1. Please print your Customer ID or driver license number or social security number AND date of birth. Customer ID No. Or Driver License No. Or Social Security No. AND Date of Birth 2. Please print your name. MM / DD / YYYY APPLICATION PERIODS All periods begin at 10:00 a.m. Eastern time and end at 11:59 p.m. Eastern time Phase I November 01, 2017 - November 30, 2017 Phase II December 04, 2017 - December 14, 2017 Phase III December 18, 2017 - April 22, 2018 First Middle Last 3. If exempt from purchasing a Management Area Permit, please indicate the exemption that you qualify for: Florida Resident no-cost Fishing/ing Certificate: D Exp Date: Florida Resident Age 65 or older Youth Under 16 4. Please indicate your 4-digit hunt choice(s) (# that appears to the left of each hunt) in the boxes provided. 1st Choice 2nd Choice 3rd Choice 4th Choice 5th Choice 5. You can apply online at http://gooutdoorsflorida.com (choose 'Apply for Limited Entry/Quota Permits') or you can complete this form and present it to any license agent or tax collector office and they will submit your application for you. Submitting false information or using another person s identity without their consent is considered identity theft and may result in felony charges and the loss of hunting privileges. The Florida Fish and Wildlife Conservation Commission (FWC) collects social security numbers (SSN) for the issuance of recreational and professional fishing or hunting licenses or permits to an individual in accordance with chapter 379 F.S. and 42 USC 666 for the purposes of administration of the Title IV-D program for child support enforcement, use by the Commission, and as otherwise provided by law. FOR AGENT USE ONLY To Submit an Application: INSTRUCTIONS FOR TAX COLLECTOR OFFICES AND LICENSE AGENTS In RLIS, navigate to the Customer Lookup Screen and enter the customer s date of birth and customer ID number, Florida Driver s License number, or the last four digits of the customer s Social Security and last name. Under the Customer s Detail section, select Apply for Limited Entry/Quota. Choose the appropriate application and proceed through with prompts according to the customer's requests. Verify all permit choice information before submitting, and print document receipt for the customer.
Northwest Region 3001 Apalachee Zones B and C 03/17/2018 03/18/2018 5 3002 Apalachee Zones B and C 03/23/2018 03/25/2018 5 3003 Apalachee Zones B and C 03/30/2018 04/01/2018 5 3004 Apalachee Zones B and C 04/06/2018 04/08/2018 5 3005 Apalachee Zones B and C 04/13/2018 04/15/2018 5 3006 Apalachee Zones B and C 04/20/2018 04/22/2018 5 3007 Apalachicola Bradwell Unit 03/17/2018 03/18/2018 5 3008 Apalachicola Bradwell Unit 03/30/2018 04/01/2018 5 3232 Beaverdam Creek 03/17/2018 03/20/2018 5 3233 Beaverdam Creek 03/28/2018 04/01/2018 5 3009 Blackwater Hutton Unit 