Schedule – 3
(Related to Sub–rule (3) of the Rule 19)

……………………. Conservation Area
…………………… Conservation Office
………………… Committee
License for Fishing
1. Name, Surname of Licensee :– ……………………………….
2. Address :–
(a) Permanent :– …………………………….
(b) Temporary :– ……………………………
3. Citizenship of the Licensee :– ……………………………….
4. Name of the River or Pond where the Fishing has been Allowed or
Details of its Part or Portion :– …………………………..
5. Days or Duration of the Validity of the License :– …………………………….
6. Fees Paid for the License :– ………………………….
License Issuing Officers,–
Signature : ……………………………………
Name, Surname : ……………………………
Designation : …………………………………
Date : ……………………………………………