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FCITY OF BLAIR® 2022 4iET LIPPi /ZT'i N If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City Of Blair • 218 S 16th St o Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs' or three (3) adult cats per residential or dwelling unit. I {' LICENSE RENEWALS ARE DUE: March 15, 2022 ***PLEASE READ CAREFULLY*** Owner Name: !9 f eq ro;'ect.,l i Q., e/' YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Owner Address: 2, 2 � yek, i w A', Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. city/state/zip: Blair, NE 68008 PET LICENSES RENEWALS ARE DUE BY 3/15/2022. The City shall Phone # 1/02 6, e' y recognize a microchip Identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city Identification other than that Issued by the City of Blair for such dog or cat, The City of Blair requires proof of rabies vaccination. LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET # 1 Dog ❑ Cat 0 Spayed/Neutered License Fee $ Z1, 60 Pot Name & ; ✓►-C e,5 5 Birthdate Sex r4 C for e, acBreed** �G-r 7eilr`e,� Replacement $ ** it 0 D clared Dangerous or Potenti Ily Dangerous Dog: ❑ Y M N ICROCHIP # (If applicable) SUBTOTAL: $ /, ®c BIES VACCINATION DATE: .20 (3 yr) —_�L— (1 yr) City Tag # 002&,� I ET # 2 Gil Dog ❑ Cat Ud Spayed/Neutered License Fee $ 00 P t Name ,a Birthdate Sex F C for 61111- A &A re r; c k Breed** s�o�_P,6&, Iko., ° Replacement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y ® N MICROCHIP # (If applicable) SUBTOTAL: $ //, 00 RABIES VACCINATION DATE: 0IT (3 yr) X_ (1 yr) City Tag #vo~ 6;' PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ W1 (1 yr) License Fee $ Replacement $ SUBTOTAL: $ ,, *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED $ -22.6f If you have questions, please contact Blair Police Department at (402) 426-4747 ++.++++.+++++++.++..... ¢+++++.+++++++++++.........+++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS(March 15late fee date not applicablefor newpe&lnewresidenis) Newly Acquired Pets: New Residents to Blair: Must be lioensed within 10 days of ownership a Must register pets within 10 days of 0 <OR> at 6 months of age if puppy/kitten residency. V LICATIOV C � 0 � LI"4A 14 .a If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair a 218 S 16th St o Blair, NE 68008 You may legally own d combination of four (4) adult pets, but no more than three (3), adult dogs or three (3) adult cats per residential or dwelling unit. j I �`a LICENSE RENEWALS ARE DUE: March 15, 2022 ***PLEASE PEW CAREFULLY*** Owner Name' �Y�� I YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Owner Address' Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. City/State/Zip: Blair, NE 68008 PET LICENSES RENEWALS ARE DUE BY 3/15/2022. The City shall Phone # recognize a microchip Identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city Identification other than that Issued by the City of Blair for such dog or cat. The City of Blair requires proof of rabies vaccination. LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 Replacement Fee for Lost Tag' $5,00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Ins 'on Program 111 T #I Dog ❑ Cat ,Spayed/Neutered License Fee $ Pe Name �m- ,) (I Birthda*te 120 -Sex Replacement �** Co r �ro,-n Breed rtill _ p $ De Jared Dangerous or Potentially Dangerou Dog: ❑ Y AN I ROCHIP # (If applicable) SUBTOTAL: $ ~ IES VACCINATION DATE: �. RU _ (3 yr) (I yr) City Tag # jT #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pe Name Birthdate _ Sex Co r Breed** eclared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: _ (3 yr) _ ET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name _ Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: _ — (3 yr) _ W License Fee $ Replacement $ SUBTOTAL: $ (I yr) City Tag # License Fee $ Replacement $ SUBTOTAL: $ (I yr) City Tag # —®* *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) ®o Not Send cash by Mail TOTAL N If you have questions, please contact Blair Police Department at (402) 426-4747 .....++.+++.....+-�.........+..}............................................. +��- NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Match 15late fee date not applicable fornewpets/new residents) Newly Acquired Pets: New Residents to Blair: Must be licensed within 10 days of ownership n Must register pets within 10 days of Eii <OR> at 6 months of age if puppy/kitten residency. VCA Animal Medical Center of Omaha 2323 South 64th Avenue Omaha, NE 68106 (402) 558 - 1522 RABIES VACCINATION CERTIFICATE (REPRINT) Pet's Name: Arnold Species: Canine Breed: Bulldog, English Sex: Male (Neutered) Birthdate: 10/01/201S Color: Brown Weight: 58.30 lb Date of Vaccination: 7/30/2020 Date Due: 7/30/2023 Microchip: 985112007 702526 Duration: 3 years Owner: Allyson Friel 1461 South St Blair, NE 68008 (712) 259 - 3917 Vaccination information Verified at VCA Animal Medical Center of Omaha By: Dr. Halsey Manufacturer: Pfizer/Zoetis Defensor 3 Lot/Serial Number: 407672 Lot Expiration: 8/10/2021 Tag Number: 20-39660 License Number: 2902 For information on how we collect and use information about you and your pet, and how you may opt -out of some uses, please see our Privacy Policy at vcahospitals.com/privacy-policy. ■ M :BSAC FRX NO. :402-533-2722 Jan. 20 2022 02:12PM P1 CITY OF GLAIR - 2022 PET LICENSE APPLICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair * 218 S 16th St • Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3j adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: M=b 15,2Q22 Owner Name: Owner Address: city/State/zip: glair, NE 68008 Phone # Inz. 11-1 6 46z 5)� 17-1141 LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 ***PLEASE READ CAREFULLY*'* YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so Is a vlolRtlon of City ordinances 6.103 and carries a ponaky of a fine up to $150.00 per pet, PET LICENSES RENEWALS ARE DUE BY 3/15/2tl2Z. The City Shall recognize a microchip Identification number as the llcsnsc number. It shall be unlawful for any dog or cat to wear any license or other city identification other than that Issued by the City of Blair for such dog or cat. The City of Blair requires proof of retries vaccination. Replacement Fee for Lost Tag; $5.00 Included Is a Staite Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET #z LWDo ❑ Cat Spayed/Neutered License Fee $„ �� Pet Name 0 _ Birthdate.-Sex Color Breed** Rep/acement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ MICROCHIP # (If applicable SUBTOTAL: $ 1,10._ RABIES VACCINATION DATE; (3 yr) --A (1 yr) City Tag # �* Ta— . PET PET #Z ❑ Dog D Cat CU Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (I yr) City Tag #,�_____„* PET #3 ❑ Dog ❑ Cat U Spayed/Neutered Pet Name Birthdate Sex Color Breed** _ Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE; (3 yr) License Fee $ Replacement $ ** ❑N SUBTOTAL; $ (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Pee If requesting at the time of license renewal.) Do Not Send Cash by Mal/ TOTAL. ENCLOSED $,62L),,_, If you have questions, please contact Blair Police Department at (402) 426-4747 NEW PET/NEW RESIDENT LICENSING REQUIREMENTS(Maa*15MA?fe- date hotaplAwblefor newpetVnewre-sYekats) NtMdyAg%UjMd Pets: New Residents to Blair: ■ Must be ky6ed within 10 days of owriershiip ■ Must register pets within 10 days of ■ ¢OR} at 6 months of age If puppy/iut en residency. Client ID: Client Name: Address: I Phone: 7828 Jennifer Fangmeier 2079 Grant St Blair, NE 68008 (402)290-0372 Blair Small Animal Clinic PC David E. Johnson DVM 1734 Front Street Blair, Nebraska, 68008 (402) 533-2722 Rabies Certificate F , f Patient ID: 13192 Patient Name: Luna Species: Canine Breed: Goldendoodle Sex: Female Color: Blonde Markings: Birthday: 10/26/2021 Weight: 12.31 pounds on 12/27/2021 Microchip ID: Tag Number: 6821 Vaccination Date: 1/18/2022 Vaccine: Imrab Rabies Vaccine Expiration Date: 1/1812023 Producer: Merial Lot Number: 18520 Brand: Imrab 3 TF Drug Expiration Date: 5/22/2023 pe: Killed Virus Manner of Subcutaneously Administration: Staff Name: David E. Johnson DVM License Number: 1893 Doctor Signature, CITY OF BLAIR - 2022 PET LICENSE APPLICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair • 218 S 16th St • Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEW'�jA,LS ARE DUE: March 15, 2022 Owner Name: f/��.9.1�tyY L.