03/17/2018 03/19/2018 10 3010 Blackwater Hutton Unit 03/30/2018 04/01/2018 10 3011 Blackwater Hutton Unit 04/13/2018 04/15/2018 10 3012 Box R 03/17/2018 03/20/2018 5 3013 Box R 03/29/2018 04/01/2018 5 3014 Box R 04/12/2018 04/15/2018 5 3229 Chipola River Altha Tract 03/17/2018 03/19/2018 5 3230 Chipola River Altha Tract 03/30/2018 04/01/2018 5 3231 Chipola River Altha Tract 04/13/2018 04/15/2018 5 3015 Choctawhatchee River North 03/17/2018 03/19/2018 10 3186 Choctawhatchee River North 03/30/2018 04/01/2018 10 3016 Econfina Creek 03/17/2018 03/25/2018 25 3017 Econfina Creek Cat Creek Area 03/17/2018 03/19/2018 5 3018 Econfina Creek Cat Creek Area 03/30/2018 04/01/2018 5 3019 Econfina Creek Cat Creek Area 04/13/2018 04/15/2018 5 3020 Econfina Creek Fitzhugh Carter Area 03/17/2018 03/19/2018 5 3021 Econfina Creek Fitzhugh Carter Area 03/30/2018 04/01/2018 5 3022 Econfina Creek Fitzhugh Carter Area 04/13/2018 04/15/2018 5 3028 Escribano Point 03/17/2018 03/19/2018 5 3029 Escribano Point 03/30/2018 04/01/2018 5 3030 Escribano Point 04/06/2018 04/08/2018 5 3207 Escribano Point 04/20/2018 04/22/2018 5 3250 Joe Budd 03/17/2018 03/18/2018 20 3251 Joe Budd 03/24/2018 03/25/2018 20 3252 Joe Budd 03/31/2018 04/01/2018 20 3253 Joe Budd 04/07/2018 04/08/2018 20 3254 Joe Budd 04/14/2018 04/15/2018 20 3255 Joe Budd 04/21/2018 04/22/2018 20 3210 L. Kirk Edwards 03/17/2018 03/19/2018 3 3211 L. Kirk Edwards 03/30/2018 04/01/2018 3 3212 L. Kirk Edwards 04/13/2018 04/15/2018 3 3166 Lafayette Creek 03/17/2018 03/19/2018 5
3167 Lafayette Creek 03/23/2018 03/25/2018 5 3168 Lafayette Creek 03/30/2018 04/01/2018 5 3169 Lafayette Creek 04/06/2018 04/08/2018 5 3170 Lafayette Creek 04/13/2018 04/15/2018 5 3171 Lafayette Creek 04/20/2018 04/22/2018 5 3182 Perdido River 03/17/2018 03/25/2018 15 3183 Perdido River 03/26/2018 04/08/2018 15 3023 Tate's Hell 03/17/2018 04/22/2018 200 3024 Tate's Hell Womack Creek Unit 03/17/2018 03/20/2018 15 3025 Tate's Hell Womack Creek Unit 03/29/2018 04/01/2018 15 3026 Tate's Hell Womack Creek Unit 04/05/2018 04/08/2018 15 3172 Wakulla 03/17/2018 03/18/2018 10 3173 Wakulla 03/24/2018 03/25/2018 10 3174 Wakulla 03/31/2018 04/01/2018 10 3175 Wakulla 04/07/2018 04/08/2018 10 3176 Wakulla 04/14/2018 04/15/2018 10 3177 Wakulla 04/21/2018 04/22/2018 10 North Central Region 3031 Andrews 03/23/2018 03/26/2018 25 3032 Andrews 04/13/2018 04/15/2018 25 3033 Bayard 03/17/2018 03/19/2018 10 3034 Bayard 03/30/2018 04/01/2018 10 3035 Bayard 04/13/2018 04/15/2018 10 3187 Belmore 03/17/2018 03/19/2018 10 3188 Belmore 03/23/2018 03/25/2018 10 3189 Belmore 03/30/2018 04/01/2018 10 3036 Big Bend Snipe Island Unit 03/17/2018 03/25/2018 40 3037 Big Bend Snipe Island Unit 03/26/2018 04/01/2018 40 3038 Big Shoals 03/22/2018 03/24/2018 20 3039 Big Shoals 04/12/2018 04/14/2018 20 3040 Camp Blanding 03/19/2018 03/25/2018 35 3041 Camp Blanding 03/31/2018 04/06/2018 35 3190 Cary 03/17/2018 03/19/2018 20 3191 Cary 03/23/2018 03/25/2018 20 3192 Cary 03/30/2018 04/01/2018 20 3178 Citrus 03/20/2018 03/23/2018 25 3179 Citrus 04/03/2018 04/06/2018 25 3180 Citrus 04/17/2018 04/20/2018 25 3042 Cypress Creek 03/17/2018 03/25/2018 12 3043 Devil's Hammock 03/17/2018 03/20/2018 15 3044 Devil's Hammock 03/21/2018 03/25/2018 15
