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CITY OF WODONGA - New dog/cat registration formIn person: 104 Hovell St, Wodonga, VIC 3690 Phone: (02) 6022 9300Post: PO Box 923, Wodonga, VIC 3689 Fax: (02) 6022 9322 Email: info@wodonga.vic.gov.au

The Domestic Animals Act 1994 requires an owner of a cat or dog to register and microchip their pet from three months of age.

Owner’s details Title: Mr Mrs Ms Miss

Given name/s:

Surname:

Unit number: Street number: Street name:

Suburb: State: Post code:

Phone (work): Phone (home):

Moblie: Fax:

Email:

Animal’s details

Pet type:

Breed:

Colour/marking:

Name:

Desexed:

Gender:

Microchip number:

Date of birth/age:

Restricted breed:*

Dangerous breed:*

Pet tag wording:

Pet tag shape:

Pet one Pet two Pet three Pet four Cat Dog Cat Dog Cat Dog Cat Dog

Yes No Yes No Yes No Yes No

Male Female Male Female Male Female Male Female

Yes No Yes No Yes No Yes No

Yes No Yes No Yes No Yes No

Pet name and Pet name and Pet name and Pet name and phone number phone number phone number phone number

Pet name, Pet name, Pet name, Pet name, phone number phone number phone number phone number and address and address and address and address

Round - s/steel Round - s/steel Round - s/steel Round - s/steel

S M L S M L S M L S M L

Round - blue plastic Round - blue plastic Round - blue plastic Round - blue plastic M M M M

Heart - s/steel Heart - s/steel Heart - s/steel Heart - s/steel S L S L S L S L

Bone - s/steel Bone - s/steel Bone - s/steel Bone - s/steel S L S L S L S L

OFFICE USE ONLY

New disk number

Pet one: Pet two: Pet three: Pet four:

Animal reference number

Pet one: Pet two: Pet three: Pet four:

Total fee payable: Receipt number:

Signature required - see reverse. * Refer to back of form for full details.

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DeclarationYou are required to complete all sections of this form including microchip number in order for your application to be accepted.

I, the owner, make an application for registration of the animal(s) described on this form. I declare that the information contained in my application is true and correct.

Name:

Signature:

Date: / /

Agent’s detailsComplete this section if you are registering the animal on behalf of the owner

Title: Mr Mrs Ms Miss

Given name/s:

Surname:

Unit number: Street number: Street name:

Suburb: State: Post code:

Phone (work): Phone (home):

Moblie: Fax:

Agent’s ID (ID required):

Agent’s signature: Date: / /

Fees

Current fees are published on the council’s website, please visit wodonga.vic.gov.au or contact the community focus team on (02) 6022 9300. These include a State Government Levy under the Domestic Animals Act 1994.

Restricted breeds

• Pit Bull Terrier or American Pit Bull Terrier;• Fila Brasilero;• Dogo Argentino;• Japanese Tosa; and• Perro depresa Canario or Presa Canerio

Dangerous dog• A dog used for guarding; and• A dog declared dangerous by a council.

Lost animals

All animals found by a council ranger will be taken to the pound in Kane Rd, Wodonga and listed on the council’s website at wodonga.vic.gov.au

Fines apply to retrieve your animal.

Registration renewals

Animal registrations are due by April 10 each year. This date is not set by Wodonga Council. It is the owner’s responsibility to renew their animal registration each year under the Domestic Animals Act 1994. After the intial registration, an invoice will be sent to your mailing address and you can pay this online at wodonga.vic.gov.au

If you details change such as your address, please inform the community focus team on (02) 6022 9300.

Animal registration tag

All cats and dogs are required to wear a registration tag when not on the registered premises. Wodonga Council provides options for pet tags at a fee.Shapes available:• Small round (stainless steel);• Medium round (stainless steel);• Large round (stainless steel);• Medium round (blue plastic);• Medium heart;• Small bone; and• Large bone.

Other information• All cats registered by Wodonga Council are to be

desexed;

• Cats must be confined to their owner’s property between 7pm and 7am, seven days a week;

• Dogs in public places must be under control - either on a leash or voice control - at all times;

• You must pick-up after your animal. You may be fined if your animal’s excrement remains on any road, street, nature strip, reserve, and public or council land;

• It is an offence to keep more than two dogs and/or two cats on a property without consent in writing from the council in the form of a permit; and

• It is an offence to falsify information on this application (penalties apply).

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Personal and/or health information collected by the council is used for municipal purposes as specified in the Local Government Act 1989. The personal and or health information will be used solely by the council for these purposes and or directly related purposes. The council may disclose this information to other organisations if required by legislation. The applicant understands that the personal and or health information provided is for the above purpose and that he or she may apply to the council for access to and/or amendment of the information. Requests for access and or correction should be made to the council’s privacy officer.

Payment options

In person - EFTPOS, credit card, cheque* or cash

Mail options - cheque or credit card (please complete credit card details below):

Card number:

Expiry date:

CCV number (three digit number on back of card)

Name on card:

Signature:

* Please make cheques payable to ‘Wodonga City Council’.