page 2 of 2 | notification of deceased dog and application for refund
Application for refund
Section 39 of the Dog Control Act 1996 sets out the regualtions for the refund of registration fees.
You will be refunded a part of the registration fee.
The part fee refundable shall be calculated on the basis of the number of complete months remaining in the registration year after
the date of the application for refund (e.g. if you apply for the refund in February, you will be refunded the remaining fee from
March to July).
1. Do you require a refund? Yes No
2
. If you would like the refund direct credited to your bank account, please provide a completed deposit slip and attach it to the
top left at the front of this form.
Declaration
I hereby declare that my dog(s) as listed in ‘Particulars of deceased dog(s)’ have died or have been euthanised and, therefore, I wish
to claim a refund of the registration fees under Section 39 of the Dog Control Act 1996. I understand that making a false declaration
may result in prosecution.
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Signature of dog owner Date
Office use only
Notes:
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signature
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