�'% l I�� X1 Owner Address: `I "1� N • �� I ��e0 City/State/Zip: Blair, NE 68008 ff0 Phone # `7-A b-15 - 119 4 LICENSE FEES: Dog or Cat: $16.00 Altered Do or rat: $11 00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3115/2022. The City shall recognize a microchip Identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city identification other than that issued by the City of Blair for such dog or cat, The City of Blair requires proof of rabies vaccination. g Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET #1 tg Dog ❑ Cat ASpayedd/NNeutered License Fee $ ll L Pet Name 2 -- BBeed** �— Sex Replacement $ ** Color Declared Dangerous or Potentiall, Da er us Dog: ❑ Y ❑ N MICROCHIP # � 9(If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: - (3 yr) (1 yr)_ City Tag # PET # 2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex ** Color Breed** Replacement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex ** Color Breed** Rep/acement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED $ If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/ NEW RESIDENT LICENSING REQUIREMENTS(March 15late fee date not applicable for new pets/new residents) Newly Acquired Pets: New Residents to Blair: ■ Must be licensed within 10 days of ownership ■ Must register pets within 10 days of ■ <OR> at 6 months of age if puppy/kitten residency. "ERTIFICATE OF VACCINATIO 1, L� Date of Rabies Vaccination: 9/9/2021 Next Rabies Vaccination On: 9/9/2022 VETERINARY CLINIC Arlington Pet Hospital 225 N. 3rd St. Arlington, NE 68002 402-478-4141 PATIENT: Grizzley SPECIES: Canine SEX: Neutered Male Color and markings: Tan .Certificate No: 0 1 h&Aalk-Aaht-U12&� OWNER OF ANIMAL Dodge County 202"1 787 S Luther -Ad Fremont, NE 68025 County: Dodge Iry TAG NO: 028291 WEIGHT: 66.00 AGE: 2Y j Signed �Ve GRANT LITTLE, DVM License: 4022 9/9/2021 GL RABIES 1 YEAR, #028291 Rabies Vaccine Information... MFG BY: NOBIV SER.NO: 478193 LOT EXP: 07/05/22 ADM: SQ CITY OF BLAIR - 2021 PET LICENSE APPLICATION 0;2 If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair e 218 S 16th St a Blair,, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. i W"T iffiltifiXUAW IF,, city/state/zip- Blair,, NE 68008 Phone # YO B --r) 3 3 - X!3D (0 LICENSE FEES: Dog or Cat: $16.00, 5 Replacement Fee for Lost Tag: $5.00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/1512021. The city shall recognize a microchip Identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city Identification other than that Issued by the City of Blair for such dog or cat. The City of Blair requires proof of rabies vaccination. H0160 PET #1 Dog 0 Cat El Sp'ayed/,,N,,e tered License Fee $ Pet Na e Birthdate W, ILI Sex M Color Breed** 'bot -e "Ik .—Replacement $ Declared Dangerous or Potentially Dangerous Dog: LJ Y I N MICROCHIP # (If applicable) SUBTOTAL:$ RABIES VACCINATION DATE: '3o (3 yr) _ (I yr) CKY Tag # 2J PET #2 L3 Dog Ll Cat 0 Spayed/Neutered Pet Name Birthdate Sex Color Breed" Declared Dangerous or Potentially Dangerous Dog: 0 Y U N MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) — License Fee $ Replacement $ SUBTOTAL: $ (1 yr) _ City Tag PET #3 Ell Dog Ll Cat u Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Replacement $ Declared Dangerous or Potentially Dangerous Dog: LJ Y D N MICROCHIP # (If applicable) , SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) — (I yr) _ City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED $ If you have questions, please contact Blair Police Department at (402) 426-4747 .................................................................... I .......... NEW PET/ NEW RESIDENT LICENSING REQUIREMENTS (march 15 late fee date not applicable for newpet�lnew residents) Newly Acquired Pets: New Residents to Blair. Is Must be licensed within 10 days of ownership m Must register pets within 10 days of m <OR> at 6 months of age if puppy/kitten residency. I Loretta Fechner 1124 North 28th St Blair, NE 68008 11 /30/2021 Blair Small Animal Clinic PC David E. Johnson DVM 1734 Front Street Blair, Nebraska, 68008 (402)533-2722 Page 1 / 1 Client ID: 8903 Invoice #: 165729 Date: 11 /30/2021 (402) 719-9306 Patient ID: 13138 Weight: 9.12 pounds Patient Name: Dash Birthday: 08/20/2021 Species: Canine Sex: Male Breed: Poodle Mix Description Examination General Distemper Hep Lep Parvo 14 wk Intranasal Bordetella/Parainfluenza Rabies Vaccination -Canine 1yr Interceptor Plus 8.1 - 25# x dose Credelio Tab 6.1-12lbs x dose (Pink) Staff Name Quantity David E. Johnson DVM 1.00 1.00 1.00 1.00 1.00 1.00 Patient Subtotal: Total $26.28 $33.28 $33.30 $29.66 $7.95 T $20.10 T $150.57 Instructions Yr- it puppy has received the last in the series of vaccinations for Distemper, Parvo, Hepatitis, Leptospirosis, and Flu E 3 now fully protected. Annual boosters are required to maintain this protection. Some pain at the injection site, letnargy, and loss of appetite for 24-36 hours is normal. Call this office if reactions become severe. Reminder 11/30/2022 Distemper Hep Lep Parvo-Annual Rabies Vaccination - Canine Syr Intranasal Bordetella/Parainfluenza Invoice Total: $150.57 default Tax Rate: $1.97 Total: $152.54 Balance Due: $152.54 Previous Balance: $0.00 Balance Due: $152.54 Check Check # 3976: ($152.54) Less Payment: ($152.54) Balance Due: $0.00 Order your pets supplies online now through our website www.blairsmallanimalclinic.vetsfirstchoice.com For questions contact us at 402-533-2722. Client ID: Client Name: Address: I Phone: 8903 Loretta Fechner 1124 North 28th St Blair, NE 68008 (402)719-9306 Tag Number: 6660 Vaccine: Imrab Rabies Vaccine Producer: Merial grand: Imrab 3 TF 'pe: Killed Virus Manner of Subcutaneously Administration: Staff Name: David E. Johnson DVM License Number: 1893 Doctor Signature: Blair Small Animal Clinic PC David E. Johnson DVM 1734 Front Street Blair, Nebraska, 68008 (402) 533-2722 Rabies Certificate Patient ID: 13138 Patient Name: Dash Species: Canine Breed: Poodle Mix Sex: Male Color: White/Brown Markings: Birthday: 08/20/2021 Weight: 9.12 pounds on 11/30/2021 Microchip ID: Vaccination Date: 11/30/2021 Expiration Date: 11/30/2022 Lot Number: 18514 Drug Expiration Date: 3/11/2023 0 0/07/2022 11:33MI FAX 4025332723 BLAIR SMALL ANIMAL 2 0001/0001 GK,00( CITY OF BLAIR - 2022 PET LICENSE APPLICATION ?IIVIaa If you live in Blair City limits and own a dog(s) and/or Cat(s), Complete this form and return with check made pay ble to: City of Blair a 218 S 16th St • Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE; March 154 2022 Owner Name: /t'A4V' F � Owner Address: 15VI A), /U %�5 7' City/state/zip: Blair, NE 68008 Phone # _�& 2 ` Jr9O r LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS, Failure to do so is a violation of City ordinances 6.103 and Bard" a penalty of o tine up to $150.00 per pet PET LICENSES RENEWALS ARE DUE BY,A/1512Q22. The City shall recognize a microchip identification numW as the Ilcen$* number, It shall be unlawful for any dog or Cat to weer any license or other city Identification other than that Issued by the City of Blair for such dog or rat. The City of Blair repuiros prwf of tables vaccination. Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund thhe Nebraska Dog & Cat Operaibor IFWPeCdOn Program PET #1 D Dog Cat CYSpayed/Neutered Pet Name �-.s Birthdate Color Breed** Declared Dangerous or Potentially Dangerous Dog: D Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered P t N e Birthdate Sex �7 License Fee $ I I J&�3fy i ,.- Replacement $ N SUBTOTAL: $ -_ City Tag # License Fee, $ e am Color I Breed** Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) ," (1 yr) City Tag # PET #3 iQ Dog D Cat D Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Replacement $ Declared Dangerous or Potentially Dangerous Dog: 13 Y D N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED $_ If you have questions, please contact Blair Police Department at (402) 426.4747 ........ h.........*•F.•M•F..*+*t**...*....•Fig*...♦•f.•t•h•F••F.......................... NEW PET/NEW RESIDENT LICENSING REQUIREMEN75 (March 15late /be date notappllrable %ornewpets/newlasioinnts) NewlyA oohed Pets. New Residents to Blair: • Mta�t be fi cased WOM 10 days of mostup ■ Must regisber pets within 10 days of ■ <OR> at 6 monft of age if puppy/Wtten t' '. 04/14/2022 1:12 PM FAX 4025332723 BLAIR SMALL ANIMAL 0 0001//0001 —G> 90( CITY OF BLAIR - 2022 PET LICENSE APPLICATION ellY a if you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made pay ble t4: City of Blair a 218 S 16th St a Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2022 Owner Name: owner Address: clty/State/zip: Blair,/NE 68008 Phone # L02, ' ✓�9O /� LICENSE FEES: Dog or Cat: $16.00 d Do or Cat• $11 00 ***PLEASE READ CAREFULLY"* YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so Is a violation of City ondinpnCea 6.103 and carries ,a penalty of a Ane up to $150.00 per pat PUT LICENSES RENEWALS ARE DUE BY 2LLV j=. The Oty shag recognize a microchip identlficatlon number as the license number. It shall be unlawful for any dog or cat to wear any IicenSe or other city Idendfkation other than that Issued by the City of Blair for such dog or cat. The City of Blair requires proof of rables voWnation. Altere it Replacement Fee for Lost Tag: $5.00 Lmdluded is a State free of $1.2S being collected to fund the Nebraska Dog & CSt OPT+' UsPecdOn Program PET #1 ❑ Dog WCat Lr5payec/NeU1erea Pet Name A4em5, Bgrrthhdda*e Color M�� Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: a (3 yr) License Fee $_11..._ Replacement $ aN t r SUBTOTAL: $ — City Tag * PET # 2 ❑ Dog 0 Cat ❑ Spayed/Neutered License Fee $� Pet Name BB��** Sex Replacement ** Declared Dangerous or Potentially Dangerous Dog: 0 Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: _ (3 yr) (I. yr) City Tag #* PET #3 Ca Dog ❑ Cat 0 Spayed/Neutered License Fee Pet Name Birthdate Sex _ ** t$ Breed** Replacemen Color Declared Dangerous or Potentially Dangerous Dog: 0 Y Cl N MICROCHIP # (If applicable) RABIES VACCINATION DATE: ^ (3 yr) SUBTOTAL: $ --� (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee If requesting at the time of license renewal.) TOTAL ENCLOSED $_ Do Not Send Cash by Mail If you have questions, please contact Blair Police Department at (402) 426-4747 +++++++++++++++++++++++++++++.+++++++++++++.r.++++++++++++++++++++*++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Maki 15/aleJ date /7otapp✓lm�rn°a' ✓ ' °��) f�eAMv Ao0ui 1 P�fs: — N= Ra"n s to Blair ■ Must be hoe ised within 10 days of avner.,hlp ■ Must register pets wittlin 10 days of ■ <OR> at 6 months of age if pupPy/tten If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check,made payable to: City of Blair a 218 S 16th St e Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15 2022 ***PLEASE READ (FULLY*** Owner Name: ��'e ( r�s't�S�, C`s � YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Owner Address' i / Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. City/state/zip: Blair, NE 68008 PET LICENSES RENEWALS ARE DUE BY 3/15/2022. The City shall Phone # J 'J4t° JL�24`� recognize a microchip Identification number as the license number. It _ shall be unlawful for any dog or cat to wear any license or other city Identification other than that Issued by the City of Blair for such dog or cat. The City of Blair requires proof of rabies vaccination. LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat operator Inspection Program ry -- P T # 1 _ [ Dog ❑ Cat paye/Neutered License Fee $ y P „ Plat Name G Birthdate w. ,)l Sex Color i .. Breed** (La Replacement$ ** ' D clarecl Dangerous or Potentially Dangerous Dog: ❑ Y ® N ICROCHIP # (If applicable) SOOT®TAL: $ BIES VACCINATTON DATE:/ i (3 yr) (1 yr) City Tag �AMI ET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ i et Name Birthdate Sex olor Breed** Replacement $ "° eclared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) _ (1 yr) City Tag # PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate i Sex ** Color Breed** Replacement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (I applicable) ;ilBTOTAL: $ RABIES VACCINATION DATE: _ (3 yr) _ (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not send Gash by ,Mail TL NC L®S ® i . If you have questions, please contact Blair Police Department at (402) 426-4747 .++++...........++++++.........................++++++++++++++.++++++++++.+.+ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15late fee date not applicable fornewpets/new residents) Newly Acguired Pets: New Residents to Blair: • Must be lioensed within 10 days of ownership n Must register pets within.10 days of • <OR> at 6 months of age if puppy/kitten residency. CITY OF BLAIR o 2b22-PET L CENS APVLj.0%'r1ON If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City Of Blair ® 218 S 16th St e Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs I or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2022 ***PLEASE READ CAREFULLY*** Owner Name' � A — ® YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS, Owner Address' Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. City/State/Zip' Blair, NE 68008 PET LICENSES RENEWALS ARE DUE BY 311512022. The City shall Phone # recognize a microchip Identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city Identification other than that Issued by the City of Blair for such dog or cat. The City of Blair requires proof of rabies vaccination. LICENSE FEES: Dog or Cat: $16.00 Altered Clog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program T #1 U/D o g ❑ Cat YSpayed/Neutered � License Fee $ ll - 00 A Name_ - ' Birth date � _ Sex - ** �IorB1,,jjC-iAAr ®s'� Breed** tl �� rAik 6; PA Replacement$ aclared Dangerous or otentially Dapgerous Dog: ❑ Y LdN ICROCHTP # r A -- If applicable) SUBTOTAL: $ ABIES VACCINATION DATE: 3 /1 l(3 yr) ✓ (1 yr) City Tag # 0614� E� # 2 0 Dog ❑ Cat [ASpayed/Neutered et Name _ Birthdate _ Sex olor Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: _ (3 yr) ❑N License Fee $ Replacement $ SUBTOTAL: $ (1 yr) City Tag # PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate — Sex ** Color Breed Re p/acement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (if applicable) SUBTOTAL: $ RABIES VACCINATION DATE: _ (3 yr) (1 yr) City Tag # _* *PLEASE INCLUDE THE CITY TANG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by hail TOTAL ENCLOSED If you have questions, please contact Blair Police Department at (402) 426-4747 NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15late fee date not applicable for newpets/newresldents) Newly Acquired Pets: New Residents to Blair. • Must be licensed within 10 days of ownership m Must register pets within 10 days of • <OR> at 6 months of age if puppy/Idtten residency. 