NYC DOG LICENSE APPLICATION FORM
This form is to be used for first time License (NOT renewals)
INSTRUCTIONS
Fill out the form.
Upload Required Documents.
You will receive a link for payment. Please pay promptly.
You will be notified when your dog's tag is ready for pick up.
Questions? Contact Desma at SICDTC@hotmail.com
Owner's Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
example@example.com
Mobile Number
*
Dog's Name/Breed
*
Name
Breed
Dog's Primary Color
Dog's Secondary/Third Color
Dog's Gender
Please Select
Female
Male
Microchip or Tatoo number if applicable
Has your dog received a Rabies Vaccination?
Please Select
Yes 1 yr vaccine
Yes 3 yr vaccine
No
If Yes, Please submit supporting documents
Rabies Vaccine -Veterinarian's Name
First Name
Last Name
Rabies Vaccine-Veterinarian's Phone Number
Please enter a valid phone number.
Rabies Vaccine-Veterinarian's Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Dog Spayed or Neutered?
Please Select
Yes
No
If Yes, Please submit supporting documents
Spay/Neuter-Veterinarian's Name (if different than Rabies)
First Name
Last Name
Spay/Neuter-Veterinarian's Phone Number (if different than Rabies)
Please enter a valid phone number.
Spay/Neuter -Veterinarian's Address (if different than Rabies)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
In submitting this application, I also state that the information I have provided is accurate. I recognize that making false statements in this application violates NYC Health Code section 3.19 and other applicable law and may subject me to civil and criminal fines and penalties, and invalidation of any license issued.
Upload Spay/Neuter/Rabies Documents
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Save
Continue
Continue
Should be Empty: