West Virginia Code of State Rules › Agency 58 - Natural Resources › Title 58 - LEGISLATIVE EXEMPT RULE BUREAU OF COMMERCE DIVISION OF NATURAL RESOURCES › Series 58-17 - Fur Dealer Transactions › Appendix A

Current through Register Vol. XLI, No. 28, July 12, 2024
RESIDENT COUNTY OR STATEWIDE
FUR DEALER'S APPLICATION FORM
WEST VIRGINIA DIVISION OF NATURAL
				  RESOURCES
APPLICATION FOR A RESIDENT FUR DEALER'S
				  LICENSE
(West Virginia Code '20-2-49)
INITIAL APPLICATION (___) RENEWAL APPLICATION (___)
CHECK ONE:
(___) Resident County License for the Counties of:
_______________________________________________
(___) Resident Statewide License
NAME:
				  __________________________________________________
STREET or BOX:
				  __________________________________________
CITY and COUNTY:
				  ________________________________________
STATE and ZIP CODE:
				  _____________________________________
TELEPHONE NUMBER: ____________________________________
CURRENT LICENSE NUMBER: ______________________________
I certify that I have been a domiciled resident of the state
				  of West Virginia for a period of at least six (6) months prior to the date of
				  this application. I agree to abide by the terms and conditions of my
				  license.
_____________________________ ______________
(Signature of Applicant) (Date)
Annual Fee for Resident County License: $1.00 per
						  county Annual Fee for Resident Statewide License: $10.00 Law Enforcement
						  Section Annual Fee for Agent's Permit: $2.50 for each agent
RETURN
						  TO: WV Division of Natural Resources Law Enforcement Section Room 837, Building
						  3 State Capitol Complex Charleston, WV. 25305
THE FOLLOWING AGENTS ARE EMPLOYED BY THE APPLICANT:
_____________________________________________________________
Name of Agent (Street or Box)
_____________________________________________________________
(City) (County) (State) (Zip Code)
I agree to abide by the terms and conditions of my
				  permit.
_________________________ _____________
(Signature of Agent) (Date)
-------------------------------------------------------------------------------------------------------------------
__________________________________________________________
(Name of Agent) (Street or Box)
_______________________________________________________________
(City) (County) (State) (Zip Code)
I agree to abide by the terms and conditions of my
				  permit.
_________________________ _____________
(Signature of Agent) (Date)
-------------------------------------------------------------------------------------------------------------------
___________________________________________________________
(Name of Agent) (Street or Box)
_____________________________________________________________
(City) (County) (State) (Zip Code)
I agree to abide by the terms and conditions of my
				  permit.
_________________________ ______________
(Signature of Agent) (Date)
___________________________________________________________
(Name of Agent) (Street or Box)
_____________________________________________________________
(City) (County) (State) (Zip Code)
I agree to abide by the terms and conditions of my
				  permit.
_________________________ _____________
(Signature of Agent) (Date)