Dog License Request Form
ADVERTISEMENT
1Tag #1________
Tag #2________
Tag #3________
Kelly J. Dumas
Uxbridge Town Clerk
Date _________
21 S. Main Street
Uxbridge, MA 01569
Tel. 508-278-8600 ext. 3 Fax. 508-278-3154
Dog License Request Form
A few reminders from the Town of Uxbridge:
1.
All resident dogs, six months and older must be licensed with the Town of Uxbridge by March 31
.
st
2.
Licenses are $7.00 for a neutered/spayed dog or $11.00 for a dog that has not been neutered or spayed. There is a
$10.00 per dog late fee for licenses issued after March 31
.
st
3.
A current rabies certificate must accompany the application, it will be returned with the license.
4.
Licenses are valid from January 1
through December 31
.
st
st
5.
Households with four dogs or more require a kennel license. Please contact the Town Clerk’s Office for further
Information.
6.
Please inform the office if any of your dogs have passed away.
Mailing Directions:
1.
Fill out the information below for each dog.
2.
Make the check payable to the Town of Uxbridge for the proper amount.
3.
Send a copy of the current rabies certificate, it will be returned with the license.
4.
Send a self-addressed stamped envelope for the license and rabies certificate to be returned to you.
Any requests without the proper fee, current rabies certificate or return envelope will not be processed.
Owner’s Name:
Telephone #:
Street Address:
Payment Amount:
Mailing Address:
Payment Type:
E-mail address:
Check #:
Dog # 1
Dog #2
Dog # 3
Name
Gender
Neutered/Spayed
Breed
Color
Age
Microchip #
Rabies Tag #
Rabies Expiration
Date
Owner’s Signature
Date
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business