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GFeb 1122 04:01 p Thone Animal Hospital (402) 426-3630 902 S Hwy 30 Blair, NE 68008 CITY OF BLAIR - -202t-PET LICENSE APPLICATION If you live in Blai(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 16tih St • alair, NE 68008 YOU may legally awn 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 iRENEWAi S ARE DUE: March 15 20Zj Owner Name: Owner Address: City/State/Zip: i'ilair N[: 68Sip8 �. Phone # v U LICENSE FEES: Dog or Cat: $16.D0 ***PLEASE READ CAREFULI: 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 $I50,00 per pet, PET LICENSES RENEWALS ARE DUE BY 3/j kL20?.] , 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 Altered Dog or Cat: $11.0 D 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 I rlspection Program PET #1 ,Dog ❑ Cat & Spayed/Neutered License Fee $- Pet Name Birtfidate • Lco-1 Sex . t� Color �?\ �:.� ,\� �� •� Breed . �f\r, _ Declared Dangerous or Potentially Dangerous Dog: ❑ Y [kN Replacement $ ** #MICROCHIP # (If applicable) RABIES VACCINATION DATE: ,'} 1G1 (3 yr) SUBTOTAL: $ 'e� CY _� (I Yr) CityTag #_ , PET #2 Pet Name' ` 1Dog Cat Spayed/Neutered i3irthdate SexZtti� License Fee $ _ — Color :��=LJ Breed** Declared Dangerous or Potentially Dangerous Dog: Replacement$ ** ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL; $` RABIES VACCINATION DATE: i 1, �01' ` (3 yr) (1 yr) City Tag PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate License Fee $ �! Color Breed** Sex Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ Replacement $ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (I yr) _ City Ta # 9 *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time or license renewal.) DoNot Send Cash by Mail TOTAL ENCLOSED $7 U.0 If you have questions, please contact Blair Police Department at (402) 426-4747 .......t.....l-....}.f.....-F......... .................*++t++.............++.t.....+ NEW PET/NEW RESIDENTUICIENSING REQUIREMENTS(MaarhlSlatt=feedate not applicablefrxnewpetsyneWraricty7ts) N@WjY AC uimd Pets:New Residents to Mali Must Le Ik7 1Sed wftl n 10 days oPo vnersl7p w Must register pets within 0-days of J111 <OR> at 6 months of age if PUPWM tM residency, Feb 1122 04:01 p � � o�p•2 Thone Animal Hospital (402) 426-3630 902 S Hwy 30 Blair, NE 68008 CITY OF BLAIR - •202-k PET LICENSE APPLIC,A71ON If you five 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 o 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 2Q21 Owner Name:,'i r fv�� ",�t,_,'. Owner Address: City/State/Zip: lair, NE 68008 �— Phone# �11.'G1gy� • ('-TML LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $•1i.00 Replacement Fee for Lost Tag: $5.00 Included ***PLEASE READ YOU ARE REQUIRED BYLAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a petralty of a fine up to $iso.00 per pet. PET LLCENSEs RENEWALS ARE DUE BY L.LVW&22 y. The Cityshall recognize a mirrochip Identl5cation number as the license number. It shall he anlaylful fbr 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 eat. The City of Blair requires proof of rabies vaccination. <S a Stain of $1,25 beetg collected to fund the Nebraska Dog & Cat operator Inspection Program o *PLEASE INCLUDE THE a Y 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 $ Z'�.� If you have questions, please Contact Blair Police Department at (402) 426-4747 -�.+->....f.....+.+++++.*..t.�.....�r-�+-�.........t�.......................+ .........