Author: Town Clerk
Company: Toshiba
Keywords: CreatedByIRIS_DPE_12.03

Town of Hinsdale

NEW DOG LICENSE APPLICATION FORM 
(TO BE USED FOR MAIL IN NEW DOG LICENSE· IF YOU ARE LICENSING THE DOG IN PERSON 
YOU DO NOT NEED TO FILL OUT THIS FORM) 
OWNER NAME 	_ 
OWNER ADDRESS 	_ 
OWNER PHONE NUMBER, 	_ 
DOG NAME 	_ 
DOG BREED 	_ 
DOG COLOR 	_ 
DOG BIRTH YEAR 	_
 
DOG SPAYED/NEUTERED Y/N __ (PROOF REQUIRED) 

SEND THIS APPLICATION TO: 			
	HINSDALE TOWN CLERK 
	ANN L. CARR	
	PO BOX 95                                                                                 	HINSDALE, NY 14743
Please send in current rabies certificate and Proof of Spaying or neutering (will be returned to you)

Licensing fees $20.00 for unspayed /unneutered OR $10.00 for spay/neuter 
IF YOU HAVE QUESTIONS CALL 716 557 2478 EXT 104
OR EMAIL hinsdaletownclerk2014@gmail.com