Owner to complete this form.

Owner details

Full name, no abbreviations please
Enter NA if you don't have a middle name

Cheque refunds will be posted unless bank account details are provided here

Dog details

 

Note: It is an offence to make a false statement relating to dog registration.

Statement for the Purpose of Principle 3 of the Privacy Act

  1. The information is being collected to enable the Council to maintain its dog register and records
  2. The intended user of the information is the Council's Environmental Services Unit
  3. You have the right of access to and correction of any personal information held about you by the Council
  4. This information is held on the Council's dog register
  5. Supply of information from the dog register is strictly limited by Section 35 of the Dog Control Act 1996.