RESIDENT Department of Inland FISHING FEE $9.50 Fisheries & Wildlife LICENSE MAINE 1980 No. 32- 25005 LAST STOREY FIRST NAME Polly MID. - NUMBER TREET STREET MAIL TOWN STATE ADD ZIP RESS Cranberry TOWN sales. me 04625 LECAL STATE RESI Crawberry later me EXPIRES DENCE 12/31/80 FOLD ON THIS LINE LICENSEE SIGN HERE Polly Storey SOCIAL SECURITY NUMBER explane - DATE OF BIRTH 032204830 4 7 MAY 1916 SEX HEIGHT / we IGHT 56 COLOR OF EYES COLON OF HAIR MON r FEET 125 GRAY Brown DATE OF ISSUE 4 28 80 HOUR or ISSUE RENEWAL CHANGE ADD 140 DAY 6 is lvs N Y YR. L is :V ISSUED BY AGENT TOWN Islespond STATE me