DOG LICENSE APPLICATION

OWNER NAME______________________________________ PHONE # _________________________________ OWNER ADDRESS_____________________________________________________________________________ NEUTERED/SPAYED YES_____

NO_____

MALE

FEMALE

ANIMAL NAME _____________________ BREED______________________ COLOR______________________ VACCINE MANUFACTURER & SERIAL # ________________________________________________________ DATE OF LAST RABIES SHOT

DATE NEXT SHOT DUE

******************************************************************************************

OWNER NAME______________________________________ PHONE # _________________________________ OWNER ADDRESS_____________________________________________________________________________ NEUTERED/SPAYED YES_____

NO_____

MALE

FEMALE

ANIMAL NAME _____________________ BREED______________________ COLOR______________________ VACCINE MANUFACTURER & SERIAL # ________________________________________________________ DATE OF LAST RABIES SHOT

DATE NEXT SHOT DUE

The cost of license is $10.00 for a spayed or neutered dog and $15.00 if not spayed or neutered. An additional $5.00 will be assessed if the owner fails to obtain a license by April 1st or within 30 days after the dog becomes 5 months or age or within 30 days after acquiring a dog.

Dog License Application.pdf

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