Dog Registration Amendment Form

IMPORTANT! Use this form to update the details associated with a single dog registration.

TO AMEND YOUR PRIMARY NAME, ADDRESS AND/OR CONTACT DETAILS, REFER TO THE NOTIFICATION OF CHANGE OF DETAILS FORM .

Animal Owner Details

The applicant requesting the change of details must be the current registered owner.

Given Name *

Surname *

Primary Phone *

Secondary Phone

Email address *

Registered Animal Details

To update more than one registered animal, please submit a separate form for each animal.

Animal Name *

Please supply one of the following numbers to identify the animal record:

Animal ID Number

Microchip Number

Tag Number

I understand that the following details will be updated for Animal Registration purposes only. *

TO AMEND YOUR PRIMARY NAME, ADDRESS AND/OR CONTACT DETAILS, REFER TO THE Notification of Change of Details Form.

Postal Address (for Animal Registration purposes only) *

I understand that this postal address will be added to my Animal Registration record for Animal Registration purposes only. *

Select animals details you would like to change:

How would you like to receive Renewal NoticesSterilisation/DesexedDeceasedNo longer resides in the Mareeba ShireAddress where dog is keptReplacement tag - a Customer Service Officer will contact you for paymentKennel Club or Canine AssociationOther

How would you like to receive Renewal Notices? *

EmailPost

Renewal Notice email address *

Renewal Notice postal address *Please ensure suburb is specified.

Proof of Desexing *

Browse

Please attach certificate of sterilisation/desexing unless you've previously provided this information.

Deceased Date *

Address where dog is kept *

Proof of Concession *

Browse

Please attach proof of Kennel Club or Canine Association membership

Other *

Declaration of Applicant

I hereby apply for amendment of the animal record described and declare that the details are correct to the best of my knowledge.

I am aware that the number of animals kept at this property is in accordance with the allowable number of dogs to be kept on a property as stated in Council's Local Law No 2 (Animal Management) 2018.
If applicant is under the age of 18 years, the parent or guardian is deemed to be the keeper of the animal.
I have a suitable enclosure or adequate fencing to prevent my animal from escaping.

Applicant Signature

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Animal Management (Cats and Dogs) Act 2008.

Council DOES NOT offer refunds on dogs that have left the Shire or are deceased.

Collection Notice: Mareeba Shire Council is collecting your personal information under the Local Government Act (Qld) in order to process your animal registration form. Your personal information will not be used for any other purpose and will not be disclosed to any other entity or person without your express consent or we are required by law. Your personal information will be handled in accordance with the provisions contained within the Information Privacy Act 2009 (Qld).

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