Animal Licensing

Animal License Renewal Form

Owner Information

First Name:

Last Name:

Address:

City:

Zip:

Phone:

Email Address:

Mailing Address:

Same as above

Not the Same

Mailing Address:

Mailing City:

Mailing Zip:

Animal Info

Animal Name:

Animal Breed:

Animal Color:

Age:

Microchip Number:

Animal Sex:

Male

Neutered Male

Female

Neutered Female

Rabies Information

Please Make sure rabies vaccine is up to date

Rabies Vaccine Expiration Date:

Vet Hospital or Clinic:

Animal License Fees

Non-sterilized $25.00 per dog

Sterilized $10.00 per dog

Sterilized Owned by Senior Citizen (65 older) $5.00 per dog

Mandatory Late Fee (due 30 days after license expires) $20.00 per household

Licensing is due 1 year from previous licensing date. For instance if you license, March 15, 2009, your license expires March 15, 2010, and the late fee applies April 15, 2010.

License Expiration Date:

Donate

Would you like to donate toward the care of stray and adoptable animals housed at the shelter?

Donation Amount:

Is this one of the following?

Donation Description:

Reset

THE FORM BELOW IS FOR LICENSE RENEWAL ONLY

Weber County Animal Shelter · 1373 N. 750 W. Ogden - 84404 - Phone-(801)399-8244 Fax-(801)778-6411