Laration Must Be Completed by All Animal Owners

APPLICATION TO REGISTER YOUR PET For Year Ending 9 April 2018

Surname Given Name Title

Address Details Street

Postal (If different)

Animal Location (if different)

Contact Details Mobile Other

Memberships FCC No. VCA No.

(Concession Fees not valid on Health Pensioner No. Care Cards) ANIMAL 1 DETAILS Name Animal Type  Dog  Cat Breed Gender  Male  Female Colour Desexed  Yes  No Microchip No. Restricted Breed Dog  Yes  No

Age/Date of Birth Age: DOB: Declared Dangerous  Yes  No

OFFICE USE: Tag No: Fee: Declared Menacing  Yes  No ANIMAL 2 DETAILS Name Animal Type  Dog  Cat Breed Gender  Male  Female Colour Desexed  Yes  No Microchip No. Restricted Breed Dog  Yes  No

Age/Date of Birth Age: DOB: Declared Dangerous  Yes  No

OFFICE USE: Tag No: Fee: Declared Menacing  Yes  No DECLARATION

I, ______, declare that the information contained in this application regarding my animal/s is true and correct and I make it on the understanding that a person supplying false information is liable to prosecution under the Domestic Animals Act 1994. I also declare that any dog/s on this application has/have been correctly identified as to whether or not it is/they are a restricted breed.

Signature of Owner ______Date ______EXCESS ANIMAL PERMITS This table explains if you are required to apply for an Excess Animal Permit. Application forms are available at www.yarraranges.vic.gov.au and fees apply. Animals are required to be registered before applying for an Excess Animal Permit. If registering more than 2 pets complete the animal details and declaration on another application and staple to this one. LARATION MUST BE COMPLETED BY ALL ANIMAL OWNERS

Registration Fees Dogs Cats (Fees valid until 9 April 2018) Full Fee Concession Full Fee Concession

Unsterilised $111.00 $53.00 $100.00 $47.00 Desexed Over 10 years $37.00 $17.50 $26.00 $13.00 Vic. Canine Association; or Feline Control Council

Obedience Trained Working Dog $37.00 $17.50 $2.50 Transfer fee – must show proof of current registration with Guide Dog (hearing/vision impaired) $0.00 $0.00 previous Council AND must be Dangerous Dog as Guard Dog FULL FEE microchipped. (at residential or non-residential residences) ONLY Incl. desexed, FREE – Replacement tag only if Declared Dangerous, Menacing or $171.00 microchipped, registration is current Restricted Breed pensioner etc IT IS AN OFFENCE NOT TO REGISTER YOUR ANIMAL - $311 PENALTIES APPLY NO REFUNDS FOR CANCELLED REGISTRATIONS

Animal Registration Fees Pensioner Concession  Please present your card in person when lodging your application.  Concession fees are not applicable to Health Care cardholders.

State Government Levy  Your registration fee includes the State Government Levy of $2.00 per cat or $3.50 per dog.  This levy is used to fund responsible pet ownership education programs.

Microchipping  All cats and dogs must be microchipped for registration to be accepted.

Restricted Breeds, Declared Menacing or Dangerous Dogs Restricted Breeds  All dogs fitting the standard, except where exemptions are given by the standard, are considered Restricted Breed Dogs.  For more information on Restricted Breed Dogs visit http://agriculture.vic.gov.au/pets/dogs/restricted-breed-dogs

Declared Menacing Dogs  Is any dog that has been declared menacing by a Council.

Declared Dangerous Dogs  Dogs that are kept as a guard dog for the purpose of guarding non-residential premises; or  Trained to attack or bite any person or any thing when attached to or worn by a person; or  Declared dangerous by a Council.

Cat Curfew

 Cat owners are required to keep cats within their property boundary at all times. You can also keep your cat inside or install a cat enclosure.

 For more information on cat enclosures visit http://agriculture.vic.gov.au/pets/cats/cat-confinement-enclosures-and-fencing

Domestic Animals Amendment

State government recently introduced the Domestic Animals Amendment (Puppy Farms and Pet Shops) Bill 2016 to Parliament.

The government are currently assessing a number of recommendations regarding the Bill.

 Visit http://agriculture.vic.gov.au/pets/registration-legislation-and-permits/domestic-animal-legislation-and-latest-news for the most up to date information on how this may affect your future animal activities.

Privacy Information

 The information gathered in the form is used by Council to process the application. To view Council's privacy policy, please visit any of our Community Links or go to the Council Privacy Statement located at: www.yarraranges.vic.gov.au.

Payment Methods

Type of Card: (please circle) Visa / MasterCard Please forward this with your payment to: Credit Card No ...... /...... /...... /...... PO Box 105 Lilydale VIC 3140

Expiry Date: ...... /...... Amount: $...... In Person at any of our Community Links. Visit www.yarraranges.vic.gov.au/links Cardholder Name: ......

Signature:...... For further information call 1300 368 333 or visit www.yarraranges.vic.gov.au