Fillable Dog License Worcester City Clerk City Hall Room (City of Worcester)

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Dog License Worcester City Clerk City Hall Room (City of Worcester)

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The Dog License Worcester City Clerk City Hall Room (City of Worcester) form is 2 pages long and contains:

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File type: PDF

U.S.A. forms for City of Worcester

BROWSE CITY OF WORCESTER (MA) FORMS

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Dog License
Please print out this form and return to:
Worcester City Clerk
City Hall Room 206
455 Main Street
Worcester, MA 01608-1889
Owner information:
Name of owner
___________________________________________________________________________
First Middle Last
Residence
___________________________________________________________________________
Number
& Street Apt # Zip
Home Phone Secondary Phone
_________________________ __________________________________
Date of Owner's Birth
______________________________________________________
Month Day Year
Dog Information:
Name of Dog
_______________________________________________________
Sex _________
(Male? If neutered, please provide veterinarian certificate)
(Female? If spayed, please provide veterinarian certificate)
Color/s
_______________________________________________________
Breed/s
_______________________________________________________
Date of animal's Birth
______________________________________________________
Month Day Year
Please include the anti-rabies vaccination from your veterinarian.
Annual License Fee:
Make check payable to City of Worcester
Male $30.00 Female $30.00
Neutered Male $25.00 Spayed Female $25.00
Any person who fails to obtain an annual dog license on or before May 31st shall be charged
when applying for a license, in addition to the license fee, a late fee of $15.00.
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Dog License Worcester City Clerk City Hall Room (City of Worcester)

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Completed 10 February 2021

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