2020 PET LICENSE APPLICATION
City of DuPont
1700 Civic Drive.
DuPont, WA 98327
Phone 253.964.8121
Pet Owner Information:
Annual Renewals: We will send email courtesy reminders at the end of each year. Please supply your
email address. Please print legible.
Email address: _______________________________________________________________________
First Name(s): ________________________________________________________________________
Last Name(s): ________________________________________________________________________
Address: ____________________________________________________________________________
Home/Cell or Work Phone Numbers: ______________________________________________________
If someone finds your lost animal, the City may provide them with (Please check):
Phone #’s _____ Address _____ Both Phone & Address _____ No Information _______
Animal Information: **Office Use: Rabies Vaccination Current:_____ Verify Neutered/Spayed:_____**
Dog or Cat: _______________________ Approx. Age of Animal: ______________________________
Sex of Animal ________________ Please circle: (N) Neutered (S) Spayed ( ) Not Fixed
Name of Animal: ______________________________________________________________________
Breed: ______________________________________________________________________________
Markings/Coloring: ___________________________________________________________________
Microchip Number & Manufacturer: ______________________________________________________
Please bring or mail application and fee to: City Hall, 1700 Civic Drive, DuPont (located off Center Drive)
2020 Fee Schedule:
Pet License Tags expire December 31
st
and must be renewed by January 31
st
Late Fee (30-59 days) $10.00
Late Fee (60+ days) $20.00
Unaltered cats/dogs $60.00*
Spayed/neutered cats $12.00 (if a new pet license, documentation of surgery is required)
Spayed/neutered dogs $20.00 (if a new pet license, documentation of surgery is required)
Pet License replacement tag $ 5.00
PROOF OF VACCINATION AND IF THE ANIMAL IS SPAY OR NEUTERED
MUST BE PRESENTED AT THE TIME OF LICENSING.
*A dog or cat owner, presenting a written statement from a veterinarian that the spay/neuter surgery would be harmful, may
purchase a license at the fee for neutered/spayed animals.
Dog or cat owners who fail to comply with pet licensing are subject to a civil fine of $100.00.
IF YOU MOVE OR NO LONGER HAVE YOUR PET, PLEASE CONTACT CITY HALL AT 253-964-8121
TO HAVE YOUR PET’S NAME REMOVED FROM OUR ROSTER.
For Office Use:
TAG # 000___________
RECEIPT#____________
DATE:______________