3045 Flying Eagle 03/17/2018 03/20/2018 30 3046 Flying Eagle 03/23/2018 03/27/2018 30 3213 Fort White 03/17/2018 03/21/2018 3 3214 Fort White 03/24/2018 03/28/2018 3 3193 Four Creeks 03/17/2018 03/19/2018 15 3194 Four Creeks 03/23/2018 03/25/2018 15 3195 Four Creeks 03/30/2018 04/01/2018 15 3047 Goethe 03/17/2018 03/23/2018 130 3181 Goethe 03/24/2018 04/01/2018 130 3234 Goethe 04/02/2018 04/08/2018 130 3196 Hatchet Creek 03/17/2018 03/19/2018 5 3197 Hatchet Creek 03/23/2018 03/25/2018 5 3198 Hatchet Creek 03/30/2018 04/01/2018 5 3048 Holton Creek - Mobility Impaired 03/23/2018 03/25/2018 10 3049 Holton Creek - Mobility Impaired 04/13/2018 04/15/2018 10 3050 Jennings Forest 03/17/2018 03/19/2018 30 3051 Jennings Forest 03/20/2018 03/22/2018 30 3215 Jennings Forest 03/23/2018 03/25/2018 30 3216 Lafayette Forest 03/17/2018 03/19/2018 5 3217 Lafayette Forest 03/23/2018 03/25/2018 5 3241 Little River 03/17/2018 03/19/2018 5 3242 Little River 03/30/2018 04/01/2018 5 3052 Middle Aucilla 03/17/2018 04/22/2018 30 3053 Potts 03/17/2018 03/20/2018 20 3054 Potts 03/23/2018 03/27/2018 20 3055 Raiford 03/17/2018 03/25/2018 25 3056 Ralph E. Simmons 03/17/2018 03/19/2018 15 3057 Ralph E. Simmons 03/30/2018 04/01/2018 15 3058 Ralph E. Simmons 04/13/2018 04/15/2018 15 3059 Steinhatchee Springs 03/17/2018 03/20/2018 88 3060 Steinhatchee Springs 03/21/2018 03/25/2018 88 3061 Suwannee Ridge - Mobility Impaired 03/23/2018 03/25/2018 4 3062 Suwannee Ridge - Mobility Impaired 04/13/2018 04/15/2018 4 3199 Thomas Creek Kings Road Unit 03/17/2018 03/19/2018 5 3200 Thomas Creek Kings Road Unit 03/26/2018 03/28/2018 5 3201 Thomas Creek Kings Road Unit 04/02/2018 04/04/2018 5 3063 Twin Rivers 03/23/2018 03/25/2018 20 3064 Twin Rivers 04/13/2018 04/15/2018 20 Northeast Region 3065 Buck Lake 03/17/2018 03/20/2018 20 3066 Buck Lake 03/22/2018 03/26/2018 20
3067 Caravelle Ranch 03/17/2018 03/20/2018 35 3068 Caravelle Ranch 03/21/2018 03/25/2018 35 3218 Charles H. Bronson 03/17/2018 03/20/2018 15 3219 Charles H. Bronson 03/23/2018 03/26/2018 15 3220 Charles H. Bronson 03/30/2018 04/02/2018 15 3069 Dunns Creek 03/17/2018 03/19/2018 15 3070 Dunns Creek 03/30/2018 04/01/2018 15 3071 Dunns Creek 04/13/2018 04/15/2018 15 3072 Etoniah Creek 03/17/2018 03/20/2018 10 3073 Etoniah Creek 03/23/2018 03/26/2018 10 3074 Etoniah Creek 03/30/2018 04/01/2018 10 3099 Gores Landing 03/17/2018 03/20/2018 10 3100 Gores Landing 03/21/2018 03/25/2018 10 3202 Guana River 03/23/2018 