HomeMy WebLinkAboutForm 2_IC Bow Hunt Program Permission Form to Hunt on Private PropertyIowa City Police Department | p: 319-356-5275 Form #2
410 E. Washington Street | Iowa City, Iowa 52240 Page 1 of 1
Iowa City Deer Management Bow Hunt Program
PERMISSION FORM to HUNT on PRIVATE PROPERTY as
GRANTED by the PROPERTY OWNER or PROPERTY MANAGER
Permission for hunting period: ____________________________
HUNTER and PROPERTY OWNER or MANAGER: By signing this voluntary authorization, the hunter, property owner,
property manager, on behalf of his or her own self and their heirs, assigns and legal representatives agree to release and
hold harmless and indemnify the City of Iowa City, its officers, agents, representatives, employees, and other participating
parties to this special hunt, from any law suit or action that is made or brought against the City for all
activities associated with this deer control program. You are required to use an elevated stand, and to obtain a special bow
hunt license for antlerless deer from the DNR. This form is for City use only and is NOT a hunting license.
Hunter’s First, Middle & Last Name Hunter’s Email Address
Hunter’s Address including City, State & Zip Code
Hunter’s Cell Phone Number Emergency Contact Name & Telephone Number
Hunter’s Driver’s License Info: _
State Issued Hunter’s Driver’s License Number
Vehicle to be used during hunt:
Year Make Model Color License Plate #
Obtain the written permission from the property owner or property manager, and return this original form to the Iowa City Police
Department, 410 E. Washington Street Iowa City, IA 52240.
Are you both the hunter and the property owner/manager? Yes No
If you are the hunter, this form is complete. If you are NOT the hunter, complete all fields below:
Are you the: Property Owner Property Manager Name: ___________________________________
Property Owner/Property Manager Mailing Address including City, State & Zip Code
Cell Phone Home Phone Email Address
Emergency Contact Name and Telephone Number
Address of property to be hunted
Location of deer stand on the property.
Signature of above Property Owner or Manager Date Signed
Map Attachment: This form will NOT be considered complete unless you attach a map image which
clearly defines your planned hunt location: You can use a screenshot from the map at https://gis.johnson-
county.com or Google maps, and mark the location with a computer program or by hand and show the approximate
location of the deer stand on the map. If you are completing this form electronically, please attach the map via e-mail
when submitting all other materials. Hardcopy applications should have a printed map attached.
Police Department completes the following:
Received By: _____________________________
Date: ________________________________________
Processed by Police Department: _____________
Permit #: _____________________________