OWNER NUMBER: _______________________
TOWN OF MILLS
EST. 1921
Pet License Form
DATE: _______________________ MILLS TAG#: ________________________
LICENSE: ☐ 1 YEAR ☐ LIFETIME EXPIRATION DATE: ___________________
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Owner information:
Owner name: ______________________________________ Phone #: ( ) ______ - ____________
Physical address: ______________________________________________ City: ____________________
State: ________________________________ Zip code: ____________________
☐ Mailing same as physical
Mailing address: _______________________________________________ City: ___________________
State: _________________________________ Zip code: ____________________
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Animal information:
Name: _________________________________ Species: ☐ DOG ☐ CAT Other: _______________
Breed: _________________________ Gender: ☐ MALE ☐ FEMALE
Color: _________________________ Weight: ________________ Age: _____________
Animal altered: ☐ YES ☐ NO Microchip number: ____________________________________
Rabies number: _______________________ Rabies expiration date: __________________________
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NOTICE:
ANIMAL LICENSE PROCESSING IS NO LESS THAN 48 HOURS (WEEKENDS
NOT INCLUDED). ONCE LICENSE IS PROCESSED, OWNER MAY COME IN
AND MAKE PAYMENT THEN RECEIVE LICENSE AND TAGS.
