POINT PLEASANT BOROUGH HEALTH DEPARTMENT DOG LICENSE APPLICATION by keara

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									            POINT PLEASANT BOROUGH HEALTH DEPARTMENT
                     2233 Bridge Ave. - PO Box 25 - Point Pleasant, NJ 08742
                          Phone: 732-892-4183 – FAX: 732-899-2655
                                         www.ptboro.com

                                DOG LICENSE APPLICATION


Owner’s Name:_________________________________                              Date:________________

Address:______________________________________                              Phone: ______________


DOG INFORMATION:

Sex:    Female_______            Male_________             Breed: _____________________________

Color: ______________________________                      Name: _____________________________

Hair:   Short____ Med. ____ Long ____                      Age:    _____________________________

        *Spay/Neutered: Yes_____ No _____ By:____________________ Date: ___________

        *Rabies Vac. Expires:_____________ Vet:: ___________________________________


            PLEASE ENCLOSE A STAMPED SELF-ADDRESSED ENVELOPE

*Written verification is required to issue a license and will be returned with your new license. NJ State
regulations require that any animal that has a rabies inoculation that expires prior to NOVEMBER 1st
of the current year will be required to obtain an updated rabies shot PRIOR to the issuance of a license.

                        Make checks payable to:           “Point Pleasant Borough”

                License Fee:     Spay/Neutered Dog = $ 8.20         (After 3/31 - $13.20) ++

                             Non-Spay/Neutered Dog = $11.20         (After 3/31 - $16.20) ++

                                    ++Does not apply to new/adopted dogs.

              DOG LICENSES ARE SUBJECT TO RENEWAL IN JANUARY
                                              *****************

                            FREE RABIES CLINICS FOR DOGS AND CATS

Point Pleasant Borough -           Clinics are held annually
Ocean County Animal Facility       Wednesdays from 11:00 to 12:00 by appointment
                                   Call 732-657-8086 or 609-978-0127

								
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