+. NEW PI=L'/NEW RESIDENT LICENSING REQUIREMENTS (M&0.t51ate eedafenot 4cWic"e for ne�v�is/rrewr�;ic�ts) New aired Pets Ne Residents to Blair: Pets- 0 Must be Ii 1 witln iQ days ofctivner�p r Must regE r pets within 10 days of QR? at 6 months of age iFpuppy/kitben reslde-cy. �VM 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 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 Owner Name: Owner Address: City/State/Zip: Blair, NE/68008 yy q Phone # ysOA- ljso " `/1<� l LICENSE FEES: Dog or Cat: $16.00 Alt d Do or Cat- $11 oo ***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. ere 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 S Dog ❑ Cat ❑ Spayed/N utered License Fee $ %l Pet Name�'i ock - O Birthdate %% /9 !Sex ** Color 1/3U.fX Breed** w-r/i�f 1,41d oR Replacement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y W N MICROCHIP # (If applicable) SUBTOTAL: $✓cli RABIES VACCINATION DATE:/ a 1 (3 yr) (I yr) City Tag #Of 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) _ License Fee $ Replacement $ ❑N PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # __(If applicable) RABIES VACCINATION DATE: (3 yr) SUBTOTAL: $ (1 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.) r Do Not 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 notapplicab/efor newpets/new residents) Newly Acouired 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. 04/08/2022 8:31 AM FAX 4025332723 BLAIR SMALL ANIMAL 2 0004/0007 OF BLAIR - 2022 PET LICENSE APPLICATION If you live in Blair limits and own a dogs) and/or cat(s), complete this form and return with check made payable to: y 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 dop or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2022 Owner Name: 7� `� 1�h�4 �•� <? h�-�.��_ (`- Owner Address; city/state/zip: Blair, NE 680.08 Phone xl i\ 0 LICENSE FEES: Dog or Cat: $16.00 C t$1100 ***PLC READ CARMLLY**'k YOU ARE REQUIRED By LAW TO LICLNSE YOUR PETS. Failure to do 90 Is a vlolatfon of City ordinances 6.103 and carries a penalty of a fine up to $15o.00 per p4t- PET LICENSES RENEWALS ARE DUE By ;�! 1 Ste• The City shall recognize a microchip Identi lcatlon number at 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 "thho Lb or for such dog or cat. The city of Blair Mulnas proofOf Altered Dog or a . Replacement Fee for Lost Tag: $5.00 DID' L program Induded is a State Fee of $L25 being colkxWd tD fund the Nebrwlo Dog & Cat PET #1 0 Dog * Cat Spayed/Neutered License Fee $ QQ Pet Nam Birthdate ►o -t, �-a c�c5ex _ ** ColorBreed** Replacement $_ Declared Dangerous or Potentially Dangerous Dog: n Y M N SUBTOTAL: $ �l t MICROCHIP # (If applicable) RABIES VACCINATION DATE: yr) City Tag # PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $______.� Pet Name Birthdate _. _ Sex Color Breed** Replacement $� Declared Dangerous or Potentially Dangerous Dog: a le ❑ N SUBTOTAL: $ MICROCHIP # (If ppcc) _ City Tag # RABIES VACCINATION DATE: (3 yr) (1 yr) PET #3 ❑ Dog El Cat ❑ Spayed/Neutered License Fee Pet Name Birthdate — Sic Color Breed** Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: le ❑ N SUBTOTAL: $ MICROCHIP # � applicable) RABIES VACCINATION DATE: (3 yr) (1 yr) _City lag # *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 Man TOTAL ENCLOSED $ 1 O� if you have questions, please contact Blair Police Department at (402) 426-4747 +++t fi++++++d•++++++++++++++.++++++fi+++•F++.++++++++♦++++. ♦+++{'+++++++++}++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Mardi 15late fee date not apF✓i�ble for new pnaw r>°srtlanL�) ■ Must be (mad within 10 days of "'lashP pim ew ■ Must register pets within 10 days Of ■ <OR> at 6 rnonft of age if PUPPY/►fin 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 checkmade 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 RENEWALS ARE DUE: March 15, 20-22 C ek V 6 Owner Name: Owner Address: City/State/Zip: Blair, NE 68008 Phone # (W U1 LICENSE FEES: Dog or Cat- $16.00 All-ghr'0011 nn or Cat: $jj 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. -Replacement Fee for Lost Tag i $5.11310 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET #1 AeDog Ej Cat LI paod/Neutered License Fee $ -1 itb'�'j C,, f-- Sex Pet Na 0NAAA Birthda —2 Color Breed** --Replacement$ DeclareRD—AgLe—ro—us or Potentially Dangerous Dog: Ll Y UJI N MICROCHIP # -LL (If applicable) SUBTOTAL:$ RABIES VACCINATION DATE: (3 yr) V --' 6 (1 yr) — City Tag i a. PET PET #2,Dog LI Cat Ll Spayed/hgqtered License Fee $ Pet Name_ Birthdate -Z,-i Sex Color Breed** Replacement $ Declared Dangerous or Potentially Dangerous Dog: LJ Y a N MICROCHIP # (Ifapplicable) SUBTOTAL:$ RABIES VACCINATION DATE: 01 (3 yr) (1 yr) — City Tag # PET #3 - Ll Dog Cat p4ed/Neutered License Fee$ -L 1 —, Pet Name "t-0 VVIV Birthda �6' .7,-,? Sex C- - Color ( - I Breed** t 60VJ Replacement$ -- 1-c '-� - Declared Dangerous or Potentially Dangerous Dog: LJ y M , N MICROCHIP # i (If applicable) SUBTOTAL:$ RABIES VACCINATION DATE: Q_ - z 2 - 2- 02L ( *,,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 for newpet5lnew residents) Newly Acquired Pets: New Residents to Blair: • Must be licensed within 10 days of ownership N Must register pets within 10 days of • <OR> at 6 months of age if puppy/kitten residency. 6 M :BSAC FAX NO. :402-533-2722 Feb. 01 2022 03:27PM P1 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 RENEWALS ARE DUE- MAW"% 2022 Owner Name: Owner Address: Zug City/State/zip: Blair, NE 68008 Phone # HD Z-Afl lwp 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 carries a penalty of a fine up to $130.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3119/ 022. The City shall recognize a microchip identification number as the license number. it 4hall 49 unlawful for ,any dog or cat to wear any license, nr other city Identification other than that Issued by the my of Blair ror 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 PET # 1 C a t Z'Spay. eutered License Fee $^,�.._!_,_,_ Pet Name Birthdate I Sex Color bjA C . Bream*nP T Replacement $ ** Declared Dangerous or Potentially Dagerous Dog: ❑ Y MICROCHIP # (If applicable) SUBTOTAL: $_ RABIES VACCINATION DATE: (3 yr) � (1 yr) City Tag # 2� PET # 2 ,f Dog ❑ Cat Ll Spay d/ eutered License Fee $1_ Pet Name o 2 _ _ Birthdate 2 Sex Color Breed** _ Q Rep/acement $ ** Declared bangerous or Potentially DangerouV Dog. ❑ Y CAI MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: I / l� (3 yr) (I yr) City Tag PET #3 0 Dog ❑ Cat f,;;1 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 Mall TOTAL ENCLOSED $ If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++*++..++++++++++***..aH++++++++++++.+*.++***++++++++++++*+*+++*++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Marra' 15/ell' date rrotapcable !ni newpetx/new n�sidmts) lred New Resfdents to Blain 11 Must btu Marised h 10 days of mnwshlp r Must reglster pets within 10 days of 0 a0R> at 6 months of age W puppy/Idthen 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 pay 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 RENEWALS ARE DUE: March 1"Z Owner Name. - Owner Address: \ Ctr _ZK-L Z'A -4::, �S�C city/State/zip: Blair, NE 68008 Phone # '-kC>�. ; -- c1�t�J� LICENSE FEES: Cog or Cat: $16.00 Altered Dog or Cat: $11.00 ***PLEASE READ CARERJLLY*** YOU AR! RlQVXRE4 BY LAW YO LICENSE YOUR PETS. Failure to do to Is a violation of City ordinances 6.103 and Cable& a penalty of a fine up to $150.00 per pet PET LICENSE'S RENEWALS ARE Out BY 3/16/2022. The City Shall recognize b 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 requites proof of rables voccinatlon. Replacement Fee for Lost Tag: $5.00 Ltduded is a State Fee of $1.25 being collected to fund the Nebraska) Dog & Cat Operator InspeclSon Program PET #1 ❑ Dog i�, Cat 4_$payed/Neutered License Fee $� Pet Name IR r. �- Birthdate '�) -lS-'44G Color Breed** -'SV\e\7 : .r Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: 