FORM 2727-A Revised 1/17 FOLE Page of

FOR DEPARTMENT USE ONLY

Report Received

Date Received Region: Post Marked

Date Review Complete Approved: Denied:

Valid From: To:

Approved By: Date:

[PLEASE PRINT OR TYPE]

ARIZONA GAME AND FISH DEPARTMENT GUIDE LICENSE APPLICATION

ARS 17-362 & R12-4-208

Calendar YearFEE: $300.00

Gender

Current hunting, fishing, or combination license number

City Business Mailing Address Outfitting/Guide Business Name

Physical Address (if different than mailing)

State Hair

State Zip Phone

Height Eyes Phone

______ Number of Yrs ResidentResidentNon Resident

Valid from to

ANSWER ALL OF THE BELOW QUESTIONS

Have you been convicted of a Wildlife felony during the past 5 years?Yes No

Is your privilege to take wildlife currently under suspension or revocation by the government of any state or the United States?

Yes No

Have you been convicted for a hunting, guiding/outfitting or fishing violation in any state within the past year?Yes No

Email

for the year in which you intend to guide

NEW or RENEWAL

Hunting Guide Fishing Guide Hunting & Fishing Guide

Date of BirthDepartment ID Number or SSN:

Name Mailing Address

Weight ZipCity

If you answered yes to any of the questions above explain in the box below

FORM 2727-A Revised 1/17 FOLE Page of

Attachments: Additional information required under R12-4-208Copy of Applicant's proof of identitySuccessfully passed guides testAnnual report submitted with renewal applicationYes No

***RENEWAL APPLICATIONS MUST BE RECEIVED OR POSTMARKED BY DECEMBER 31st ***

Applicant Signature: Date

By signing this document I affirm that I meet the eligibility requirements of this rule and the information provided on the application is true and accurate. The guiding services to be carried out, if license herein applied for is granted, will be conducted in compliance with Arizona laws.

If this is a renewal application, a Guide license holder shall submit an annual report to the Department before January 10th each year for activities performed under the license for the previous calendar year. The report must be submitted regardless whether or not you guided the previous year. The license becomes invalid if the report is not submitted and the Department will not process this renewal application until the report is received.

In accordance with provisions under Section 41-1030, Arizona Revised Statutes: An agency shall not base a licensing decision in whole or in part on a licensing requirement or condition that is not specifically authorized by a statute, rule or state tribal gaming compact. A general grant of authority in statute does not constitute a basis for imposing a licensing requirement or condition unless a rule is made pursuant to that general grant of authority that specifically authorizes the requirement or condition. This section may be enforced in a private civil action and relief may be awarded against the state. The court may award reasonable attorney fees, damages and all fees associated with the license application to a party that prevails in an action against the state for a violation of this section. A state employee may not intentionally or knowingly violate this section. A violation of this section is cause for disciplinary action or dismissal pursuant to the Agency's adopted personnel policy. This section does not abrogate the immunity provided by section 12-820.01 or 12-820.02.