Dog owner to complete this form to enable the Council to update its dog register and to enable a refund, where appropriate.

Owner details

Full name, no abbreviations please
Enter NA if you don't have a middle name

A refund of a portion of the registration may be refunded to the registered owner only.

The Council prefers to pay refunds to a bank account. Please provide details below. (a cheque may be sent if a bank account is not available)

Dog details


Note: It is an offence to make a false statement relating to dog registration.

Statement for the Purpose of Principle 3 of the Privacy Act

  1. The information is being collected to enable the Council to maintain its dog register and records
  2. The intended user of the information is the Council's Environmental Services Unit
  3. You have the right of access to and correction of any personal information held about you by the Council
  4. This information is held on the Council's dog register
  5. Supply of information from the dog register is strictly limited by Section 35 of the Dog Control Act 1996.