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Dog registration – Register my dog
Dog registration – Register my dog
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Dog registration – Register my dog
Dog registration
Application for registration or renewal or change of details for registration of a dog
With this form you can register your dog, or change details of your current registration. The registration is under the
Animal Management (Cats and Dogs) Act 2008 - Section 46, 47, 554 and 55.
Please ensure you have the following documents prepared to attach to this application: 1. Evidence of desexing or letter from a vet. 2. Evidence of microchipping. 3. Evidence of assistance dog status (if applicable).
Application date
*
DD slash MM slash YYYY
Registration currency is per financial year.
Application type
*
New registration
Change of details to existing registration
Regulated dog registration
Applicant details
Name
*
First
Last
Date of birth
*
DD slash MM slash YYYY
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
*
Mobile number (optional)
Email
Enter Email
Confirm Email
Dog details
Dog's name
*
Name
Dog's breed
*
Dog's date of birth
*
DD slash MM slash YYYY
Dog's sex
*
Male
Female
Is the dog desexed?
*
Yes
No
Certificate of desexing
Max. file size: 128 MB.
You must provide a certificate of desexing or a letter from a vet to state that desexing the dog would pose a significant risk to the dog's health. A photo of the dogs ear branding (tattoo) does will not be excepted. Maximum file size 2MB
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?
*
Yes
No
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?
*
Yes
No
Second dog's name
*
Name
Second dog's breed
*
Second dog's date of birth
*
DD slash MM slash YYYY
Second dog's sex
*
Male
Female
Is the second dog desexed?
*
Yes
No
Second dog certificate of desexing
Max. file size: 128 MB.
You must provide a certificate of desexing or a letter from a vet to state that desexing the dog would pose a significant risk to the dog's health. Photo of dog branding (ear tattoo) will not be accepted. Maximum file size 2MB
Second dog's permanent identification number (PID)/ Microchip
Is the second dog's kept at a different address to the residential address above?
*
Yes
No
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?
*
Yes
No
Name of card holder
*
First
Last
Pension number
*
Card expiry date
*
DD slash MM slash YYYY
Type (select all that apply)
*
Aged
Widow
Disabled/ invalid
Is the dog an assistance dog?
*
Yes
No
You will need to supply evidence.
Evidence of assistance dog status
*
Max. file size: 128 MB.
Maximum file size 2MB
Terms and conditions
1. I am aware that the number of dogs kept at this property cannot exceed the allowable number of dogs on a property of this size as state in Central Highlands Regional Council's (CHRC) local laws. 2. I approve of CHRC releasing my details (if my dog is currently registered) to another person, should they find my dog wandering, for the purpose of that person to returning my dog to me. 3. I recognise that failure to comply with CHRC's local laws and any relevant provisions of the
Animal Management (Cats and Dogs) Act 2008
may result in CHRC taking enforcement action against myself. 4. I have a proper enclosure to keep my dog in, to prevent it from wandering or escaping from my land. 5. I acknowledge that my dog must be under effective control at all times if in a public place. 6. I will ensure that my dog wears the prescribed registration device (registration tag) at all times. Should the registration tag become lost of damaged, I must make an application to CHRC for a replacement registration tag. 7. I must not keep a restricted dog without a current
Restricted dog permit
.
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.
Phone
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