[COB] Update Pet Registration

Name(Required)

Phone(Required)

Address(Required)

Postal Address (if different to residential)

Owner/Agent Signature(Required)

I declare that I am the owner/agent of the animal described below and that all details on this document are true and correct to the best of my knowledge and belief.

Date(Required)

Pet type(Required)

Dog

Cat

Pet name(Required)

Animal ID(Required)

Pet's Microchip Number(Required)

Former Address (if applicable)

Please enter your pet's former address

New Address (if applicable)

Please enter your pet's new address

Name of New Owner (if applicable)

New Owner Address (if applicable)

Phone

Are you requesting an animal sterlised refund

Yes

Photocopy proof of sterilisation must be attached below

Animal Deceased Date (if applicable)

Please note there is no registration fee rebate for deceased animal as (as per the Act).

Customer Support Officer Signature

Office Use Only

Date

Office Use Only

Proof of Sterlisation

Max. file size: 50 MB.

Proof of Microchipping(Required)

Max. file size: 50 MB.

Proof of concession

Max. file size: 50 MB.