Free F-666-18 - Indiana

VIOLATION OF TIMBER BUYERS LICENSING LAW COMPLAINT FORM
Department of Natural Resources / Division of Forestry
State Form 50299 (7-01)

FROM: Gary Gretter TO COUNTY: VIOLATOR'S NAME: ADDRESS: CITY, STATE, ZIP: Note: Prepare a separate set of forms for each person involved in a violation. A. TYPE OF VIOLATION (Check one or more as applicable) 1. 2. 3. Buying without a license Failure to pay for timber as per agreement for timber purchased Failure to pay for timber which was cut, but not purchased (District Lieutenant responsible for county in which violation occurred)

4. False statement in connection with information required to be given to the Department or a timber grower 5. Failure to honestly account to the timber grower or the Department for timber purchased when he was under an obligation to do so. 6. 7. 8. B. Committed fraud in connection with the purchase of the timber Refusal to permit inspection of his records by authorized Department personnel Other, Specify violation:

SOURCE OF COMPLAINT (Give name and address of person or persons giving information

1. 2. 3. C. LIST ANY EVIDENCE COLLECTED TO DATE (If none, state none) _______________________________________________________________________________ _______________________________________________________________________________

D.

Briefly summarize knowledge of case, and where evidence might be collected

NOTE:

Attach all listed evidence to first copy of form and forward directly to District Lieutenant, second copy to Central Office, third copy for your file - "Reported Violations". Destroy your copy when notified of disposition of case.

Prepare 3 copies: 1 - District Lieutenant, Enforcement 2 - State Office, Forestry 3 - Your file Date Form submitted to Lieutenant: