TRANSFERRING OUT OF DISTRICT
If during the year, you move addresses, or make changes affecting the details held
on the Council’s Dog Register you are required by law to advise the authority.
Please complete this form and send to: Masterton District Council, Animal Services, PO Box 444, Masterton 5840 or email
to: animalservices@mstn.govt.nz
DOG DETAILS
Name Breed Age Sex Tag ID
Please add extra dogs on the back of this form
OWNER DETAILS
Owner’s name
(if known – may be obtained from your dog registration invoice)
Physical address
Postal address (if different from above)
Home telephone number
Mobile phone number
Email
DECLARATION
I hereby declare that I will no longer be residing in Masterton with the above dog/s on or about / /
Signature of registered owner Date
That it is an offence when making an application for the registration of a dog to make any written statement
knowing that statement to be false. On conviction a court may impose a fine not exceeding
$1500.00
− The Dog Control Act 1996 requires Council to record the dog owner’s date of birth
Animal Services, P O Box 444, Masterton 5840, 06 370 6300, animalservices@mstn.govt.nz, www.mstn.govt.nz