6 Y 03/14/2022 10:37 4024260101 HOLSTEIN VET CLINIC PAGE 01/01:k; ■ ■ 2022 PET LICENSE VERIFICATION,/APPLICATION FOR CITY OF BLAIR IF YOU LIVE: IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT($), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR - 218 S. 1.6TH ST - BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN 'THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT. *''PLEASE READ CAREFULLY**'r YOU ARE REQUIRED BY LAW TO LICENSE YOMR PETS THE QTY OF BLAIR REQUIRES PRQOF OF RABIES VACCINATIQN Failure to do so is a violation of City Ordinances 6,103 and carries a penalty of a flue up to $150.00 per pet. PET LICENSE RENEWALS ARE DUE BY 3/15/2072, The city shall recognize a microchip ID number as the license number. It shall be unlawful for any dog or cat to Wear any license or other city ID other than that issued by the City of Blair for such dog or cat. NEW PET LICENSING Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten NEW RESIDENTS TO BLAIR Must register pets within 10 days of residency Owner Name Spouse Owner Address City/State/Zip Phone # >P Pet Name: Babs Age: 6Y DOB: 10-06-15 Breed: Eng Mast Sex: Spayed Female Microchip # 985112006056667 PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A REN RABIES VACCINATION DONE ON 102.29-20 Rabies Description: 1 YEAR Brian & Marita Fernau 1541 Oak Drive, Blair, NE 68008 402-426-8448 og . 4 0 2- 2 3 -7, 19 2. Color: Fawn Rabies Tag # 17760 (IF AVAILABLE): # 3 YEAR Holstein Veterinary Clinic Ar Lisa Schrum DVM : Dr. Krista Holstein DVM 718 South 191" Street Blair, NE 68008 402-426-7387'402-426-0101 Fax holsteinclinic@gmail.com LICENSE FEES Intact Dog or Cat: $16.00 Altar, Dog or cat: $11.0 Rep ac men aq $5.00 Total $_ PEn THATARE QN THE ACTIVE POTENTIALLY DANGEROUS OR DANGEROUS DOCK FIST NEED TO REGISTER DIRECT,�,YAT CITY HALL. FAXED 03-14-22 BY FAX To BPD @ 402-426-7144 `q py CITY OF BLAI LIC'ENS��APPLICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City Of Blair a 218 S 16th St a Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2022 Owner Name: Owner Address: City/state/zip: Blair, NE 68008 / Phone # )10 2 — 6 3 r — I ;7 — LICENSE FEES: Dog or Cat: $16.00 Altered Do or Cat: $11 00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 2/15/2022. The City shall recognize a microchip Identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city Identification other than that Issued by the City of Blair for such dog or cat. The City of Blair requires proof of rabies vaccination. g Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET #1 Dog ❑ Cat J� Spayed/Neutered License Fee $ � 6 Pet Name ✓;0✓1 Birthd�late / 19 k° Sex f�1 _ ** Color i yL fi� Breed** o I d Rep/acement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # Q JS 1111 06 3 111 5/�(If applicable) SUBTOTAL. $ y RABIES VACCINATION DATE: �/ /' `1 / z= / — (3 yr) (1 yr) tl City Tag # 060/ * PET #'2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name _ Birthdate Sex ** Color _ Breed** —Replacement $ _ Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # PET #'3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex _ ** Color Breed** Replacement $ i Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP #_ (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) ! City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not send cash by Mail TOTAL ENCLOSED $ If you have questions, please contact Blair Malice Department at (402) 426-4747 .++.+++.+.++++++.+.............. a++...........I... ............................ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (march 1.5late fee date not applicablefornewpeWnewresldentV Newly Acquired Pets: New Residents to Blair: • Must be licensed within 10 days of ownership w Must register pets within 10 days of • <OR> at 6 months of age if puppy/kitten residency. )`� 1 '4 CITY OF BLAIR - 0 ET LIUC SE APr I ATiON 'f you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair ® 218 S 16th St e Blair® NE 68008 You may legally. own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per, residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15., Owner Name: 6 Owner Address: lx� City/State/zip: Blair, NE 68008 q., Phone # LICENSE FEES: Dog or Cat: $16.00 AliFpvprl nn or Cat- 4t1100 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/15/202 . The City shall recognize a microchip Identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city Identification other than that issued by the City of Blair for such dog or cat. The City of Blair requires proof of rabies vaccination. Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program r #1 CA Dog LI Cat Spayed/Nutered License Fee$ 4 p Name ILL Birthdate Sex ir Breed" Replacement$ a-(z-kc lared Dangerous or Potentially Dangerous Dog: LI Y N $ ROCHIP # (If applicable) SUBTOTAL: IES VACCINATION DATE: i) i zo �j (3 yr) \ _X— (1 yr) _ City Tag # P T#2 0 Dog LJ Cat LJ Spayed/Neutered License Fee $ Name— Pot, lo r Birthdate _ Sex Breed** Replacement $ Declared Dangerous or Potentially Dangerous Dog: LJ Y Ll N MICROCHIP # (If applicable) SUBTOTAL:$ RABIES VACCINATION DATE: __ (3 yr) — (1 yr) — City Tag # PET #3 L1 Dog L1 Cat Ll Spayed/Neutered License Fee $ Pet Name Color Birthdate Sex Breed", Replacement $ Declared Dangerous or Potentially Dangerous Dog: L1 Y Ll N MICROCHIP 4 —(If applicable) SUBTOTAL:$ RABIES VACCINATION DATE: i (3 yr) — (1 yr) _ City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED $ If you have questions, please contact Blair Police Department at (402) 426-4747 .............................................................................. NEW PET/ NEW RESIDENT LICENSING REQUIREMENTS (March 151ate fee date not applIcable fornewpetsInew residents) Newly Acquired Pets: New Residents to Blair: • Must be licensed within 10 days of owneiship N Must register pets within 10 days of • <OR> at 6 months of age if puppy/kitten residency. r Thone Animal Hospital 902 S Hwy 30 Blair, NE 68008 402-426-3630 Printed: 01-25-22 at 12:30p CLIENT INFORMATION Name Erin Field (2750) Address 2271 Cedar Cr. Spouse Cheston Blair, NE 68008 Phone 402 426-7040 Balance 0.00 12-14-05 Do Not Charge S & H To Mail Interceptor To Them!!!!11!!111!! PATIENT INFORMATION Name Bella Species Canine Sex Female, Spayed Breed Australian Shepherd Birthday 05-22-14 Age 7y ID Rabies 007280 Color Tri Color Weight 40.60 Ibs Reminded 10-28-21 Codes 11-24-20 8:04a: CAUTION WILL BITE Patient Chart MEDICAL HISTORY - Vaccination View Date By Code Description Qty (Variance) Photo 11-16-21 KF R3 Rabies Vaccination (3 Year), #007280 2 DA2PPV+L 03-12-21 RXC B1 Bordetella Oral 02-18-21 RXC B1 Bordetella Oral 11-24-20 KF 2 DA2PPV+L 12-02-19 JRD 2 DA2PPV+L 11-17-18 LL R3 Rabies Vaccination (3 Year), #004459 AC6 Check up, DA2PPV+L e/d good no c/s/v/d eats Purina One hwp needs more 11-18-17 LL AC6 Check up, DA2PPV+L 11-15-16 LL AC6 Check up, DA2PPV+L 11-14-15 VK R3 Rabies Vaccination (3 Year), #002340 AC6 Annual Checkup, DA2PPV+L 11-18-14 LL 2 DA2PPV+L r r Patient Chart for Bella Date: 01-25-22, Time: 12:30p Date By Code Description Client: Erin Field Page: 2 Qty (Variance) Photo 11-18-14 LL R1 Rabies Vaccination (1 Year), #001649 09-05-14 LL AC6 Annual Checkup, DA2PPV+L 08-06-14 LL AC6 Checkup, DA2PPV+L CITY OF BLAIR - PET LICENSE APPLICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair e 218 S 16th St 9 Blair,, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE .