Change of Dog Details

Use this form when......
- You have moved address with your dog.
- You have changed ownership of your dog.
- Your dog has passed away.
- Advising Council of your dogs Microchip number.

Under the Dog Control Act 2000, a person is required to notify the General Manager in writing of the dog's death, loss or removal, or change of ownership within 14 days.

* Mandatory Field

Change of Dog Details
DOG DETAILS:
Registration Number:*
Microchip Number:
Breed*
Colour*
Sex:*
De-sexed:*
Dog's Name:*
Alteration:*
DOG OWNER / ADDRESS DETAILS
Name
Previous Address
Previous Telephone
New Address
New Telephone
Postal Address
CHANGED OWNERSHIP TO
Name
Address
Telephone No.
If your dog has been recently sterilised you will need to come into Council and have the veterinary certificate sighted or sign a statutory declaration for proof of sterilisation.
If you see this, leave this form field blank.

Privacy Statement
Completion of this form may require the disclosure of personal information. The intended recipients of this information are officers of the Kingborough Council in order to advance the purposes of this form and to carry out Council business. The Personal Information Protection Act 2004 and Council's Privacy Policy regulate the use of this information, which will not be disclosed to any other party, except with your permission or if required or authorised by law. You may make application to access or amend personal information held by Council by contacting the Customer Service Unit on (03) 6211 8200. Should you not provide the information sought, Council will not be able to process this form.

© 2011 Kingborough Council
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