Dog Registration Application

*- indicates required field.

Only use this form if you have never registered this dog before. If this dog has already been registered before use our Dog Registration Renewal form instead.

Please complete this application to register your dog/s after reading the Notes and Conditions for Dog Registration page on our website. You will be required to indicate that you have read and accept the conditions before you can submit your application. The Notes can be found on our website at Notes and conditions for Dog Registration.

After you have submitted your application Council will contact you with the amount you need to pay and ways to make payment before your dog's registration is issued.

Dog registration fees (on or before/after 1 August) are:

Entire dog: $110.00/$165.00

Neutered dog: $55.00/82.50

Working dog: $40.00/$60.00

Certified disability assist dog: $15.00/15.00

Microchipping: $25.00

Owner details

Owners full name: *

Date of birth *

Required under the Dog Control Act 1996

Address where dog normally kept: *

Include rural delivery (RD) number, if applicable

Postal address (if different): (optional)

Home phone: (optional)

This may be the same as your mobile number.

Work phone: (optional)

Mobile phone: (optional)

Your email: *

Dog details

Dog's name *

Age *

Your dog's breed *

If your dog is mixed breed enter one of its breed types here and then check the mixed breed box below. At least one breed type must be entered to enable processing of your application.

My dog is a mixed breed

(optional)

Colour *

Distinguishing marks (optional)

Microchip number (optional)

(Vet certificate required. Please upload a copy with your application.)

Upload your certificate for microchipping here if required: (optional)

Upload

(pdf, doc, docx, txt, jpg, png or jpeg)

Sex *

Dangerous dog?* *

*If your dog has been classified as dangerous by any Council you must select Yes.

Menacing dog?* *

*The Dog Control Act automatically classifies dogs that are wholly or predominantly of these breeds as menacing, no matter how they behave individually. If your dog is classified as menacing you must select Yes above: American Pit Bull Terrier, Brazilian Fila, Japanese Tosa, Dogo Argentino, Perro de Presa Canario. Any dog can also be classified as menacing by deed regardless of its breed. You must select Yes above if your dog has been classified as menacing by any Council.

Is your dog desexed? *

Purpose: *

Pet

Working or Hunting dog*

Certified disability assist dog

Information for owners of multiple dogs

Note: Part 9.10 of the Ōpōtiki District Council Consolidated Bylaws 2020 places a limit on the number of dogs on a premises. If you live in a Residential Zone, Mixed Activity Zone, Ōhiwa Harbour Zone, or Coastal Settlement Zone and want to keep more than two dogs older than three months, complete an 'application for licence to keep more than two dogs' form.. There are no limits in the Rural Zone or Coastal Zone. Contact Council to request this form if required.

Upload your licence to keep morre than two dog form here if required. (optional)

Upload

(pdf, doc, docx or txt)

Terms and conditions

I have read, understand and agree to abide by the Notes on Dog Registration *

I agree

Owner's signature *

By entering your name here you certify that the information on this form is true and correct.

Date *