OWNER'S INSTRUCTIONS ALL 4 months of age or older must to be licensed. In addition, any under 4 months of age running at large, must be licensed. 1. PRINT all information in the appropriate boxes (NOTE that some areas are for Office Use ONLY). Remember to sign and date the form. 2. From the list below, choose 1 or 2 COLORS and the BREED that best describes your dog. Enter the color(s), breed or mixed name AND the corresponding codes on the application. 3. Markings - please indicate if one or both ears have been cut off wholly or in part. Microchip / Tattoo – please enter the number. 4. Check the type of license you are applying for: Male–neutered, Female–spayed, Male–unneutered, Female–unsprayed or Exempt Dog. Enter the corresponding statutory fees in the box to the right. Total all fees and submit this amount to the issuing clerk. 5. Items required for validation of this license: (A) application (B) fees (C) certification of spaying or neutering or proof of exemption (D) proof of fees exemption (E) proof of rabies vaccination where required. Submit in person or by mail to the issuing clerk in the town where the dog is harbored.

CODE COLORS CODE BREED CODE BREED CODE BREED A Black 011 Afghan 043 075 Samoycd B 012 Airedale 044 German Shorthaired 076 C Brown (Liver) 013 Akita 045 German Wirehaired Pointer 077 D Gold 014 046 Golden 078 Sheepdog E Grey (Bluemerle) 015 Am. Staffordshire Terrier 047 079 F Red 016 048 Great Dane 080 Siberian G Spotted (Patched) 017 Basenji 049 Great Pyrenees 081 Silky Terrier H Tan (Beige) 018 050 Irish Setter 082 Soft Coated Wheatcn Terrier I White 019 051 Irish Wolfhound 083 Standard Schnauzer J Apricot 020 Frise 052 Italian 084 Vizsla K Blonde 021 053 085 Weimaraner L Salt and Pepper 022 Borzois 054 086 (Pembroke) M Silver 023 055 087 N Ticked 024 Bouvicrs Dcs Flandres 056 088 West Highland White Terrier O Yellow 025 Boxer 057 089 P Rust 026 Spaniel 058 Maltese 090 Q Sable 027 059 091 Doodle R Orange 028 060 Mastiff 092 Foxhound S Tri-Color 029 061 093 Coonhound 030 062 Miniature Schnauzer 094 Terrier CODE MIXES 031 Chesapeake Bay Retriever 063 Newfoundland 095 Spaniel 001 Mix 032 064 096 Husky 002 Hound Mix 033 065 Sheepdog 097 Hound 003 Long Hair Mix 034 Cocker Spaniel 066 Papillon 098 Sheepdog 004 Setter Mix 035 Collie 067 Pekinese 099 Other Purebred 005 Shepherd Mix 036 068 Pomeranian 006 Smooth Hair Mix 037 Dalmatian 069 007 Spaniel Mix 038 Doberman Pinscher 070 008 Terrier Mix 039 071 Rhodcsian Ridgeback 009 Toy Mix 040 072 Rottweiler 010 Labrador Mix 041 073 St. Bernard 000 Other Mix Breed 042 074 Saluki