47715
Purchases Price
Trout/Salmon Stamp $9.25
Res. Deer Firearm $24.00
Migratory Waterfowl Stamp $6.75
Res. Hunt/Fish $20.75
  Total $60.75

Your License Number:  0506070236175
Thank you for your purchase!
This license is non-transferable and non-refundable.


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