0 Y CAN MICROCHIP # 0 (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: '3,c�Dta;.. (3 yr) (1 yr) City Tag # PET #2 Dog 0 Cat ,,Spa ed/Neutered License Fee $� Pet Name l Birthdate'4'-� Sex �_� Color a \ . e K A— Breed** —Rep/acement $ ** Declared Dangerous orPotentially Dangerous Dog: ❑ Y S�N/ MICROCHIP # (If applicable SUBTOTAL: $ RABIES VACCINA17 N DATE: Q-V,:5 _ (3 yr) (I yr) City Tag * % PET # 3 ❑ Dog C] Cat ❑ Spayed/Neutered License Fee $� Pet Name Birthdate Sex Color Breed** Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y C3 N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # * *PURSE INCLUDE THE CITY TAG NUMBER IF THIS 15 A RENEWAL ** (This fee is due along with License Fee It requesting at the time of license renewal,) Do Not Send Cash by Mall TOTAL ENCLOSED $ ES�,��o If you have questions, please contact Blair Police Department at (402) 426.4747 ++++++t.++it++++♦t+++++++++++++++++++++*++++++-F++**+++++++++++++t*+++t♦.+-F+++.. NEW PET/NEW RESIDENTLICENSINGr REQUIREMENTS(Matd�lSlateii?echit°otappr/cablefornewpel,�/newtestoewts) NSM& Acguired Pets: New ResMenta t» Blair: 0 Must be ioen9ed w" 10 days 0fWWihp ■ Must register pets within 10 days of 0 <OR> at 6 mor t>s of age 9 puppy/Idt w re0ency. 00 12/22/2021 14:48 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. 16T" ST — BLAIR, NE 68008 LEGALLYYOU MAY BUT NO MORE THAN THREE (3) ADULT A DOGS OR THREE (3) ADULT CATS PER RESIDENT FL OR DWELLING U ***PLEASE READ CAREFULLY*** YOU A E REQ IRED BY LAW TO LICENSE YOUR PETS. THE CITY OF BLAIR REQI�IRES P QOF 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 I5 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/Statealp Phone # Pet Name: Maggie Age; 12Y DOB: 07-07-09 Breed, Havanese Microchip # Sex: Spayed Female Marsha Gilliland 555 N 16th Blair, NE 68008 426-3755 Color: White/Gray Rabies Tag # 19688 PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF -AVAILABLE).- RABIES VACCINATION DONE ON 12-22-21 Rabies Description. 1 YEAR 3 YEAR Holstein Veterinary Clinic ,Or. Lisa Schrum DVM :.Dr. Krista Holstein DVM 718 South 19th Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteinclinic@gmail.com LICENSE FEES Intact Dog or Cat: $16.00 or cat: $11.00 Replacament Tag $5.00 Total It PETS ATARE ON THE ACTIVE' POTENTIALLY DANGEROUS OR DANGEROUS POG LIST NEED TO REGISTER QIRECTLyAT CITY H LL Feb 28 22 03;13p p.1 Thane Animal (402) 902 S Hwy w 4,f Blair, NE 68008 CITY OF BLAIR - 202&PIET 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 mare than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: M=h 15, 2021 Owner Name: �0.SOr� % \r\ F's (D' e-, owner Addrem 14 7 City/state/Zip; Blair, NE 68008 — — Phone # 4p -7 `7 i t Q ci t p 11, LICENSE FEIES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 ***PLEASE READ YOU ARE REQUIRED BY LAW TO LICENSE YOUR PMTS. Fallure to do so Is a violation of City ordinances 6.103 and carries a penalty of a fine upto $150.00 perpet. PET LICENSES RENEWALS ARE DUE BY 3115/2021. The Cityshall recognize a microchip Identiflcatian number as the license number. it shall be unlawful for any dog or cat to wear any license or other city IdentlticatloA other than that issued by the City of Blair for such dog or cat The City of Blair requires proof of rabies vaccination, Included is a State Fee of $1.25 being eoliecbed to fund the Nebraska Dog & Cat Operator Inspection Program PET #1 :Dog ❑ Cat C'�,Spayed/Neutered License Fee $1 00 Pet NamY1 Birthdates-Z •1"t Sex lac � Color Yy_Breed** V, 'Y� Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y (A N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION OATE:'L• 7.Q • 7 (3 yr) __X(1 yr) City Tag # PET #2 Q Dog ❑ Cat O Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: Q Y Cl N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag PET #3 ❑ bog ❑ 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 # P�PPAJe artia.wue I nC L4I T I Ab NUMBERIF THIS ISA 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 +++.