DOG LICENSE APPLICATION
Town of Surf City
SEC 3-10(b) SURF CITY ORDINANCE
(Owners) Last Name First MI
Physical Address Telephone Number
Mailing Address (street address, city, state, zip code)
Pet Name:
Breed:
DO NOT WRITE BELOW THIS LINE
LICENSE ISSUED___________________________________EXPIRES_____________
____________________
LICENSE NUMBER
Color:
Birth Year:
Rabies #:
Exp. Date:
Microchip:
Tattoo:
Sex:
____________________
TAG SHAPE/COLOR
____________________
PARCEL NUMBER
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