Notice To Dog Owners Listing Official Lists - Town Of Anderson

NOTICE TO DOG OWNERS

Listing Official lists __________ dogs.

Please contact the town treasurer if you no longer own a previously licensed dog so they may be removed

from the municipal dog list. This will assist in preventing delinquent notices for unlicensed dogs.

Send separate check for dog license fees payable to town or village treasurer. Do not include in tax payment

check or on tax statement. Dog license fees are payable in full.

Fill in the information on this page and send with dog license payment; list additional dogs on the back of this

page. Presentation to the treasurer of a current rabies vaccination certificate for each dog is required.

The license year is January 1 – December 31. A $5.00 late fee penalty will be assessed after April 1.

Wisconsin Statutes 95.21(2)(a): “the owner of a dog shall have the dog vaccinated against rabies by a veterinarian at no later than 5 months of age and revaccinated within

one year after the initial vaccination… The owner of a dog shall have the dog revaccinated against rabies by a veterinarian before the date that the immunization expires as

stated on the certificate of vaccination or, if no date is specified, within 3 years after the previous vaccination.” 95.21(10): “An owner who fails to have a dog vaccinated

against rabies as required under sub. (2)(a) may be required to forfeit not less than $50 nor more than $100.”

Chapter 174 Wisconsin Statutes requires all dogs 5 months of age or older to be licensed. Burnett County Ordinance 03-08 ordains “…that any dog owner who fails or refuses

to obtain a license for a dog as certified by any town treasurer required under Chapter 174, Wisconsin Statutes, shall forfeit not less than $25 nor more than $100 for the first

offense plus court costs and not less than $50 nor more than $200 for subsequent offenses plus court costs; and ordains, that each unlicensed dog shall be considered a separate

offense…”

Wisconsin Statutes 174.042(4): “If the owner of a dog negligently or otherwise permits the dog to run at large or be untagged, the owner shall forfeit not less than $25 nor

more than $100 for the first offense and not less than $50 nor more than $200 for subsequent offenses.”

Individual Dog License Fees: See chart below. Fees are ½ of these amounts if the dog became 5 months of age

after July 1 of the current license year.

Multiple Dog License Fees: $35.00 for 12 or fewer dogs plus $3.00 for each dog in excess of 12

OWNER’S NAME (print) _______________________________________________________________________

ADDRESS____________________________________________________________________________________

TELEPHONE # ___________________________ EMAIL _____________________________________________

DOG 1

DOG 2

DOG 3

Dog Name

Color

Breed

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□

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□

□

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Male $8

Neutered Male $3

Male $8

Neutered Male $3

Male $8

Neutered Male $3

Sex:

□

□

□

□

□

□

Check one box per column.

Female $8

Spayed Female $3

Female $8

Spayed Female $3

Female $8

Spayed Female $3

Chip Number

(if applicable)

Name of Veterinarian

Rabies Vaccination Date

Next Vaccination Due Date

Vaccine Manufacturer

Vaccine Serial Number

Rabies Tag Number

MULTIPLE DOG LICENSE OPTION

Number of dogs (up to 12)

______________ $35.00 Fee

=

$ __________________

Number of dogs in excess of 12 ______________ x $3.00 per dog = +$ __________________

Total Multiple Dog License Fee…………………………………………..$ __________________

Upon payment of the required fee and upon presentation of a current rabies vaccination certificate for each dog listed

above, the license(s) and collar tag(s) will be issued.

I hereby certify that I have read and understand the above and that all statements made by me are correct.

(Signed)________________________________________________________________________