Animal Registration Form

Village of Warrensburg

Animal Registration Form
Animal Registrations
It shall be unlawful for any person to own, keep or harbor a dog or cat without first having obtained a license to do so. An application for registration/tab may be obtained at the Village Hall or on the licenses page. The fee for each tag is $5.00

Please complete a form for each pet in your household.

Once your form has been received a Village representative will contact you regarding payment.

Payment may be made by cash or check.
Date of Application

Month Day Year
Date
Owner's Name

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number

Area Code Phone Number
E-mail
Village Registration Tag Number
Rabies Vaccination Tag Number
Vaccination Year

Animal Description

	Gender	Status	Microchip	Animal's Name	Breed	Color	Age
Dog
Cat

Microchip Number
Total Number of Animals in the Household
By checking this box I agree to all Village terms regarding the ownership of animals.

I agree
Please verify that you are human *
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