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Name: License #: Year: FUR BUYER RECORD This booklet is your permanent record of the coming year s sales. Before you send it back to us, be sure to make copies for your own records. Not only is this book important to you, but it also is of vital importance to the management of the furbearers you trade in. Your records are our best way of measuring the annual harvest of these animals. Your dedication to the wise use of this valuable natural resource will no doubt be reflected in the accuracy and completeness of these records. You will notice that an application for next year s license is included in this book. If you want a license for the coming year, complete the application and leave it in the book. Incomplete books or inaccurate records will result in a violation of a Fish and Wildlife statute. Make sure the book is notarized in the space provided. Entries shall be made on the day of transactions. Vermont law requires that you allow the Commissioner or his agent access to these records and fur storage areas at any time. Please consult the regulations listed on the back page. Thank you for your cooperation.

Vermont Fish & Wildlife Department 1 National Life Drive, Dewey Building Montpelier, VT 05620-3208 Please give all information requested. Incomplete and illegible reports will not be accepted. 0001 VERMONT FUR BUYER RECORD Name of Seller: (Trapper, Dealer, Hunter) Check One: Hunter Dealer Trapper Address of Seller (Town and State) Seller s License Number Date of Purchase

0001 Furbuyer s Name: Furbuyer s License Number: Year: Record number of pelts purchased in appropriate column. County (if in Vermont or state where fur was taken) Fox, red Fox, grey Coyote Raccoon Skunk Muskrat Mink Fisher Weasel Beaver Otter Bobcat Other (Specify) Deer

Vermont Fish & Wildlife Department 1 National Life Drive, Dewey Building Montpelier, VT 05620-3208 Please give all information requested. Incomplete and illegible reports will not be accepted. 0002 VERMONT FUR BUYER RECORD Name of Seller: (Trapper, Dealer, Hunter) Check One: Hunter Dealer Trapper Address of Seller (Town and State) Seller s License Number Date of Purchase

0002 Furbuyer s Name: Furbuyer s License Number: Year: Record number of pelts purchased in appropriate column. County (if in Vermont or state where fur was taken) Fox, red Fox, grey Coyote Raccoon Skunk Muskrat Mink Fisher Weasel Beaver Otter Bobcat Other (Specify) Deer

I hereby swear that this is a true and correct statement concerning the number of skins and furs of furbearing animals indicated herein, which were purchased by me during the period July 1, 20 to June 30, 20,inclusive. Name: STATE OF VERMONT) COUNTY) The above subscribed and sworn to before me at in said county, this day of, 20. Notary Public Commission Expires: Pursuant to the provisions of Section 4270, Title 10, V.S.A. the Commissioner requests that this record must be filed with the Fish & Wildlife Department, 1 National Life Drive, Dewey Building, Montpelier, VT 05620-3208, not later than July 30 th following end of license year. THIS STATEMENT MUST BE SIGNED, NOTARIZED, AND RETURNED TO THIS OFFICE BEFORE A FURBUYER LICENSE MAY BE ISSUED.

VERMONT FISH & WILDLIFE DEPARTMENT 1 National Life Drive, Dewey Building Montpelier, VT 05620-3208 (802) 828-1190 or 828-1191 Furbuyer License Applicants CERTIFICATION OF GOOD STANDING WITH TAX DEPARTMENT Legislation prohibits renewal of licenses or other authority to do business in Vermont unless the applicant verifies in writing that he/she is in good standing with respect to payment of state taxes (32 V.S.A. Section 3113). This applies to all licenses, permits, charters, or certificates of authority to conduct a trade, business, or profession. issued. If the applicant is unable or unwilling to verify the tax status, no license will be Enclosed you will find a Tax Certification form that should be filled out by you and returned to the Fish & Wildlife Department, along with your license application. If you are in good standing with the Tax Department, your furbuyer license will be issued to you. If you need further information on this matter and if you have the need to achieve good standing, please contact the Vermont Department of Taxes at (802) 828-2518. (over please)

