Replacement dog tag
Please read this first
This form will be scanned by electronic equipment. It is important that you:
• use a blue or black pen to mark your answers; and
• print clearly.
tararua district council
26 gordon street
po box 115
06 374 4080
Office use only
Replacement tag number(s)
1. 2. 3.
Tag issued by
Computer records updated: Yes No
Owner details (Please print in CAPITALS)
Name of owner
- / /
Phone number Owner’s date of birth
Dog name Breed Colour Sex Age Tag No. Dog ID
Describe what happened to the old tag.
Note: Attach old tag(s) if possible.
I certify that the above particulars are true and correct.
Signature of applicant Date
click to sign
click to edit