Freshwater Fishing E-Licence

Vendor Licence Cancellation Request

I, *, am requesting cancellation of the following licence(s).
The total amount of these items is *$. *
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*Reason for Cancellation:
*Vendor Name:
*Vendor #:
*Vendor E-mail:
(needed to send confirmation of licences cancelled)

Date:

By checking this box, I certify the information I have provided is true. I understand it is an offence to provide false information.
Fax #: 250-387-4339