(GRANDFATHERED) THREE DOG APPLICATION

APPLICATION FOR DOG LICENSE 2006

FEES: Spayed or Neutered $10.00; unaltered $15.00. DUE BEFORE JANUARY 31, 2006

*NOTICE* (Late fees are an additional $5 for each dog)

Please pay with cash or a check payable to: TOWN OF OCONOMOWOC.

DO NOT INCLUDE THIS FEE AS PART OF YOUR TAX CHECK. PLEASE WRITE A SEPARATE CHECK.

NAME OF DOG SEX NEUT/SPAY BREED COLOR

1.____________________ _________ _________________ _________________ ____________

2.____________________ _________ _________________ _________________ ____________

3.____________________ _________ _________________ _________________ ____________

If you have more than TWO dogs you must obtain approval AND a kennel permit through the Plan Commission.

FEES: $35 AND $3 for each dog over 12 dogs.

Rabies Vaccination: Month Day Year

1.___________ __________ __________ Expiration Date: ______________

2.___________ __________ __________ Expiration Date: ______________

3.___________ __________ __________ Expiration Date: ______________

I, hereby certify the information above is true and correct to the best of my knowledge:

_____________________________________________

(Signature of Dog Owner)

Street Address:___________________________________________________________________________________

(Street) (Town, City, Village) (State) (Zip)

Wisconsin Law requires your dog to be vaccinated for rabies within 30 days after it is 5 months old. Bring or mail your rabies certificate with your application. You can mail your license application, payment, and rabies vaccination to:

TOWN OF OCONOMOWOC

C/O CLERK TREASURER

W359 N6812 BROWN STREET

OCONOMOWOC, WI 53066

Licenses cannot be issued without a current rabies shot. Your certificate will be mailed back to you.