�IJE: March 15, 2022 ***PLEASE READ CAREFULLY*** Owner Name: W YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Owner Address" Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $10.00 per pet. City/State/Zip: 71i IVE 68008 �1 PET LICENSES RENEWALS ARE DUE BY 3/I5/2022. The City shall Phone # 4-04-3 recognize a microchip Identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city Identification other than that Issued by the City of Blair for such dog or cat, The City of Blair requires proof of rabies vaccination, LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Included is a to Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program #1 ZY'Spaye u re License Fee $ >L U e t ame Dog ®Cat Birthdate ( I 1� A I r (At\tkZ1Z;:j Breed" Ct Replacement$ e aredbangerous or Potentially Dangerous Dog: LJ Y N MI ROCHIP # (If applicable) SUBTOTAL: $ IES VACCINATION DATE: 24 JZJ — (3 yr) — (1 yr) City Tag # te d Sex a me Tc, y —c,- V r ar%ed ROC JR HIF JES VA( _� JD T #2 LJ Dog Ll Cat Spa d utered License Fee$Name C(i Birthd, Sex r Breed q Replacement$ lared Dangerous or Potentially Dangerous Dog: LJ Y N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: 9 1 z3 _ (3 yr) — (1 yr) — City Tag #�5m PET #3 0 Dog Ll Cat 0 Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Replacement $ Declared Dangerous or Potentially Dangerous Dog: J Y LJ N MICROCHIP # —(If applicable) ' SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) ___ (1 yr) . City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED $ If you have questions, please contact Blair Police Department at (402) 426-4747 ' .............................................................................. NEW PET/ NEW RESIDENT LICENSING REQUIREMENTS (MRMh 15 late fee date not applIcable fornewpetslnew residents) Newly Acouired Pets: New Residents to Blair: * Must be lioensed within 10 days of ownership m Must register pets within 10 days of * <OR> at months of age if puppy/Kitten residency. If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair a 218 S 16th St e Blair, NE 68008 Youf may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. t LICENSE RENEWALS ARE DUE: March 15, 2022 ***PLEASE READ CAREFULLY*** Owner Name: YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Owner Address: Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. City/state/zip: Blair, NE 68008 PET LICENSES RENEWALS ARE DUE BY J15/2022. The City shall Phone # (o recognize a microchip Identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city Identification other than that Issued by the City of Blair for such dog or cat. The City of Blair requires proof of rabies vaccination. LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 �2anlargF??ent Fee for Most Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program T # 1 ❑� � D o g ❑ Cat spayed/Neutered License Fee $ ., Pit Name Birthdate Sex ', r "Color Breed** � , ,r, �. r Replacement $ Ieclared Dangerous or Potentially Dangerous Dog: ❑ Y 'W; N RMICROCHIP # (If applicable) SUBTOTAL: $ ABIES .ACCJNATIO] DATE:, (3 ,yr)_ (1 yr) City Tag # AV 4m f + #. PET # 2 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ (1 yr) License Fee $ Replacement $ SUBTOTAL: $ City Tag # PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color _ Breed** Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: L (3 yr) __ (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) DoNot Send Cash by Mail TOTAL ENCLOSE $ If you have questions, please contact Blair Police Department at (402) 426-4747 ...............+++.++++++++++++++...............++++++++++++++++++++.++....+. NEW PET/NEW RESIDENT LICENSING REQUIREMENTS(March 15late fee date not applicablefornewpets/newre5idents) Newly Acquired Pets: New Residents to Blair: • Must be lioensed within 10 days of ownership m Must register pets within 10 days of • <OR> at 6 months of age if puppy/kitten residency. Holstein Vet Clinic 718 South 19th Street Blair, NE 68008 402-426-7387 Printed: 01-14-22 at 3:59p CLIENT INFORMATION Name Michael Prinds (9520) Address 1987 Soren Drive Blair, NE 68008 Phone 913 754-6089 PATIENT INFORMATION Name Jasper Sex Male, Neutered Birthday 12-13-12 (unknown) ID Color White Reminded (none) Species Canine Breed Golden Retriever Age 9y (unknown) Rabies 19471 Weight 96.50lbs Codes Reminders for: Jasper Last done .........._ 09-07-24 Denfensor 3 (3 Year Rabies) 09-08-21 09-08-22 Vangard Plus 5 09-08-21 09-08-22 Heartworm Test & Prevention 09-08-21 09-08-22 Bronchi Shield - Oral Bordetel 09-08-21 MEDICAL HISTORY - Vaccination View Date By Code Description 09-08-21 KKH 4RAB3 Defensor 3 ( 3Y RABIES }, #19471 410009 Vanguard® B ORAL ( Bordetella } 410005 Vanguard® Plus 5 ( Distemper ) Patient Chart Oty (Variance) Photo CITY OF BLAIR - 2022 PET LICENSE APPLICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair • 218 S 16th St • Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWA S ARE DUE: March 15, 2022 Owner Name: UahF II I Owner Address: n El city/state/zip: BI ir, NE 68008 Phone # Z- " LICENSE FEES: Dog or Cat: $16.00 Alt red Do or Cat• $11 00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/15/2022. The City shall recognize a microchip identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city Identification other than that issued by the City of Blair for such dog or cat. The City of Blair requires proof of rabies vaccination. e g Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET #1 og t ❑ S aged Neutered License Fee $J 1 •lam° Pet Nam Birthdate 2-1 Sex _V Color Breed** Rep/acement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) _>!�_ (1 yr) City Tag # ILH V PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex ** Color Breed** Replacement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N ' MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex ** Color Breed** Rep/acement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED $ if you have questions, please contact Blair Police Department at (402) 426-4747 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15late fee date not applicable for new pets/new residents) Newly Acquired Pets New Residents to Blair: ■ Must be licensed Wthin 10 days of ownership ■ Must register pets within 10 days of ■ <OR> at 6 months of age if puppy/kitten residency. Client ID: Client Name: Address: I Phone 8994 Jan Fitzler 2315 Fieldcrest Drive Blair, NE 68008 (402)238-2930 Tag Number: 6913 Vaccine: Imrab Rabies Vaccine Producer: Merial Brand: Imrab 3 TF Type: Killed Virus anner of Subcutaneously I Administration: Staff Name: David E. Johnson DVM License Number: 1893 Doctor Signature: Blair Small Animal Clinic PC David E. Johnson DVM 1734 Front Street Blair, Nebraska, 68008 (402) 533-2722 Rabies Certificate Patient ID: 13307 Patient Name: Coocoo Puff Species: Canine } Breed: Shih Tzu ' Sex: tt Female t i Color: cream/black Markings: Birthday: 02/16/2013 Weight: 19,12 pounds on 3/10/2022 Microchip ID: Vaccination Date: 3/10/2022 Expiration Date: 3/1012025 Lot Number: 18526 Drug Expiration Date: 5/20/2023 V/ MY OF-BL4M---7-022—PET-LICERS-E--AP—PLICATIOI If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair e 218 S 16th St e Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEVVALS ARE DU E: rMarch 15, 2022 ***PLEASE READ CAREFULLY*** k Owner Name: YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS., kq I Owner Address: t Failure to do so is a violation of City ordinances 6 103 and carries a penalty of a fine up to $iso.00 per pet. City/Mate/Zip: Blair, NE 68008 PET LICENSES RENEWALS ARE DUE BY 3/15/2022. The City shall recognize a microchip Identification number as the license number. It Phone # L shall be unlawful for any dog or cat to wear any license or other city Identification other than that Issued by the City of Blair for such dog or cat. The City of Blair requires proof of rabies vaccination. LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat, $11.00 P-enjacement Fee for Lost Tag: $5.00 r, pectrogV Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Insion Pram PET #1 L1 Do Li C a t QA Spayed/Neutered License Fee $ —1 Pet Name Birthdat e Sex breed** Replacement$ Color Def'Mared Dangerous or Potentially Dangerous Dog: Ll Y L3 N MIC OCHIP # (if applicable ER SUBTOTAL:$ RABIES VACCINATION DATE: L (3 yr) (1 yr) City Tag # _ PE*r#2 L1 Dog LJ Cat Ll Spayed/Neutered License Fee $ Pet N, me------ Birthdate Sex Color,-- Breed** Replacement $ Potentially Dangerous Dog: J Y Ll N .