++++.+.++++++++++++....................+++++*+++++*+++++f++++++++..+.+++++ NEW PET/NEW RESIDENTUCENSIN© REQUIREMENTS (Mare`t.LSlatefee da&-riot4cpllcable trfL-wce&1n&WA?51a(S71s) i Pets, New ei�'dents to Rlaiw ■ Must be 1cwsed vM, n 10 days or gwnershlp ■ Must reglMr pets within 10 days of B SOR> at 6 niaV,6 of age if Wppy/ldttan „ma y J CITY OF BLAIR ® 20LICENSE APPLICAT10 IN' 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 r . 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 CAREFULLY*** Owner Name: YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of city ordinances 6.103 and carries Owner Address: penalty of a fine up to $iso.00 per pet. City/State/Zip: Blair, NE 68008 :ET LICENSES RENEWALS ARE DUE BY 3/15/2022. The City shall 6-, 2 recognize a microchip Identification number as the license number. It Phone # 3-9 - _e2zZ 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 eutere License Fee $ PET #1 A Dog D Cat p Spayeclt§�- \1' Pet Name Birthdate Sex Breed" Replacement$ Color -011-4'Atn Declared Dangerous or Potentially Dangerous Dog: L3 Y 0 N $ ul MICROCHIP # (If applicable) SUBTOTAL. 1\ BI A 11 DATES 1 r City Tag # 4RA j T T #2 4 Dog U Cat 0 Spave euti-rp License Fee $ -14-j212— j Pet a �Sex Pet Name Birthdate_ Sex Replacement$ 6,CO* Color Breed** 6 _ _ Declared D%ge—rous or Potentially Dangerous Dog: LJ Y �d N SUBTOTAL: $ pp MICROCHIP # (If applicable) City Tag # RABIES VACCINATION DATE: (3 yr) yr) rf If I PET #3 Ll Dog Ll Cat L1 Spayed/Neutered License Fee $ Pet Name Birthdate Sex Replacement $ Color Breed" Declared Dangerous or Potentially Dangerous Dog: Ll Y U 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 $ &—Z-0 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 for newpet�lnew re5ldentV Newly Acquired Pets: . New Residents to Blair: • Must be licensed within 10 days of ownership n Must register pets within 10 days of. • <OR> at 6 months of age if puppy/kitten residency. 2021 PET LICENSE VERIVICATION/APPLICATION, Fop. CITV OF BL,AIR IF YOU ► IVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: av orGLAIR -- 218 S. 16'rH ST — BLAIRr NE 68000 YOU MAY LEGALLY OWN A COMBINATION �T FOUR (4) ADULT PETS, CATS PER RESIDE TIAL OR DWELLING UNIT, BUT NO MORE THAN THREE (3) ADULT 0005 OR THREE (. ) o ***PLEASE REAP CAREFULLY*** U ARE REQUIRED By LAW TO LIME YOUR PETS, Failure to do so is a Violation of City Ordinances 6.103 and terries a penalty Of a fUle up to $150.00 per pet. p'ET LICENSE JSENEW'AL5 ARE DUE BY 3/15 2021. The city shall recognize a microchiP ID number as the license number. It shall be unlawful for Any dog or cat to woor any license or other city ID other than that issued by the City of Blair ore such dog or cat. NEW PST LICENSING Must bo licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitt NEW I1f=SI[7EN75 TORI-A+IFt Must register pets within 10 days of residency owner Name spouse owner Address City/State/Zlp phone # JL # or DOB Pet Name., Leopold Age: 23M Sex: -Neutered Male DoBe 06-1.7-19 13 reed: Nevvfoundld Microchip # Susan Giilstrap Mike 315 South 20th St, RAtITES VACCYNIATION DONE ON 0947-20 Rabies Description: .1 YEAR Holstein Veterinary Clinic Dj-, ,Lisa Schrum DV9 : Dr Krista Holsteln DVM 718 South 1911 Street Blair, NE 68008 402-426-7387 402-426-0101 Fax h0lsteindinic@gmail,cOm 131air, NE 68008 402-533-236.3 colon 01ock Rabies Tay # I3z8!5 3 YLA FAX05-14-21 BY LICENSE FEES intact [)Og or Cat: $16.00 Altered ar cat: $1� Replacement Tag $5.00 Total $ � 1w 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 RENEWAI S ARE March 15, 2022 