03/25/2018 6 3203 Guana River 03/30/2018 04/01/2018 6 3075 Half Moon 03/17/2018 03/19/2018 30 3076 Half Moon 03/23/2018 03/25/2018 30 3077 Half Moon 03/30/2018 04/01/2018 30 3078 Lake George 03/17/2018 03/20/2018 50 3079 Lake George 03/29/2018 04/01/2018 50 3080 Lake George 04/12/2018 04/15/2018 50 3221 Little Big Econ 03/17/2018 03/20/2018 10 3222 Little Big Econ 03/22/2018 03/25/2018 10 3223 Little Big Econ 03/29/2018 04/01/2018 10 3224 Marshall Swamp 03/17/2018 03/19/2018 5 3225 Marshall Swamp 03/23/2018 03/25/2018 5 3226 Marshall Swamp 03/30/2018 04/01/2018 5 3081 Matanzas 03/17/2018 03/20/2018 15 3082 Matanzas 03/29/2018 04/01/2018 15 3235 Matanzas 04/05/2018 04/08/2018 15 3083 Ocala Church Lake Unit 03/22/2018 03/25/2018 15 3084 Ocala Church Lake Unit 03/29/2018 04/01/2018 15 3085 Ocala Church Lake Unit 04/05/2018 04/08/2018 15 3086 Ocala Church Lake Unit 04/12/2018 04/15/2018 15 3087 Ocala Hopkins Prairie 03/22/2018 03/25/2018 30 3088 Ocala Hopkins Prairie 03/29/2018 04/01/2018 30 3089 Ocala Hopkins Prairie 04/05/2018 04/08/2018 30 3090 Ocala Hopkins Prairie 04/12/2018 04/15/2018 30 3091 Ocala Lake Delancy 03/22/2018 03/25/2018 100 3092 Ocala Lake Delancy 03/29/2018 04/01/2018 100 3093 Ocala Lake Delancy 04/05/2018 04/08/2018 100 3094 Ocala Lake Delancy 04/12/2018 04/15/2018 100 3095 Ocala Pipeline Unit 03/22/2018 03/25/2018 220
3096 Ocala Pipeline Unit 03/29/2018 04/01/2018 220 3097 Ocala Pipeline Unit 04/05/2018 04/08/2018 220 3098 Ocala Pipeline Unit 04/12/2018 04/15/2018 220 3101 Richloam 03/17/2018 03/25/2018 250 3102 Richloam Baird Unit 03/17/2018 03/19/2018 30 3103 Richloam Baird Unit 03/23/2018 03/25/2018 30 3104 Richloam Baird Unit 03/30/2018 04/01/2018 30 3236 Ross Prairie 03/23/2018 03/25/2018 5 3105 Salt Lake 03/17/2018 03/20/2018 15 3106 Salt Lake 03/21/2018 03/25/2018 15 3107 Seminole Forest 03/17/2018 03/21/2018 30 3108 Seminole Forest 03/24/2018 03/28/2018 30 3109 Seminole Forest Lake Tracy Unit 03/17/2018 03/19/2018 20 3110 Seminole Forest Lake Tracy Unit 03/23/2018 03/25/2018 20 3111 Seminole Ranch 03/17/2018 03/19/2018 25 3112 Seminole Ranch 03/23/2018 03/25/2018 25 3113 Seminole Ranch 03/30/2018 04/01/2018 25 3114 Three Lakes Prairie Lakes Unit 03/17/2018 03/19/2018 25 3115 Three Lakes Prairie Lakes Unit 03/30/2018 04/01/2018 25 3116 Three Lakes Prairie Lakes Unit 04/13/2018 04/15/2018 25 3117 Tiger Bay 03/17/2018 03/20/2018 25 3118 Tiger Bay 03/29/2018 04/02/2018 25 3119 Tiger Bay 04/12/2018 04/15/2018 25 3120 Tiger Bay Rima Ridge Unit 03/17/2018 03/19/2018 20 3121 Tiger Bay Rima Ridge Unit 03/30/2018 04/01/2018 20 3122 Tiger Bay Rima Ridge Unit 04/13/2018 04/15/2018 20 3123 Tosohatchee 03/17/2018 03/19/2018 35 3124 Tosohatchee 03/30/2018 04/01/2018 35 3125 Tosohatchee 04/13/2018 04/15/2018 35
