VENDOR SALES REPORT   FISH AND WILDLIFE LICENCE SALES ANGLING

COLLECTION PERIOD From   To   Vendor No.     I certify accuracy of the details listed below     Signature         Date Signed

FIRM NAME Telephone: FIRM ADDRESS Mailing Address City Postal Code

Licence Type Service Code Qty sold Licence Fee HCTF Surcharge GST AGENCY RECEIVED STAMP OFFICE USE ONLY Date: _________________ Deposit to Prepaid Acct. # ____________________ RMS Transaction # ____________________

TOTAL ENCLOSED IF NO ADJUSTMENTS FROM PREVIOUS SALES REPORT   Overage Underage +/- ADJUSTMENTS FROM PRIOR RETURNS TOTAL ENCLOSED IF ADJUSTMENT FROM PREVIOUS SALES REPORT

Column 1 Column 2 Column 3 Column 4 Column 5 Licence Type Service Code Qty Sold Fee Per Day Licence Fee HCTF Surcharge GST   Non-resident/Nonresident Alien Licences Classified Waters * Returns for licences issued must be made to the Government Agent once a month at least or more if so instructed, and in the event no sales are made in the period of a month, a nil report must be submitted. * ORIGINAL and all copies of cancelled licences must be forwarded with the return, otherwise payment will be required. * Fixed amounts or printing on licences must not be altered. * Commission is $1.50 per licence.