Application For Dog License printable pdf download

Application For Dog License

Application for Dog License

Notice is hereby given that, pursuant to Sections 95.21 (2) 174.05 and 174.07 (1)(b), WI Statutes, the owner of a dog(s) more than

five months of age on January 1, or five months of age within this year, shall annually, prior to April 1, on or before the date the

dog becomes five months of age, pay the dog license tax and obtain a license. Notice is hereby further given that evidence

that the dog is currently immunized against rabies must be presented before a license will be issued.

A copy of the updated rabies vaccination record is needed before a dog license can be issued.

If you no longer have a dog(s),

please contact the Clerk/Treasurer and the Town Records will be updated.

License Fee:

$ 5.00 for neutered or spayed dog

$ 10.00 for male or female dog (for unfixed)

Please complete the Application below. Then, mail application and payment to :

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Application for Dog License

Date____________________ 20_____

Owner’s Name

Owner’s Address

Name of Dog

Sex

Breed

Age

Color

Marking(s)

Date Rabies Vaccination Due

Chip Number

Vaccine Manufacturer

Serial #

DATE

DATE OF

TAG AND LICENSE

AMOUNT

REMARKS

RABIES VAC.

NUMBER

DAY

YEAR

MONTH

Application For Dog License