* Denotes that the field is mandatory.
Animal Reference Number *
Animal Renewal Period *
Owners Name *
Owners Address *
Owners Contact Number *
Owners Email Address *
Can the City use this email
address to issue renewal
notices or other
relevant information?
*
Any further information?
Declare that:

(i) I am / the owner is not under 18 years of age

(ii) I have answered all the questions truthfully and all the information that I have provided is true and correct

(iii) I certify that for the purposes of the Dog Act 1976, that means exist on the premises at which the dog will ordinarily be kept for effectively confining the dog within those premises

I am aware that it is an offence to provide false and misleading information.