Southwest Region 3237 Arbuckle 03/20/2018 03/22/2018 15 3238 Arbuckle 04/03/2018 04/05/2018 15 3208 Babcock Ranch Preserve 03/03/2018 03/05/2018 15 3209 Babcock Ranch Preserve 03/10/2018 03/12/2018 15 3126 Chassahowitzka 03/23/2018 03/25/2018 10 3127 Chassahowitzka 04/06/2018 04/08/2018 10 3204 Chassahowitzka 04/20/2018 04/22/2018 10 3128 Croom 03/20/2018 03/22/2018 15 3129 Croom 04/03/2018 04/05/2018 15 3130 Croom 04/17/2018 04/19/2018 15 3131 Green Swamp 03/17/2018 03/18/2018 200 3132 Hickory Hammock 03/22/2018 03/24/2018 5 3133 Hickory Hammock 04/12/2018 04/14/2018 5 3134 Hilochee 03/23/2018 03/25/2018 5 3135 Hilochee 04/06/2018 04/08/2018 5 3205 Hilochee Osprey Unit 04/13/2018 04/15/2018 5 3206 Hilochee Osprey Unit 04/20/2018 04/22/2018 5 3136 KICCO 03/17/2018 03/18/2018 10 3137 KICCO 03/24/2018 03/25/2018 10 3138 KICCO 03/31/2018 04/01/2018 10 3139 KICCO 04/07/2018 04/08/2018 10 3140 KICCO 04/14/2018 04/15/2018 10 3141 Lake Marion Creek 03/17/2018 03/19/2018 15 3142 Lake Marion Creek 03/30/2018 04/01/2018 15 3143 Lake Marion Creek 04/13/2018 04/15/2018 15 3144 Lake Wales Ridge Royce Unit 03/17/2018 03/19/2018 5 3145 Lake Wales Ridge Royce Unit 03/30/2018 04/01/2018 5 3239 Walk In The Water 03/27/2018 03/29/2018 5
South Region 3184 Allapattah Flats 03/03/2018 03/06/2018 20 3185 Allapattah Flats 03/07/2018 03/11/2018 20 3240 Big Cypress Addition Unit 03/03/2018 04/08/2018 30 3146 CREW Corkscrew Marsh 03/03/2018 03/06/2018 5 3147 CREW Corkscrew Marsh 03/07/2018 03/11/2018 5 3148 CREW Flint Pen/Rookery Swamp Units 03/03/2018 03/06/2018 5 3149 CREW Flint Pen/Rookery Swamp Units 03/07/2018 03/11/2018 5 3150 Dinner Island Ranch 03/03/2018 03/05/2018 20 3151 Dinner Island Ranch 03/10/2018 03/12/2018 20 3227 Dinner Island Ranch 03/31/2018 04/02/2018 20 3152 Dupuis WEA 03/06/2018 03/08/2018 35 3153 Dupuis WEA 03/16/2018 03/18/2018 35 3154 Dupuis WEA 03/23/2018 03/25/2018 35 3155 Fisheating Creek West 03/03/2018 03/06/2018 15 3156 Fisheating Creek West 03/09/2018 03/12/2018 15 3157 Fisheating Creek West 03/16/2018 03/19/2018 15 3158 Fisheating Creek West 03/23/2018 03/26/2018 15 3159 Fisheating Creek West 03/30/2018 04/02/2018 15 3160 Okaloacoochee Slough 03/03/2018 03/06/2018 50 3161 Okaloacoochee Slough 03/07/2018 03/11/2018 50 3162 Picayune Strand 03/03/2018 03/06/2018 65 3163 Picayune Strand 03/07/2018 03/11/2018 65 3164 Spirit Of The Wild 03/03/2018 03/05/2018 10 3165 Spirit Of The Wild 03/10/2018 03/12/2018 10 3228 Spirit Of The Wild 03/31/2018 04/02/2018 10 Exempt hunts on this worksheet are NOT indicated in bold print. If you are an exempt hunter and apply for an exempt hunt (either by accident, or as a group member), and are successful, you will not be issued a quota permit and cannot have a guest hunter. The hunts indicated in bold print on this application worksheet have no exemptions and all hunters must have a quota permit, or be the guest of a quota permit holder, to participate in those hunts.