Form Bra-4 - Application & Instructions For A Dog License Code-701

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GOVERNMENT OF THE DISTRICT OF COLUMBIA
DEPARTMENT OF CONSUMER AND REGULATORY AFFAIRS
BUSINESS REGULATION ADMINISTRATION
ONE STOP BUSINESS CENTER
941 NORTH CAPITOL STREET, N.E., ROOM #1100
WASHINGTON, D.C. 20002
(202) 442-8957
APPLICATION & INSTRUCTIONS FOR A
DOG LICENSE
CODE-701
(Please Print in Ink or Type)
1. Name of Applicant: ________________________________________________________________
2. Home address of applicant: __________________________________________________________
_________________________________________________________
3. Home phone number of applicant: _____________________________________________________
4. Work phone number: ______________________________________________________________
Information about your Pet
1. Name of dog: ___________________________________________________________________
2. Dog’s breed: _____________________________________________________________________
3. Color of dog: _____________________________________________________________________
4. Sex of dog: ______________________________________________________________________
Party Billed and Mailing Address
________________________________________
________________________________________
________________________________________

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