Central Highlands Regional CouncilDog registration - Register my dog

Phone

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With this form you can register your dog, change details of your registration or transfer details of registration from another local government. The registration and details recorded align with the requirements of the Animal Management (Cats and Dogs) Act 2008 sections 46, 47 & 54. Please ensure you have the following documents prepared to attach to this application (where applicable): 1. Evidence of desexing 2. Evidence of current registration in another local government 3. Details of pension card 4. Evidence of assistance dog status.

Application date*

Registration currency is per financial year.

Application type*

Council declared under

Name of council

Name of council transferring from*

Evidence of registration*

Max. file size: 128 MB.

Applicant details

Name*

First Last

Date of birth*

Residential address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Postal address (if different to residential address)

Street Address PO Box City State / Province / Region ZIP / Postal Code

Phone number*

Email

Enter Email Confirm Email

Dog details

Dog's name*

Name

Dog's breed*

Dog's date of birth*

Dog's sex*

Is the dog desexed?*

Certificate of desexing*

Max. file size: 128 MB.

It is a requirement that certification from a veterinary practice must be provided to register your dog as ‘desexed’

Is the dog microchipped?*

Yes
No

If yes, what is the microchip number (15 digits)?

Please provide microchip number if your dog has been microchipped.

Is the dog kept at a different address to the residential address above?*

Address the dog is kept at*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Dog colour and features*

Upload image of dog

Max. file size: 128 MB.

(Optional)

Would you like to register another dog?*

Transfer from another council?*

Yes
No

Name of council transferring from*

Evidence of registration*

Max. file size: 128 MB.

Second dog's name*

Name

Second dog's breed*

Second dog's date of birth*

Second dog's sex*

Is the second dog desexed?*

Second dog certificate of desexing*

Max. file size: 128 MB.

It is a requirement that certification from a veterinary practice must be provided to register your dog as ‘desexed’

Second dog's permanent identification number (PID)/ Microchip

Is the second dog's kept at a different address to the residential address above?*

Address the second dog's is kept at*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Dog colour and features*

Upload image of second dog

Max. file size: 128 MB.

(Optional)

Regulated dog only

Please identify whether any of the dogs has been declared as

Restricted dog
Dangerous dog
Menacing dog

Eligibility for concession

Do you hold a pension or concession card?*

Name of card holder*

First Last

Pension number*

9 Numbers + 1 Letter (123456789A)

Card expiry date*

Scan or copy of pension or concession card*

Max. file size: 128 MB.

Maximum file size 2MB

Type (select all that apply)*

Is the dog an assistance dog?*

Evidence of assistance dog status*

Max. file size: 128 MB.

Maximum file size 2MB

Terms and conditions

1. I am aware that the total number of dogs kept at this property, if in the urban area, cannot exceed the allowable number on an allotment of my size, as stated in Central Highlands Regional Council Local Law No.2 Subordinate, without an approved Multiple Animal (Domestic Cat & Dog) Permit. 2. I approve of authorised council officers returning my dog to my property if found wandering for the first time, while currently registered. 3. I will maintain a proper enclosure to keep my dog on the property to prevent it from wandering or escaping from my land, as per Minimum Standards stated in Local Law No.2 Subordinate Schedule 4-5. 4. I acknowledge that my dog must always be under effective control if in a public place. 5. I will ensure that my dog wears the prescribed registration device (Registration Licence Tag) at all times. Should the registration tag become lost or damaged, I must make a request to council for a replacement tag at a cost, as per the current Fees and Charges Schedule. 6. I must not keep a restricted dog without a current approved Restricted Dog Permit. 7. I recognise that failure to comply with council’s Local Laws, relevant provisions of the Animal Management (Cats and Dogs) Act 2008 and these Terms and Conditions may result in council undertaking enforcement action.

Declaration*

I apply for the registration/ renewal/ change of details of the dog(s) described and declare that the particulars are correct in every detail. I have read, agree with and will comply with the Terms and conditions above.

Privacy Statement: Central Highlands Regional Council is collecting this information in order to comply with its responsibilities and obligations as a local government. The information will only be used by council officers or agencies which may have a legitimate need for the information to process applications or the like. This information will not be disclosed to a third party unless you have given your written consent, or we are required to do so by law. For more information about privacy in Central Highlands Regional Council see our privacy plan on our website.

Terms and Conditions of Pension or Concession Card 1. I authorise: • The Central Highlands Regional Council (council) to use Centrelink Confirmation eServices to perform a Centrelink/DVA enquiry of my Centrelink or Department qualify for a concession, rebate or service. • The Australian Government Department of Human Services (the department) to provide the results of that enquiry to Central Highlands Regional Council. 2. I understand that: • The department will disclose personal information to Central Highlands Regional Council including my name, address and concession card type and status to confirm my eligibility for pensioner rebate with council. • This consent, once signed, remains valid while I am a customer of Central Highlands Regional Council unless I withdraw it by contacting the Central Highlands Regional Council or the department. • I can get proof of my circumstances/details from the department and provide it to Central Highlands Regional Council so my eligibility for pensioner rebates can be determined. • If I withdraw my consent or do not alternatively provide proof of my circumstances/details, I may not be eligible for the pensioner rebate provided by Central Highlands Regional Council and am required to provide proof of eligibility of the concession every 6 months.

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Dog registration – Register my dog

ON THIS PAGE

Dog registration

Applicant details

Dog details

Regulated dog only

Eligibility for concession

Terms and conditions