-Declired Dangerous or MICROCHIP # (If applicable) ' 111 - / A 1 SUBTOTAL: $ City Tag RABIES VACCINATION DATE- , (3 yr) yr) PET #3, 0 Dog Ll Cat L1 Spayed/Neutered Pet Name Birthdate -- Sex Color Breed" Declared Dangerous or Potentially Dangerous Dog: L1 Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: __ (3 yr) — am License Fee $ Replacement $ SUBTOTAL:$ — (1 yr) _— City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL (This fee is due along with License Fee if requesting at the time of license renewal.) _J Do Not Send Cash by Mail TOTAL ENCLOSED If you have questions, please contact Blair Police Department at (402) 426-4747 .............................................................................. NEW PET/ NEW RESIDENT LICENSING REQUIREMENTS (March 15 late fee date not dppllcable for newpet�lnew m5ldents) Newly Acquired Pets: New Residents to Blair: • Must be licensed within 10 days of ownership w Must register pets within 10 days of • <OR> at 6 months of age if puppy/kitten residency. CITY OF BLAIR - 2022 PET LICENSE APPLICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair a 218 S 16th St a Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more ,than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2022 Owner Name: 9� Owner Address: City/state/zip: B ir, NE 68008 / Phone # i LICENSE FEES: Dog or Cat: $16.00 Altered Do or Cat: $11 00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/15/2022. The City shall recognize a microchip Identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city Identification other than that Issued by the City of Blair for such dog or cat, The City of Blair requires proof of rabies vaccination. g Replacement Fee for Lost: Tag: $5_rrn Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program ma T # 1 Dog ❑ Cat M� Spayed/Neutered License Fee $ _ Pet Name Birthdate �t Se ** Color f Breed** A Replacement $ Declared Dangerou "orotentially Dangerous Dog: ❑ Y A, N ao MICROCHIP # % '�� I / -do ,W (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: C3 yr) �— (1 yr) City Tag # b* PET #2 ❑ Dog ❑ Cat - ❑ Spayed/Neutered Pet Name Birthdate _ Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ m License Fee Replacement $ SUBTOTAL: $ (1 yr) City Tag # PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex ** Color Breed** Replacement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE:! (3 yr) (i. yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED If you have questions, please contact Blair Police Department at (402) 426-4747 ...........................r1".....+-Fi-.°i-...t...+°h+.-1•-i.......I-.....-i.........i--9... NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Afb1ch 15late fee date notanpllcable fornew/xets/new residents) Newly Acquired Pets: New Residents to Blair: • Must be lioensed within 10 days of ownership a Must register pets within 10 days of • <OR> at 6 months of age if puppy/kitten residency. 01 01/05/2022 15:36 4024260101 HOLSTEIN VET CLINIC PAGE 01/03 2022 PET LICENSE Ci VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR — 218 S. 16TH ST — BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT, ***PLEASE READ CAREFULLY*** YOU ARE REQUIREb BY LAW TO LICENSE YQ R PETS. TWE CITY OF BLAIR RECIUIRE5 PROOF QF RABIES VACCINATION. Failure to do so Is a violation of City Ordinances 6,103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSE RENEWALS ARE DUE BY 3/15/2022 The city Shall recognize a microchip ID number as the license number. It shall be unlawful for any dog or cat to wear any license or other city ID other than that Issued by the City of Blair for such dog or cat. NEW PET LICENSING Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten NEW RESIDENTS TO BLAIR Must register pets within 10 days of residency Owner Name Spouse Owner Address City/State/Zip Phone # Pet Name; Age: 3Y DOB:-v11-25-18 Breed: Shih Tzu Mix Microchip # Sex: Spayed Female PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENE RABIES VACCINATION DONE ON F06-26-21 Rabies Description: 1 YEAR Jacob Flynn Maddie Kinnear 2333 Elm Drive Blair, NE 68008 402-278-1978 Color: Rabies Tag # 19282 (IF AVAILABLE): # 3 YEAR Holstein Veterinary Clinic Dr. Lisa Schrum DVM ; Dr. Krista Holstein DVM 718 South 191" Street Blair, NE 68008 402-426-,7387 402-426-0101 Fax hoisteinclinic@gmail.com LICENSE FEES Intact Dog or Cat; $16.00 terAd D or cat: $11.0 Replacement Tag $5.00 Total $ 11 m PM THATARE ON THEACTIVE POTENTIALLY DANGERQUS OR DANGEROUS DOG LIST NEED TO REGISTER DIRECTLY AT CITY HALL. FAXED 01-05-22 BY „ sr i+ ii?. "^:�"• ��1i {')},"�p l"l:cF,j •�V'a�� 1� � A ! i�� llH �l 4r' n(�Wr, t �t� � ��+ dl •�', oY ,r• IY, !,r r''� 11 ar�17�.T. i�i�.W��G:•V1�1t �uY mul±,p". �i fig `Yu.: 601 01/05/2022 15:36 4024260101 HOLSTEIN VET CLINIC PAGE 02/03 2022 PIET LICPN.Q VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR — 218 S. 16TH ST — BLAIR, NE 68008 YOU MAY LEGALLY OWN A OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3)COMBINATION ADULLT CATS PER RESIDENTIAL OR DWELLING UNIT. ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS THE CITY OF BLAIR REQUIRES PROOF OF RABIES VACCINATION Failure to do so Is a violatlon of City Ordinances 6.103 and carries a penalty of a fine up to $150,00 per pet. PET LICENSE RFNEWAI,S ARE DUE BY 1h rm0z2 The city shall recognize a microchip ID number as the license number. It shall be unl2Wful for any dog or cat to wear any license or other city ID other than that issued by the City of Blair for such dog or cat. NEW IET LICENSING Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten NEW RESIDENTS TO BLAIR Must register pets within 10 days of residency Owner Name Jacob Flynn Spouse Maddie Kinnear Owner Address 2333 Elm Drive City/State/Zip Blair, NE 68008 Phone # 402.278-1978 Pet Name: (Wila Age: 2Y I Sex: Spayed Female Color: Black and White DOB, 0148-19 Breed: Dalmatian Microchip # 985112006866544 Rabies Tag # 17984 PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): # RABIES VACCINATION DONE ON 1 05-30-20 Rabies Description: 1 YEAR 13 YEAR Holstein Veterinary Clinic Dr, Lisa Schrum DV44 : Dr. Xnsta No/stein DVM 718 South 19(" Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteinclWe@gmail.com '. LL�ENSE FEES Intact Dog or Cat: $16.00 er Dog r c t: $11.o0 Replacement Tag $5.00 Total PETS THAT�IRE ON THEACTIVE POTEI�ITlALLY DANGI RODS OR VANGEROUS DOG LIST N�Fp TO REGISTER DIREGTLYg7C/TY HALL 01/05/2022 15:36 4024260101 HOLSTEIN VET CLINIC PAGE 03/03 2022 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS ANb OWN A DOG(S) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR — 218 S. 16TH ST — BLAIR, NE 68008 YOU MAY LEGALBUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATSPER RESIDENTIAL OR DWELLING UNIT. ***PLEASE READ CAREFULLY*** YOU AR REQUIRED BY LAW TO LICENSE YQU. R PETS, THE CITY OF Al Ain REQUIRES PROOF OF RABIES VAC INATIOI Failure to do so is a violation of City Ordinances 6,103 and carries a penalty of a fine up to $150,00 per pet. PET LICENSE RENEWALS ARE DUE BY B I 2022. The city shall recognize e microchip ID number as the license number. It shall be unlawful for any dog or cat to wear any license or other city ID other than that Issued by the City of Blair for such dog or cat. NEW PET LICENSING Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten NEW RESIDENTS TO BLAIR Must register pets within 10 days of residency Owner Name Spouse Owner Address City/State/Zip Phone # Pet Name: Marco Age: 3y DOB:--01.01-19 Breed: Dalmat'n/X Sex: Neutered Male Jacob Flynn Meddle Kinnear 2333 Elm (Drive Blair, NE 68008 402-278-1978 Color: Black and Whits Microchip # 956000011881332 Rabies Tag # 19571 PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): # RABIES VACCINATION DONE ON 1 10-21-21 Rabies Description: 1 YEAR Holstein Veterinary Clinic Dr. Lisa Schrum DVM : Dr, Krista Holstein DVM 718 South 191h Street Blair, NE 6800E 402-426-7387 402-426-0101 Fax holsteinclinic@gmaii.com YEA INCENSE FEES /ntsct Dog or Cat: $16,00 Dog or cat: $11. Replacement Tag $5.00 Total V & POTS THAT ARE ON THE ACTIVE POTENTIALLY DANGEROUS OR DANGEROUSDO IS7'NEED oREGISTE�DIRECrLYATCITYHALL 2022 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR. IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR — 218 S. 16TH ST — BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT. ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BYLAW TO LICENSE YOUR PETS, THE CITY OF BLAIR REQUIRES PROOF OF RABIES VACCINATION. Failure to do so is a violation of City Ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSE RENEWALS ARE DUE BY 3/1S/2022, The city shall recognize a microchip ID number as the license number. It shall be unlawful for any dog or cat to wear any license or other city ID other than that issued by the City of Blair for such dog or cat. NEW PET LICENSING Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten NEW RESIDENTS TO BLAIR Must register pets within 10 days of residency Owner Name Michael Foisey Spouse Sally Owner Address 1664 Park Street City/State/Zip Blair, NE 68008 Phone # 531-209-4062 Pet Name: Moxie Age: 6Y DOB: 08-27-15 Sex: Spayed Female Color: Salt and Pepper Breed: Yorkie X Microchip # Rabies Tag # 19406 PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): # RABIES VACCINATION DONE ON 08-12-21 Rabies Description: 1 YEAR 3 YEAR Holstein Veterinary Clinic Dr. Lisa Schrum DVM : Dr, Krista Holstein DVM 718 South 191" Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteinclini.c.@gmail-com Tn-in"._I r)TKIT-In 17M KITS I Q"lnw LICENSE FEES Intact Dog or Cat: $16.00 Dog or cat: $11.00 Replacement Tag $5.00 Total $ PETS THAT ARE ON THE ACTIVE POTENTIALLY DANGEROUS OR' DANGEROUS DOG LIST NEED TO REGISTER DIRECTLYAT CITY HALL. �v--)Ox CITY OF BLAIR - 2022 PET LICENSE APPLICATION .3") If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable o'. City of Blair 9 218 S 16th St 9 Blair,, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15., 2022 Owner Name: Owner Address: City/State/zip: Blair, NE 68008 Phone # LICENSE FEES: Dog or Cat: $16.00 AIIII-ararl non or Cat- (01.100 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS, Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/15/2022. The City shall recognize a microchip Identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city Identification other than that Issued by the City of Blair for such dog or cat. The City of Blair requires proof of rabies vaccination. Replacement Fee for Lost Tag: $5.00 Included is a to Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET #1 ,UJI'lDog 0 Cat ['Spayed/Neutered N e Lite red License Fee , $ Pet Name Birthdate 16),,1 1 -Z Sex Color ("O""LA, Breed" =,' (k Replacement $ Declared Dangerous or Potentially Dangerous Dog: J Y LrN MICROCHIP # (If applicable) SUBTOTAL: $RABIES VACCINATION DATE: 1 i i (3 yr) (1 yr) _ City Tag* -3±�) �L* PET #2 CA"D 0 Cl L3 C a t U3 " Spayed/Neutered License Fee$ ,-' U, / -,- -i Sex Pet Name ?) - Birthdate �U -1v Color V Breed" A Replacement$ Declared Dangerous or Potentially Dangerous Dog: Ll Y LVN MICROCHIP # '1 7 ?) (If applicable) SUBTOTAL:$ RABIES VACCINATION DATE: I r-1 (3 yr) v` (I yr) — City Tag #-L?, �,)* PET #3 Cl Dog J Cat Ll Spayed/Neutered License Fee$ Pet Name Birthdate Sex Color Breed** Replacement $ Declared Dangerous or Potentially Dangerous Dog: LJ Y 13 N MICROCHIP # (If applicable) SUBTOTAL:$ RABIES VACCINATION DATE: (3 yr) - (1 yr) 1 City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL I ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED $ If you have questions, please contact Blair Police Department at (402) 426-4747 .............................................................................. NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Match 151ate fee date not appllc4ble fornewpet5lnew re5ldent5) Newly Acquired Pets: New Residents to Blair: IN Must be licensed within 10 days of ownership 0 Must register pets within 10 days of N <OR> at 6 months of age if puppy/kitten residency. Client ID: Client Name: Tag Number: Vaccine: Producer: | Brand: � �pe.. Manner of Staff Name: License Number: | Doctor Signature: 82 Jamie & Craig RdKars 912 20th Ave Circle Blair, NE08OO8 (4K}2)709'4809 5312 |rnnab Rabies Vaccine K8eha| |nnnab3TF Killed Virus Subcutaneously David E.Johnson DVM 1893 Blair Small Animal Clinic PC David E.Johnson DVM 1734Front Street Blair, Nebraska, 88808' N��\ ' � � `.Rabies Certificate Patient |D: Patient Name: Species: Breed: Sex: Markings: Birthday: Microchip ID: Vaccination Date Expiration Date: Lot Number: Drug Expiration Date: 7784 ~n Sadie Bea Canine Mixed Breed Spayed Female Black &White 11/3O/2O14 15.G2pounds on3/27/2O21 985112005802073 5C2O/2U10 5/2812022 18407 1O/31/2O2O Blair Small Animal Clinic PC David E. Johnson DVM 1734 Front Street Blair, Nebraska, 68008 { (402)1533-M2 Rabies Certificate Client ID: 82 Patient ID: 7578 Client Name: Jamie & Craig Folkers Patient Name: Benny Address: 912 20th Ave Circle Species: Canine Breed: Mixed Breed - Small Blair, NE 68008 Sex: Neutered Male Color: Black & White Phone: (402)709-4809 Markings: Birthday: 10/25/2012 Weight: 21.50 pounds on 11/9/2021 Microchip ID: 985112003473761 Tag Number: Vaccine: Producer: Brand: pe: Manner of Administration: Staff Name: License Number: Doctor Signature: 6624 Imrab Rabies Vaccine Merial Imrab 3 TF Killed Virus Subcutaneously David E. Johnson DVM 1893 Vaccination Date: 11/9/2021 Expiration Date: 11/9/2024 Lot Number: 18513 Drug Expiration Date: 2/24/2023 II CITY OF BLAIR ® 2022 PET LICENSE APPLICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair ® 218 S 16th St * Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENE17LS ARE DUE: March 15, 2022 Owner Name: o Owner Address: PC,, V - City/State/Zip: Phone # Blair, NE 68008 Lj LICENSE FEES: Dog or Cat: $16.00 Altered Doti or Cat: 4;11.00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/15/2022. The City shall recognize a microchip identification number as the license number, It shall be unlawful for any dog or cat to wear any license or other city identification other than that issued by the City of Blair for such dog or cat, The City of Blair requires proof of rabies vaccination. Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator inspection Program Dog Lj Cat LJ Spayed/Neutered License Fee $ Pet No e EMd-r(8 Birthdate 21102-1 Sex F (Sp--Y� Color! bxc'LAJA'�e" Breed" Lo-b tv,- t x Replacement $ 'D laed Dangerous or Potentially Dangerous Dog: LJ Y Ll N MC JOCHIP # (If appli cable) SUBTOTAL: $ A,B�S VACCINATION DATE: 2/ 1-1 L (3 yr) _ (1 yr) City Tag # PE #2 LJ Dog LJ Cat LJ Spayed/Neutered License Fee $ Pet� Name Birthdate Sex Breed" Replacement $ Declared Dangerous or Potentially Dangerous Dog: LJ Y Ll N MICROCHIP # (If applicable) SUBTOTAL:$ RABIES VACCINATION DATE: (3 yr) _ (1 yr) - City Tag # PET #3 Ll Dog L) Cat Ll Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed" - Replacement $ Declared Dangerous or Potentially Dangerous Dog: 0 Y Ll N MICROCHIP # (If applicable) SUBTOTAL:$ RABIES VACCINATION DATE: (3 yr) - (1 yr) _ City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED $ If you have questions, please contact Blair Police Department at (402) 426-4747 .............................................................................. NEW PET/ NEW RESIDENT LICENSING REQUIREMENTS (March 15 late fee date not applIcable for new pets1new residents) Newly Acquired Pets: New Residents to Blair: • Must be licensed within 10 days of ownership 0 Must register pets within 10 days of • <OR> at 6 months of age if puppy/kitten residency. .. Blair Small Animal Clinic PC David E.Johnson DVM 1734Front Street � Blair, Nebraska, 68008 Client ID: Client Name I Phone: Tag Number: Vaccine: Producer: Brand: | nmerof | Staff Name: License Number: | Doctor Signature: 5739 Patient ID: 13258 Friends ofthe Animal Shelter Patient Name: Emerald w~ � P(}.Box 233 Species: Canine Breed: Mixed Breed ~ Blair, NEG80O8 Sex: Female - Color: Black/White /402>533'2743 Markings: Birthday: 02/28/2021 Weight: 577Opounds on2/17/2U22 | 6866 |mnabRabies Vaccine K8erio| irnneb 3 TF Killed Virus Subcutaneously David E.Johnson 0VM 1893 Microchip ID: Vaccination Date: 2U7/2022 Expiration Date: 2117/2023 Lot Number: 18520 Drug Expiration Date: 5/22/2023 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2022 Owner Name: 1 �0k'tv C- r" Owner Address- Pk y k S� —i-' city/state/zip: Blair, NE 68008 Phone # Lj6Z- S33 - 812 G LICENSE FEES: Dog or Cat: $16.00 Altered non or Cat: 4z11 00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS, Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/15/2022. The City shall recognize a microchip Identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city Identification other than that Issued by the City of Blair for such dog or cat, The City of Blair requires proof of rabies vaccination, Replacement Fee for Lost Tag, $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program #1 18J Dog Ll Cat R Spayed/Neutered License Fee $ 11!01— ame b0 Birthdate 5122 /I'S Sex F �k�4 Breed Replacement $ red Dangerous or Potentially Dangerous Dog: J Y 0 N OCHIP # 9 95 112 002 6 LKo 92- 1 (If applicable) SUBTOTAL:$ _S VACCINATION DATE: 10123 / 20 (3 yr) v/ (1 yr) — City Tag # P Fij-E# 2 Ll Dog Ll Cat LJ Spayed/Neutered Pet me Birthdate Sex Colo Breed** a ared Dangerous or Potentially Dangerous Dog: LJ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) — License Fee $ Replacement $ U N PET #3 0 Dog LJ Cat Ll Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: J Y El N MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) -- SUBTOTAL:$ .(I yr) - City Tag # License Fee $ Replacement $ SUBTOTAL:$ (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL (This fee is due along with License Fee if requesting at the time of license renewal.) 00 Do Not Send Cash by Mail TOTAL ENCLOSED $ 11 If you have questions, please contact Blair Police Department at (402) 426-4747 .............................................................................. NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15 late fee date not applicable for newpelylnew residents) Newly Acquired Pets: New Residents to Blair: • Must be lioensed within 10 days of ownership m Must register pets within 10 days of • <OR> at 6 months of age if puppy/ldften residency. Q a Date of Rabies Vaccination: 10-23-20 Certificate No: 12030 Next Rabies Vaccination On: 10-23-23 VETERINARY CLINIC OWNER OF ANIMAL Elkhorn Animal Hospital Bob Frahm 21001 West Maple Rd 1133 Park St Elkhorn, NE 68022 Blair, NE 68008 (402) 289-4285 This is to certify... THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW. Patient information... PATIENT: Ebony TAG NO: 130829 SPECIES: Canine WEIGHT: 103.90 SEX: S AGE: 7 years Color and markings... White Lori Schneider, DVM License: 4082 C:Ap. Udle U-11-XI-Kzz Serial No. 18473 Vaccinations done... h1L "Tirus Manufactured by: BI 10-23-20 LS Bordetella 10-23-21 10-23-20 LS Lepto 10-23-21 10-27-18 EK DA2PPV 3 YEAR 10-26-21 10-25-17 EK DA2PPV 08-16-13 DB Rabies 1 Year, #110321 07-26-13 DB DA2PPV Booster CITY OF BLAIR - 2022 PET LICENSE APPLICATION -3 - I If you live in Blair City limits and own a dog(s) and/or cat(s), complete this, form and return with check made payable to: -City.,of Blair 218 S 16th St o Blair; NE 68008 You, may, legally own a co M'bln6tibn' of.four (4) adult pets, but no morethan three (3) adult digs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2022 Owner Name: Owner Address, �3 (J;tere' 0 City/State/Zip: Blair,, NE 68008 Phone # 11 � — 31 3 3') '& LICENSE FEES: Dog or Cat. $16.00 Replacement Fee for Lost Tag: $5.00 - - - - - - - - - - ***PLEASE READ CAREFULLY' YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/15/2022, The City shall recognize a microchip Identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city Identification other than that issued by the City of Blair for such dog or cat. The City of Blair requires proof of rabies vaccination. PET #1 Dog LJ Cat LJ Spayed/Neutored License Fee $ Pet Name r C01-;(k-, Birthdate S, Sex �11 Color i� PA;� en Breed** Replacement $ �, ' Declared Dangerous or Potentially Dangerous Dog: J Y L] N MICROCHIP # (If applicabl SUBTOTAL:$ RABIES VACCINATION DATE: ") - ''- 1, S (3 yr) �� (1 yr) _ City Tag # 3 3 k,0 PET #2 L1 Dog D Cat LJ Spayed/Neutered License Fee $ Pet Name— Birthdate Sex Color Breed** Replacement $ Declared Dangerous or Potentially Dangerous Dog: LJ Y L3 N MICROCHIP # (If applicable) SUBTOTAL: $_ RABIES VACCINATION DATE: (3 yr) — (I yr) _ City Tag # PET #3 Ll Dog LJ Cat LJ Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: 0 Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ (I yr) License Fee $ 1 Replacement $ SUBTOTAL:$ — CKY Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED $ If you have questions, please Contact Blair Police Department at (402) 426-4747 ... .............................................................................. NEW PET/NEW RESIDENT- LICENSING. REQUIREMENTS (March 15 late fee date not applicable for newpetsInew residents) Newly'Acguired Pets, New Residents to Blair: * , Must be,lioensed within 10days of ownership m Must register pets within 10 days of * <OR> at6 months of age if puppy/kitten residency. 12/27/2021 15:58 4024260101 HOLSTEIN VET CLINIC PAGE 01/01 2022 PET LICENSE , VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR — 218 S. 16TH ST — BLAIR, NB 68008 COMBINATIONYOU MAY LEGALLY OWN A BUT NO MORE THAN THREE (3) ADULT DOGS OR THHREQ (3)ADULT CATS PER RESIDENTIAL OR DWELLING UNIT. *''PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE OUR PE 5 THE CITY OF HI gIR RE FIRES PRQQF OF RABIES VACCINATION Failure to do so is a violation of City Ordinances 6.103 and carries a penalty of a fine up to $150,00 per pet. PET LICENSE RENEWALS ARE DUE BY 3/15/2022 The city shall recognize a microchip ID number as the license number. It shall be unlawful for any dog or cat to wear any license or other city 10 other than that issued by the City of Blair for such dog or cat. NEW PET LICENSING Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten NEW RESIDENTS TO BLAIR Must register pets within 10 days of residency Owner Name Spouse Owner Address City/State/Zip Phone # Pet Name: Shiloh Age: 14Y I Sex: Spayed Female DOB: 02-04-07 Breed: Italian Greyhound Microchip # Luann Fuhlrodt Brian 905 N 24th St. Blair, NE 68008 402-533.3610 Color: ies Tag # 17623 PLL-ASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): # RA131ES VACCINATION DONE ON 01.13-20 Rabies Description: 1 YEAR 3 YEA Holstein Veterinary Clinic Dr, Lisa Schrum DVM : Dr. KrIsts Holstein DVM 718 South 1911 Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteinclinic@gmail,com LICENSE FEES Intact Dog or Cat: $16.00 A e d D g or cat: $11.00 Replacement Tag $5.00 Total $ �,� PETS THAT ARE ON T F ACTIVE PgTENTIALLj DANGEROUS OR DANGEROUS qOG LIST N�'ED TO R��il5TER DIRECTLY AT CIJY HALL