ANIMAL LICENSE REGISTRATION CERTIFICATE
Registration year January 1
st
December 31
st
Annual license fee due by March 1
st
Registration Date: City License Tag #:
OWNER INFORMATION
Name(s):
Address: Bel Aire, KS 6722
Phone: (______)
ANIMAL INFORMATION
Name: Age: [Months] ______ [Years] _______
Sex: [Neutered] ______ [Unneutered] ______ [Spayed] ______ [Unspayed] ______
Breed: Color:
Veterinary Clinic:
Rabies Vaccination Date: Rabies Tag #:
PAYMENT INFORMATION
$10.00 Neutered/Spayed ______ $10.00 Penalty ______
$50.00 Unneutered/Unspayed ______ $ 3.00 Replacement License Tag ______
Fee Total: $ Receipt #:
The complete code (Section 7.2.1) regarding animal registration and vaccination is available online
at www.belaireks.gov
.
7651 E CENTRAL PARK AVE
BEL AIRE, KS 67226
PHONE: (316)744-2451
FAX: (316)744-3739
CITY LICENSE
0
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