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Stay out of trouble with New York City law: make sure that you have a legal dog license for your canine companion.
After filling in the correct information, please use the print function on your computer to print a completed copy of this form and send it with the appropriate documentation and check or money order (payable to the NYC Department of Health & Mental Hygiene) to Veterinary Public Health Services, P.O. Box 4768, Church Street Station, New York, NY 10261-4768.
Your license certificate and dog tag will be mailed to you shortly. If you need help in completing this form, please call 311, Mon-Fri. 9AM-4:45PM, for assistance.
Instrucciones en espanol en la pagina siguiente
| FOR OFFICE USE ONLY |
| LICENSE NUMBER |
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| DATE LICENSE ISSUED |
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| APPROVAL STATUS |
¤ 1.APPROVED
¤ 2.PENDING
¤ 3.DISAPPROVED |
| FEE AMOUNT |
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| SPAY/NEUTER PROOF SUBMITTED |
¤YES ¤NO |
PLEASE NOTE: NEW YORK STATE LAW REQUIRES THAT A SURCHARGE OF $3.00 BE ADDED TO THE LICENSING FEE FOR ALL DOGS NOT SPAYED OR NEUTERED. IF YOUR DOG IS SPAYED OR NEUTERED YOU MUST SUBMIT PROOF FROM YOUR VETERINARIAN WITH THIS APPLICATION OR COMPLETE AND NOTARIZE THE AFFIDAVIT LISTED BELOW.
ATTENCION: LA LEY DEL ESTADO DE NUEVA YORK REQUIERE QUE EL PRECIO DE $3.00 SEA ANADIDO AL PRECIO DE LICENSIA PARA TODO PERRO QUE NO ESTA ESTERILIZADO. SI SU PERRO ESTA ESTERILIZADO USTED DEBE SOMETER PRUEBA CERTIFICADA DE SU VETERINARIO CON ESTA SOLICITUD O COMPLETAR Y NOTARIZAR EL AFFIDAVIT.
NOTE: "IF THE PERMITTEE/LICENSEE, OR HIS EMPLOYEES OR AGENTS, REFUSE TO ANSWER QUESTIONS IN RELATION TO THIS PERMIT/LICENSE AFTER BEING GRANTED TESTIMONIAL OR USE IMMUNITY, THIS PERMIT/LICENSE MAY BE REVOKED, OR OTHER APPROPRIATE ACTION TAKEN"
HAVE YOUR DOG AND CAT VACCINATED AGAINST RABIES. IT'S THE LAW
COLOR SELECTION CODE
COLOR SELECTIONFrom the list of colors below, select the Dominant color of your dog and print that color in the first box. Next, select the Secondary color of your dog and print that in the second box. If your dog exhibits a Third color, print that color in the third box.
| COLORS |
| BLACK | | BROWN | | RUST |
| BLOND |
| GRAY |
| TAN |
| BLUE |
| ORANGE |
| WHITE |
| BRINDLE |
For example, a Dalmation dog would be listed as: Dominant color - White, Secondary color - Black. There would be no Third color. If your dog has only one color, print that color in the first box.
| INSTRUCCIONES PARA LLENAR LA SOLICITID DE REGISTRO PARA PERROS |
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Si necesita ayuda por favor llame al 311.
La primera seccion de esta solicitud es para informacion sobre el dueno del perro que se va a registrar.
Primera linea, escriba el apellido y el nombre del dueno del perro.
Segunda linea, escriba la direccion y numero de apartmento del dueno.
Tercerra linea, escriba la ciudad, el estado y el codigo de area del dueno.
Cuarta linea, firme en la casilla indicada, escriba la fecha y su numero de telfono. |
La segunda seccion de esta solicitud es para informacion acerca de su perro.
Primera linea, escriba.
Nombre, Sexo, Ano de nacimento de su perro.
Marque "SI", si a su perro lo han esterilizado.
Marque "SI", si su perro esta entrenado como perro de ataque o guardian.
Segunda linea, escriba la raza de su perro.
Tercera linea, escriba el color de su perro (se aceptan hasta tres colores). El primer color es el principal, luego el siguiente en importancia y el tercer color, si es necesario.
Si su perro esta vacunado contra la rabia marque la casilla que dice "SI" y anote la feche en que lo vacunaron.
Anote el numero total de perros que tiene actualmente en su casa. |
AFFIDAVIT FOR SPAYED OR NEUTERED DOG
____________________________ being duly sworn, says: I reside at the address and am the owner of the dog indicated on the preceding pages of this dog license application. This dog was spayed/neutered or examined and found to be spayed/neutered by Dr.______________________, Veterinarian at (Street and Number, City, State, Zip) _______________________________ on ____________________, 20____. This affidavit is made to obtain a license for the dog referred to above.
Sworn to before me this
__________________ day of 20____.
________________________________
________________________________
(Official Title)
________________________________
(Applicant)
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