CHANGE OF DOG OWNER
If during the year, you move addresses, or make changes affecting the details held
on the Council’s Dog Register you are required by law to advise the authority.
Please complete this form and send to: Masterton District Council, Animal Services, PO Box 444, Masterton 5840 or email
to: animalservices@mstn.govt.nz
DOG DETAILS
Name Breed Age Sex Tag ID
Please add extra dogs on the back of this form
CURRENT OWNER DETAILS NEW OWNER DETAILS if known
Owner’s name Full name
MDC Owner No.
(may be obtained from your dog registration invoice)
MDC Owner No. or District Dog going to
Date of birth Date of birth
Physical address Physical address
Postal address
(if different from above)
Postal address
(if different from above)
Work telephone number Work telephone number
Home telephone number Home telephone number
Mobile phone number Mobile phone number
Email Email
DECLARATION OF NON-OWNERSHIP
I hereby declare that the dog/s described above changed owner as shown above, on or about / /
Date
Note:
That it is an offence when making an application for the registration of a dog to make
any written statement
knowing that statement to be false. On conviction a court may impose a fine not exceeding
$1500.00
The Dog Control Act 1996 requires Council to record the dog owner’s date of birth
Animal Services, P O Box 444, Masterton 5840, 06 370 6300 , animalservices@mstn.govt.nz, www.mstn.govt.nz
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome