CITY OF DULUTH
CITY CLERK=S OFFICE
330 City Hall ! 411 West First Street
Duluth, Minnesota 55802-1189
Phone (218) 730-5500
Fax (218) 730-5923
Type in your information by tabbing through the boxes below.
Print, sign (if applicable) and submit this applicant to the address above.
PET LICENSE APPLICATION
January 1 to December 31
LICENSE TYPES (CHECK ONE)
INCLUDE THAT AMOUNT IN A CHECK OR MONEY ORDER WITH APPLICATION
Annual compliant $10.00 Lifetime - compliant $60.00
Annual altered non-compliant $25.00 Lifetime - change of owner $5.00
Annual unaltered $75.00 Service Animal Free
Duplicate tag $5.00
OWNER INFORMATION
NAME(S)
ADDRESS
PHONE
PET INFORMATION
SPECIES
DOG
CAT
NAME
SEX
AGE
BREED
COLOR
SPAY/NEUTER INFORMATION
SPAYED/NEUTERED? (Y/N)
DATE
VET OR VET CLINIC NAME
NOTE: If pet has been spayed or neutered, include the certificate with this application. It will be returned with
the license.
RABIES VACCINATION INFORMATION
VACCINATION DATE
EXPIRATION DATE
VET OR VET CLINIC NAME
NOTE: Include the Rabies Certificate with this application. It will be returned with the license.
PRIVACY NOTICE: The information you listed above is classified by the State of Minnesota as PUBLIC
unless you choose to keep it private. If you want your information to be kept private, date and sign your
name below. I request my data to be considered private.
_____________________________________ ____________________
Signature Date