TAX CERTIFICATION ON LICENSE APPLICATIONS By law (32 V.S.A. Section 3113), no agency of the State may renew a license or other authority to conduct a trade of business (including a license to practice a profession) unless the licensee first certifies, under the pains and penalties of perjury, that he or she is in good standing with the Department of Taxes. A person is in good standing if no taxes are due, if the liability for any tax that may be due is on appeal, if the taxpayer is in compliance with a payment plan approved by the Commissioner of Taxes, or if the licensing authority determines that immediate payment of taxes due and payable would pose an unreasonable hardship. The maximum penalty for perjury is fifteen (15) years in prison, a $10,000 fine or both. I hereby certify, under the pains and penalties of perjury, that I am in good standing with respect to, or in full compliance with a plan approved by the Commissioner of Taxes to pay, any and all taxes due the State of Vermont as of the date of this application. Date Signature IF YOU ARE NOT IN GOOD STANDING AT THIS TIME, you may do one of the following three things: (1) discontinue this license or license renewal application; (2) arrange with the Vermont Department of Taxes to bring yourself into good standing through a payment plan approved by the Commissioner or otherwise; (3) seek a determination from the licensing agency that immediate payment of taxes due and payment would impose an unreasonable hardship. IF YOU DESIRE TO CONTINUE THIS APPLICATION, you should complete the statement below. ALTERNATE CERTIFICATION I am not in good standing with the Department of Taxes at this time, and, (a) I will arrange with the Department of Taxes to bring myself into good standing; or (b) Seek a determination that immediate payment would impose an unreasonable hardship. Date Signature Arrangements to achieve good standing should be made by contacting Operations Division, Vermont Department of Taxes (802) 828-2518.

VERMONT FISH & WILDLIFE DEPARTMENT 1 National Life Drive, Dewey Building Montpelier, VT 05620-3208 (802) 828-1190 or 828-1191 No. License Issued STATE OF VERMONT FUR BUYER S LICENSE APPLICATION Resident $25.00 Nonresident $50.00 Applicant (print): Address: Business Address: Telephone: Email (optional): Are you a citizen of the United States? Yes No Have you resided in this state for six months immediately prior to the date of making application: Yes No I am a resident of the town (city) of: Have you been convicted within one year of violating any Vermont Fish and Wildlife law? Yes No Place of Birth: Date of Birth: Sex: Male Female Age: Height: Weight: Color of Hair: Color of Eyes: Dated at, Vermont this day of 20.

10 V.S.A. 4268. Fur Buyer s License: The furs and skins of fur-bearing animals and skins of deer, legally taken, may be bought and sold at any time; provided, that any person wishing to engage in the business of buying the furs or skins of fur-bearing animals or skins for deer shall first secure a license from the commissioner, as provided by law. 10 V.S.A. 4269. Fees for Fur Buyer s License: The commissioner may issue a license to a person which shall authorize him to engage in the business of buying furs or skins throughout the state while it remains in force. A person so licensed shall pay the commissioner the following fees: a) A fee of $25.00 if the applicant is a bona fide resident of the state; b) A fee of $50.00 if the applicant is a nonresident. Licensed dealers shall keep such records as the commissioner may require. Such records shall be open to inspection by the commissioner or his agents, and such dealer shall within thirty days after the expiration of his license, and upon request of the commissioner, file with the commissioner a sworn statement of such record or such part thereof as the commissioner may require. 10 V.S.A. 4271. Fur Buyer s License Year; Expiration of License: Such licenses shall be effective from July 1 to June 30 inclusive. A person while engaged in the business of buying furs and skins shall have upon his person a license as provide in section 4268 of this title and on demand of a game warden or other officer authorized by law to make arrests shall exhibit such license. 10 V.S.A. 4272. Lost Fur Buyer s License; Certificate: A licensed dealer who has lost his license issued to him as provided by section 4269 of this title may demand and shall receive from the commissioner a certificate, stating the name and residence of such dealer, the fact that a dealer s license was issued to him, the date thereof and the fee paid therefore. For such certificate the commissioner shall receive a fee of fifty cents. He shall endorse upon the original application for such license the date on which such certificate was issued. A certificate so issued shall have the same force and effect as the original license and the holder thereof shall be subject to all the provisions of law applicable to such license. 10 V.S.A. 4273. False Statement by the Furbuyer: No person shall make a false statement in an application for a furbuyer s license or change or alter such a license in any way nor permit another to have or use such a license. 10 V.S.A. 4274. Fur Buyer s License; Definition of person : The word person as used in sections 4268-4273 of this title shall mean only an individual. REGULATION NO. 618 RELATING TO FUR BUYER S RECORDS Pursuant to the provision of 4270, Title 10, V.S.A., as amended, the holder of a fur buyer s license shall keep a record of the date of each transaction, the name and address of each person from whom furs and skins of fur-bearing animals and skins of deer were purchased, the name and address of each person to whom furs and skins of fur-bearing animals and skins of deer were sold and the number of each species of furs and skins of fur-bearing animals and skins of deer bought and sold.