Pa Dog License Form PDF Details

Are you the proud owner of a new pup? If so, congratulations! Owning a pet is one of life’s great joys. With that comes quite a bit of responsibility, however – and one of those responsibilities is getting your furry friend licensed for their own safety. Don’t worry; it doesn’t have to be hard! In this blog post, we’ll show you how to get your doggo legally registered with just a few simple steps: by filling out the Pennsylvania Dog License Form. Keep reading to learn everything you need to know about getting your pup licensed in PA today!

QuestionAnswer
Form NamePa Dog License Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namespa dog license monroe county, UNSWORN, 2010, SPAYED

Form Preview Example

ADLEB 19 rev. 9/2010

PA Department of Agriculture, Bureau of Dog Law Enforcement

LIFETIME DOG LICENSE APPLICATION

Year of license

A Permanent Identification Verification Form must be completed before the license will be issued.

DOG OWNER’S NAME

 

 

 

 

 

OWNER’S BIRTHDATE

 

PHONE NUMBER

 

 

 

 

 

 

 

 

 

MO.

 

DAY

 

YR.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STREET ADDRESS

 

 

 

 

 

 

 

 

 

TOWNSHIP/BOROUGH

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY

 

 

 

 

 

 

 

 

 

 

 

 

 

STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PA

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE

 

BREED

 

 

 

DOG’S AGE

 

DOG’S NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COLOR /

 

SPOTTED

WHITE

BLACK

 

 

BROWN

 

OTHER-INDICATE

MARKINGS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REGULAR LIFETIME LICENSE

 

 

 

 

 

PERSON WITH DISABILITY

 

 

 

 

 

 

 

 

 

 

 

 

 

OR SENIOR CITIZEN FEE

 

 

NEUTERED

 

 

SPAYED

 

 

 

 

 

NEUTERED

 

 

 

SPAYED

MALE

MALE

 

FEMALE

FEMALE

 

 

MALE

 

MALE

 

FEMALE

FEMALE

$51.45

$31.45

$51.45

$31.45

 

$31.45

$21.45

 

$31.45

$21.45

ALL PRICES INCLUDE SERVICE FEES

 

 

 

 

 

ALL PRICES INCLUDE SERVICE FEES

 

ALLOWED BY LAW

 

 

 

 

 

 

 

 

 

ALLOWED BY LAW

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PLEASE NOTE: If you are applying for a lifetime license that requires the dog owner be a senior citizen (age 65 or older) or a person with disability, you must provide proof of age or disability to the County Treasurer.

I HEREBY VERIFY THAT I AM THE OWNER OF THE DOG THAT IS THE SUBJECT OF THIS DOG LICENSE

APPLICATION. I MAKE THIS STATEMENT SUBJECT TO THE CRIMINAL PENALTIES OF 18 Pa § SECTION 4904

(RELATING TO UNSWORN FALSIFICATION TO AUTHORITIES).

SIGNATURE OF DOG OWNER/APPLICANT REQUIRED

IF APPLICANT IS A MINOR, SIGNATURE OF PARENT OR GUARDIAN IS REQUIRED

MAIL TO COUNTY TREASURER’S OFFICE

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2010 completion process explained (portion 1)

2. Soon after completing this section, go to the next step and fill out the essential details in all these blank fields - ALL PRICES INCLUDE SERVICE FEES, ALL PRICES INCLUDE SERVICE FEES, ALLOWED BY LAW, ALLOWED BY LAW, PLEASE NOTE If you are applying, I HEREBY VERIFY THAT I AM THE, APPLICATION I MAKE THIS STATEMENT, RELATING TO UNSWORN FALSIFICATION, SIGNATURE OF DOG OWNERAPPLICANT, IF APPLICANT IS A MINOR SIGNATURE, and MAIL TO COUNTY TREASURERS OFFICE.

How you can fill out 2010 stage 2

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