TOWNSHIP OF KNOWLTON 628 ROUTE 94 COLUMBIA, NJ 07832 908-496-4816 x 6 2014 Dog License Application

OWNER INFORMATION:

Name: ______Phone #______Address: ______

MUST HAVE PHYSICAL STREET ADDRESS SO DOG (S) CAN BE RETURNED. OTHERWISE IT WILL GO THE VET AND YOU WILL INCUR BOARDING CHARGES.

DOG INFORMATION: New ______or Reissue______(Dogs should be 6 months old or older)

Name:______Breed:______DOB Age:______Color/Markings______Sex:______M______F Hair: Short. _ __Medium. _____ Long ______Spayed/Neutered: Yes __ No___ Rabies expires: ______(Note: expiration must be good till 11/01/14 or later)

Spayed/Neutered $ 10.00 Non-spayed or Neutered $13.00 After 2/1/14 add monthly $ 5.00 late fee

ENCLOSED: Check # ______Amount $______

Copy of valid rabies vaccination and spayed/neutered certification is required, (if not on file with the Township).

A Self-addressed stamped envelope is REQUIRED with payment.

Mail to: Knowlton Township Dog License 628 Route 94 Columbia, NJ 07832