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M D N R� .. � • e4,VL�j�� <br />88 1 2 <br />JACK TNaM AS <br />1219 Sao ����- <br />KE <br />OEM LAKE, M N 55114 <br />DOB:44f0312002 Height: 5► <br />9 q <br />Drivers License: <br />Z5,862571 5431 , Weight: 154LB <br />Firearm Safety: 8801253 Gender: M <br />3Q ; ALE <br />Eyes: BROWN <br />Res Bonus AntlerleSs Deer '� <br />Ll� �1 �.0 cc <br />HarVeSt Reg. + 625812227 4 <br />Registration of your animal is m <br />1 `S$$`705- andatory, Please oil <br />53571 logon to Www- mndnr,gov/hu.nting, location, Be prepared with the go�rl'hunting, or visit an <br />following information, <br />Write your confirmation number o <br />registration is completes <br />n the line below when <br />1. Harvest F'ieg #: 525&j'-227 <br />2: Permit Area (3 digit number <br />3.TyPeOfDeer <br />9 <br />4. Date of kill <br />Registration Confirmation #: <br />Licensee Sicgnature: <br />l certify that !meet the citizenship requirements a <br />legal residence in •ho Mate for a periodnd have maintained a <br />the date of this application. My 11aens Of <br />days it mediatoly preceding <br />} not otherwise revoked. <br />Trans #: 060874549 <br />i$stied; 101111202012:06` <br />Agent: o62o22 <br />Terminal; 52290263 <br />