Working Dog Declaration
Please return this form to: firstname.lastname@example.org or Ashburton District Council, PO Box 94, Ashburton 7740
I_______________________________________________________(full name) hereby declare that my dog
__________________________________ (dog name and breed) is a working dog as defined under Section
2(b)(ii) of the Dog Control Act 1996.
I am prepared to demonstrate my dog’s abilities to comply with Section 2(b)(ii) of the Dog Control Act
1996 should Council request such a demonstration.
Signed: _____________________________ Date: _________________________________
Note: Section 2(b)(ii) of the Dog Control Act 1996 states a working dog is any dog kept solely or principally for the
purpose of herding or driving stock. Making a false declaration renders the dog owner to an infringement notice of
$750 being issued to them under Section 41 of the Dog Control Act 1996.
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