Owner Name: Owner Address: 7-75 M City/State/Zip: Blair NE 68008 Phone # Vi�`�iC --- 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 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 ❑ Dog ❑ Cat �h4 Spay d/eeutered License Fee $ ,00 Pet Na e �� ___ Bidate - � Se * * Color - U Breed** Jim Replacement $ Declared Dange o s or Potentiall D n erous Dog: ❑ Y ❑ INMICROCHIP # �r I (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: l& (3 yr) _ (1 yr) City Tag # 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) _ W 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) (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. Holstein Vet Clinic 718 South 19th Street Blair, NE 68008 402-426-7387 Check out our online store at www.HOLSTEINVET.com for home delivery! Printed: 02-25-22 at 9:34a FOR: Pamela Glaser Date: 02-25-22 775 N. 3rd Account: 8417 Blair, NE 68008 Invoice: 125968 (402) 426-5782 Date For Qty Description Net Price 02-25-22 Millie 1 Vaccinate & Mini Exam 18.00 02-25-22 1 Vanguard® Plus 5 L4 { Distemper+Lepto } 28.00 02-25-22 1 Azithromycin Suspension 200mg/5ml- 30ml- # 27.50 43.25 02-25-22 1 HeartgardPlus < 25# (6 PACK) 02-25-22 . ! 2 RCVD K9 Hepatic CANS (LIVER HEALTH)* 7.38 02-25-22 Visa payment -124.65 Old balance Charges Tax Payments New balance 0.00 124.13 *0.52 124.65 0.00 Reminders for: Millie (Weight: 10.7 Ibs - 14y) Last done 02-27-24 Denfensor 3 (3 Year Rabies) 02-27-21 02-25-23 Vangard Plus 5 L4 02-25-22 Next appointment for Millie Qty 05-06-22 At: 8:30a With: Lisa Schrum, DVM Thanks for choosing us to take care of your pet's health care needs) 02/04/2022 16:44 402,4260101 HOLSTEIN VET CLINIC PAGE ©1 2022 PET LICENSE E IFICATION/APPL.ICATION 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 OR: THREE 3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT. ***PLEASE READ CAREFULLY*** YOU kRE LQUIRED BY LAW TO LICENSE YOUR PETS. THE CITY OF BLAIR REQUIRES PROOF OF RABIES VACCINATION. rail i re to do so is a violation of City Ordinances 0.103 dII I Ldi [IUS d peudILy ur d rive up Lu $15o.00 per pet. PET LICENSE RENEWALS ARE DUE BY 3/15/2022, The city shall recognize a microchip ID numher as, tha licPnge numher It shall be unlawfu 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 LICENS NG Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten NEW RESIDENTS TO kAIR Must register pets within 10 days of residency Owner Name Jennifer Globe . Spouse Jesse Basch Owner Address 1140 Park St City/State/Zip Blair, NE 68008 Phone # 402-237-9613 r ,. / -h I,. Pet Name: Freckl es Age: 3Y DOB: 07-21-18 Sex: Neutered Male Color: White Breed: Terrier Microchip # Rabies Tag # 18844 PI FAgF I1ucl I_InR CIT1 I TAG NUMRER IF THIS IS A Rr.NEWAL (IF AVAILAGLI01 H RABIES VACCINATION DONE ON 01-26-21 Rabies Descripti n: 1 YEAR 3 YEAR HOIs Dr. Liss 718 41 LICENSE FEES Intact Dog or Cat: $16.00 Dog or cat:.$11.00 Total $_ PETS THAT ARE ON THE ACTIVE POTENTIALLY DANGEROUS OR DANGEROUS DOG LIST NEED TO REGISTER DIRECTLY AT CITY HALL, Veterinary Clinic DVM : Dr. Kr/sta HnistPin DVM 911 Street Blair, NE 68008 7387 402-426-0101 Fax inclinic@gmail.com FAXED 02-04-22 BYy�. Mar 21 22 03:51 p p' 1 Thone Animal Hospital (402) 426-3630 902 S Hwy 30 Blair, NE 68008 202 Z CITY OF BLUR - bW6 PET LICENSE APPLICATION If you live in Blair City limits and own a dogs) 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 RENEWALS ARE DUE: March 15, 2021 Owner Name: Owner Address: r city/state/ZPI Blair NE 6800 Phone # 4o L. - I - - LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 ***PLEASE READ 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 $1SO.00 per pet. PET LICENSES RENEWALS ARE DUE BY $ l36J= . The City shall recognize a microchip identification number as the license number. It shall be uniaveul for any