Pet Registration Form
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1Registration # _______
Date:_______________
DECATUR COUNTY SHERIFF’S OFFICE
912 SPRING CREEK ROAD – BAINBRIDGE, GA 39817
Ph: 229-248-3044
Fax: 229-248-3850
P E T R E G I S T R A T I O N F O R M
OWNER INFORMATION
Owner’s Name __________________________________________________________
Physical Address _________________________________________________________
No P.O. Boxes
Mailing Address _________________________________________________________
If different
PET INFORMATION
Type of Pet:
Dog
Cat
Ferret
Pet Name ________________________
Male
Female Year of Birth ________
Breed ____________________
Description _________________________________
Special Markings ________________________________________________________
Spayed or Neutered:
Yes
No
Date: ________________
Current Vet: ____________________________________________________________
**PLEASE PROVIDE PROOF OF RABIES VACCINATION**
Sheriff’s Office Use Only
Rabies Vaccination Date: ________________
Exp. _______________
Rabies Tag Number: _______________________
Form Completed 8/27/2012
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Parent category: Life