Application for Change of Information Regarding Designates Listed on a Commercial Bait Licence | Ministry of Natural Resources and Forestry

Current License Number

Year Issued (yyyy)

Applicant Information

Name of Business/Organization/Affiliation (if applicable)

Primary Telephone Number

Ext.

Secondary Telephone Number

Ext.

and/or

Last Name

First Name

Middle Initial

Unit Number

Street Number

Street Name

PO Box

City/Town

Province

Postal Code

All Bait Harvest Areas (BHAs)

Remove Bait Harvest Areas (BHAs)

Add Bait Harvest Areas (BHAs)

I certify that the information provided in this application is true.*

Signature of Applicant*

Date of Application (YYYY/MM/DD)*