dog or cat to ►year any license or other city Identification other than that Issued by the City of Blair for such dog or cat, The Cdy of Blair requires proof of rabies vaccination. Inducted is a Stabs Fee of $1.25 being collected tofund the Nebraska Dog & Cat Operator Inspection Program PET # 1 )4 Dog ❑ Cat( Spayed/Neutered License Fee $ C%b Pet Name_ Kt-&� Birfhdate i+ZO Sex VP— \e Color njn Breed** Xef Replacement$ ** Declared Dangerous or potentially Dangerous Dog: ❑ Y A N MICROCHIP # (If applicable) SUBTOTAL: $ ��- RABIES VACCINATION DATE: J0 23-2-1 (3 yr) --�-- (1 yr) City Tag # Z 01) PET #2 ❑ Dog ❑ Cat Q 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 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) (I yr) City Tag # 9',.cr4Zkr sr F-LUM: It1t: C:i IT FAG NUMBER IF TMSIs 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 $ l . 0 , - If you have questions, please contact Blair Police Department at (402) 426-•4747 ..........++++++....+++++• ..............++++++......... •+++++................ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (/Vf&rh 15latefee tblenof8pyllca6Vekrrxv1petFlnervfz�1-c 1s) Newly Acmdred Pets: New Residents to Blair: ■ Must be licensed Wthin 10 days of'oiv im"p ■ Must register pets wlttiln 10 days of 0 <0R> at 6 mo•IU•ts of age 1f puppyA then reside- cy. CITY O BLAIR! — 2 2 Ptt L , ICENSE 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 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 RENEW LS-ARE DUE: ,.,March 15, 2022 i c Owner Name: V — Owner Address: tt�a� r � 9 . City/State/Zip: Blair, NE 68008'`°'° Phone # `� �w t l 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 S3penalty 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: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program #1 t ❑ Cat ) , , �L� 0 9��, I Spayed/Neutered E� ( �°, License Fee , $x :oor Pet Name, i n Birthdate Breed** �`� Replacement $ ** D clared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # --(Idap I cable) , �� SUBTOTAL: $ City Tag # �* F'ABIES VACCINATION DATE: .� yr) (1 yr) 'ET #2.`� ❑Cat �Spayed/Neutered S License Fee $° pet Na e :, dolor"4" Birt dates II Breed** i = Replacement$ ** Declar d ngerous or Potentially Dangerous Dog: ®Y ❑ N . MICROCHIP # I ,n(rf icable) SUBTOTAL: $ L Tag # RABIES VACCINATION DATE. .� z r yr) _ (1 yr) City PET #3 ❑ Dog ❑ Cat'. ❑ Spayed/Neutered License Fee $ Pet Name Color Birthdate.. Sex Breed** Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # jf applicable) SUBTOTAL: $' RABIES VACCINATION DATE: 1 — (3 yr) (1 yr) City Tag # * *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS 19A 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 $ .µ � ., If you have questions, please vontact Blair Police Department at (402) 426-4747 ++++++++++++++++++++++++++i-+++++l-+++++++++++++++++++++++++++++++++++++i-+++++++ NEW PET/NEW RESIDENT LICENSING REQUIREAENTS (March ISlalefee date not applicablefornewpets/new residents) Newly AaLired Pets: New Residents to Blair: • Must be licensed within 10 days of ownership III Must register pets within 10 days of ® <OR> at 6 months of age if puppy/kitten residency. CITY OF BLAIR - 2022 PET LICENSE APPLICATION (A# and return with check made payable to: 1.3 Blair o 218 S 1tip) th St 0 Blair, ME 68008 You may legally own a cbmbination*of four:(4) adult pets, but no more thantbrpq, (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE; March 15, 2022 Owner Name: Owner Address: ( D City/State/Zip: Phone # Blair, NE 68006 LICENSE FEES., Dog or Cat: $16.00 Alt red nn or Cat: 4;1100 '**VLEASt READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do sods 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 3/15L2022. 