REBATE FORM
First Name
*
Last Name
*
Address
*
Zip Code
*
State
*
City
*
Email
*
Phone #
Date Ammunition Purchased
*
Retailer
*
Upload a photo of the UPC barcode from ammunition box
*
(Allowed file types are jpg, jpeg, png, pdf, doc, docx.)
Upload receipt for non-lead ammunition
*
(Allowed file types are jpg, jpeg, png, pdf, doc, docx.)
Upload copy of your Deer Management Permit
*
(Allowed file types are jpg, jpeg, png, pdf, doc, docx.)
Upload photo of ammunition box showing product name and caliber (often on the side of the box)
*
(Allowed file types are jpg, jpeg, png, pdf, doc, docx.)
Q.1 Do you plan to use qualifying non-lead ammunition when attempting to fill your antlered buck tag?
Yes
No
Q.2 Do you currently use non-lead ammunition when hunting deer in New York?
Yes
No
By submitting this form, I agree to the following statements;
I intend to use the qualifying non-lead ammunition when attempting to fill a DMP,
I agree to fill out a survey after the hunting season about my use of non-lead ammunition.
