Change Of Owner / Details Form
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2NSW Companion Animals Register
Change of Owner / Details
C3A
Please use this form to change the ownership of your cat or dog. There
13
. Secondary address for animal
#
eg holiday house or boarding kennel
is no fee to change ownership details.
The details marked # are optional. All other information is required under
the Companion Animals Act 1998 and Regulation 1999.
It is the responsibility of the ‘old’ owner – the person selling or giving
Postcode
away the animal – to notify the change. Failure to do so may result in
a fi ne of up to $880 or up to $5500 for a dangerous or restricted dog.
New owner details
Note: This form does not Lifetime Register the animal. You need to check
The owner must be a person 18 years or over. If the animal is a dog the
with your council to fi nd out if the animal needs to be lifetime registered.
owner must not be disqualifi ed from owning a dog.
14. Name of organisation –
if applicable. Please also provide the name of the
person responsible for the care of the animal at questions 15 to 17 below
Current animal details
1. Microchip number
2. Species:
dog
cat
15. Title:
3
. Animal’s Name
#
16. Family name
4. Is the animal desexed?
yes
no
17. First name
Note: When claiming a reduced registration fee you must provide proof
of desexing.
5. Breed
18. Home phone number
6. Old address where animal was usually kept
note: street number and
19. Work phone number
street name are needed for all addresses – property name only is not suffi cient
20. Mobile phone number
Postcode
7. Has the animal been declared a Dangerous Dog?
21. E-mail address
yes
no
If yes, date order / declaration issued
/
/
22. Home address – if different to question 12
8. Has this animal been declared a Nuisance Cat / Dog?
yes
no
If yes, date order / declaration issued
/
/
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‘I am selling or transferring the animal listed on this form to the new
23. Postal address
owner listed on this form’.
9. ‘Old’ owner’s name (print)
10. ‘Old’ owner’s signature
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11. Date
I verify that the information provided on this form is correct.
/
/
24. Signature of new owner nominated
at questions 16 to 17
New address details
25. Date
12. New address where animal is to be usually kept
note: street number
/
/
and street name are needed for all addresses – property name only is not
suffi cient
COMPLETED FORM MUST BE POSTED OR SUBMITTED IN
PERSON TO YOUR LOCAL COUNCIL
Postcode
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