“The Heartland of New Jersey

 

UPPER FREEHOLD TOWNSHIP ANIMAL CONTROL

314 ROUTE 539, CREAM RIDGE, NJ  08514

609-758-7738 ext.224

 

2014 DOG LICENSE APPLICATION

 

DATE:  ______________________

 

OWNER’S NAME: ____________________________________________________________

 

ADDRESS: ___________________________________________________________________

 

ZIP CODE:  _____________________  PHONE NUMBER:  ___________________________

 

EMAIL ADDRESS(optional)_____________________________________________________

 

DOG’S NAME:___________________________________ SEX:  Male ______ Female _____

 

DOG BREED: ______________________________________ COLOR: __________________

 

AGE: _______________________ HAIR:   Short_______ Medium _______ Long _________

 

SPAYED/NEUTERED:  Yes _________ No _________ (IF YES, PLEASE ATTACH  PROOF)

 

RABIES EXPIRATION DATE: _________________________     PLEASE PROVIDE PROOF

(RABIES CERTIFICATE)

2013 LICENSE # (If applicable)__________________________

 

Spayed/Neutered-7.50    Non-Spayed/Neutered-10.50 – AMOUNT ENCLOSED: __________

 

Renewal Licenses Only (New Licenses do not pay a late fee)

**LATE FEE OF $25.00 WILL BE APPLIED AFTER FEBRUARY 28, 2014

 

** NO EXCEPTIONS**

 
Please make checks payable to:  TOWNSHIP OF UPPER FREEHOLD

 

THIS LICENSE EXPIRES 12/31/2014 AND MUST BE RENEWED DURING JANUARY 2014