CITY OF HELENA
316 N Park Avenue, Room 150
Helena MT 59623
(406) 447-8450 Fax(406) 447-8377
citywater@helenamt.gov
DOG LICENSE APPLICATION
LICENSE IS VALID FOR ONE YEAR – JANUARY 1 THROUGH DECEMBER 31
City ordinance requires that no person shall own, keep or harbor any dog over the age of 6 months within the
City limits, unless such dog is licensed. Please complete the required information below and return this form
with the applicable fee to the address shown above.
Owner’s Name: _______________________________________________________________
Physical Address: _____________________________________________________________
Mailing Address: ____________________________________Phone:___________________
Dog’s Name: __________________________________________________________
Breed & Color: _________________________________________________________
Sex: Age: ______
Dog’s Name: __________________________________________________________
Breed & Color: _________________________________________________________
Sex: Age: ______
Dog’s Name: __________________________________________________________
Breed & Color: _________________________________________________________
Sex: Age: ______
***A copy of a current rabies vaccination and papers showing if your dog is spayed or neutered must be enclosed***
A KENNEL LICENSE WILL BE REQUIRED BY ANY PERSON OR FAMILY OWNING OR HARBORING
3 OR MORE DOGS OR CATS OVER 6 MONTHS OF AGE
______ $15.00 For each male or female dog which has been neutered or spayed
______ $25.00 For each male or female dog not neutered or spayed
______ $ 1.00 Penalty for late registration on renewals after March 1
st
for each dog
______ TOTAL (Please make checks payable to the City of Helena)
Signature ___________________________________________ Date _________________________________
(Print form, sign, and return with payment)
