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New Dog License Application

ONLINE FORM SUBMISSIONS FOR PERMITS, LICENSES, REGISTRATIONS & OTHERS
(INCLUDING ONLINE PAYMENT WHEN APPLICABLE)

Select the Online Application Form
Attach Associated or Required Documents
Submit the Online Application & Payment (if applicable) in a single submission to the Municipality
Receive Immediate Notification the Online Form & Payment Submission was Received by the Municipality

* Fields in red are required

Please fill out the following online application for NEW dogs only. Dogs must be a minimum of six months old to be issued a new license. Please submit this online application to the Municipal Clerk’s Office along with the following:

• Your online payment submission to the Municipality.
• Copy of Current Rabies Vaccination Certificate (must be valid no less than 10 months of the current licensing year).
• Copy of Spay/Neuter Certificate (if you wish to qualify for a $3.00 reduction in license fee). Proof of Spay/Neutered must only be supplied one time; it will be on your pet’s permanent record thereafter.

FEES:

DOGS
$ 15.00 if Spayed/Neutered
$ 20.00 if Un-spayed/Un-neutered

Owner's Name:

Phone #:

Street Address:

Mailing Address (if different):

Dog's Name:

Breed:

Age:

Length of Hair:

Color(s):

Dog's Gender: Male

Female

Reproductive Status:

Neutered

Spayed

Non Altered

ATTACH Proof of Spay/Neuter from Veterinarian:

Date of Rabies Vaccination:

ATTACH Rabies Vaccination Certification:

End of License:

I no longer have the dog. My dog passed away.

Year Dog passed if applicable:

Payer Information

Billing Name:

Address:

Address 2:

City:

State:

ZIP Code:

Daytime Phone:

Payer E-mail Address:

Payment Information

Payment Amount:

Payment Method:

Convenience Fee:

Enter information as it appears on your check (USA Banks Only)

Routing Number:

Account Number:

Re-Enter Account #:

Using the following lower portion of a personal check as an example, enter the information that appears at the bottom of your check. Do NOT include any dashes or spaces.

Credit Card:

Convenience Fee:

Credit Card Number:

Sec. Code:

What is the Security Code?.

What is this and why do I have to do it?
Due to the amount of credit card fraud over the internet, banks will soon REQUIRE this information to process credit card orders online - you can expect to see it used everywhere in the very near future. Your benefit is that it prevents any fraudulent charges using your credit card, i.e. no one can pick up an old receipt of yours and use that info to fraudulently use your credit card. Thanks for your cooperation.

American Express
4 digits on front of card

Visa and Mastercard
last 3 digits on back of card

Note: The digits are printed on your card, rather then stamped in the plastic like the digits in your credit card number.

Exp. (Month/Year):

(2 digits, Range: 25-35)

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