Contact Info

Your Name(First and last name)



Street Address



City



State



ZIP/Postal Code



Email Address


Phone Number (optional)



Your information will be used only to contact you about the rebate and survey.

Future Non-Lead Ammunition Distribution Programs (optional)


Yes, I want to be contacted about future non-lead ammunition distribution programs.

Nonlead Ammuntion Purchased

Retailer



Date Ammunition Purchased




Upload receipt for non-lead ammunition

Make sure the date of purchse is visible on the receipt.



(Allowed file types are jpg, jpeg, png, pdf, doc, docx.)
Upload a copy of your 2024/2025 hunting license



(Allowed file types are jpg, jpeg, png, pdf, doc, docx.)
Upload a 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.)

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 ammunition when deer hunting during the 2024/2025 season.
• I agree to fill out a survey after the hunting season about my use of non-lead ammunition.
• My rebate will be issued after the completion of the post-hunt survey.

I agree to the above statements.