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 at Cat Operator Gras 'on Program PET #1 ODog q C at dSpayed]Neutered License Fee $ Pet Name Birthdate Sex F_ Color Replacement$ Declared Dan'gerous or Potentially Dangerous Dog: L3 Y Ll N MICROCHIP # I'? / b ) 1, 3 '155 3 5"S,-5 (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: -- ) o - ) 1)_ (3 yr) — (1 yr) >4--, _ City Tag # PET #2 LJ Dog LJ Cat Ll Spayed/Neutered License Fee $ Pet Name Birthdate Sex Replacement $ Color Breed** 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 Ell Cat L) Spayed/Neutered License Fee $ Pet Name -_ Birthdate Sex Color Breed** Replacement $ Declared Dangerous or Potentially Dangerous Dog: 0 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 . .............................................................................. NEW PET/'NEW RESIDENT- LICENSING. REQUIREMENTS (March 15 late fee -date not aoplIcable for,newpetsInew resldents) ,N,ewl 'AcquiredPets:. New Residents to Blair: * ..' must be�llcensedwlthln .10-days of oWneEh71p- m Must register pets within 10 days of_-, * <OR> at, 6 months of age if puppy/ldften . residency. ewt4' *71M CITY OF BLAIR - 2022 PET LICENSE APPLICATION 1 $1-)), 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 I " or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15 2022 Owner Name: -L"-" C Owner Address: z Y, City/State/Zip: lair® NE 68008 �4 Phone # LICENSE FEES: Dog or Cat, $16.00 A141. ^ .4ns%,-r=iF-4:jjoo ***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. ere W Replacement Fee for Lost Tag: $S.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET #I EDog LJ Cat L❑3 p a y e- d- /N. e- u- t er e- d License Fee Pet Name I . $ Birthdate Sex Color Breed" Replacement $ Declared Dangerous or Potentially Dangerous Dog: LJ Y LW-N MICROCHIP # (If applicable) SUBTOTAL:$ RABIES VACCINATION DATE: (3 yr) — (1 yr) X City Tag PET #2 LI Dog LI Cat Ll Spayed/Neutered Pet Name Birthdate — Sex Color Breed" Declared Dangerous or Potentially Dangerous Dog: LJ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ PET #3 LJ Dog 0 Cat 0 Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: Ll Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: — (3 yr) — M License Fee $ — Replacement $ SUBTOTAL: $ (1 yr) - City Tag License Fee $ Replacement$ D N 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.) 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 newPelslnew re,-Ident5) Newly Acquired Pets: New Residents to Blair: - N Must be licensed within 10 days of ownership m Must register pets within 10 days of Bi <OR> at 6 months of age if puppy/ldften residency. \0. CITY OF BLAIR V2' PET L C S PLIC T 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 RENE11uA1. ARE DU March 15. 2022 Owner Name: } Owner Address: i m city/state/zip: Blair, Ng"68008 Phone # fr 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 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 ET # 1 _ t Dog ❑ Cat Id Spayed/Neutered License Fee $ t t Name_ Birthda** Sex _ olor Breed Replacement $ _ ** eclared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N ICROCHIP # (If applicable) SUBTOTAL: $ m BIES VACCINATION DATE: (3 yr) (1 yr) City Tag # Tn ET #2 � D Cat ( Spayed/Neutered License Fee $ et Name i l Birthdate Sex__ Color I Breed** Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ P RABIES VACCINATION DATE: � � (3 yr) (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) (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 $ ( 1-1 L If you have questions, please contact Blair Police Department at (402) 426-4747 ....+++++++........+.++...... r+++++++.+++......... .......+++++++++++++++++.... NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Marchl5/ate fee date not applicable I&newpets/newresldenis) Newly Acquired Pets: New Residents to Blair: aI Must be licensed within 1.0 days of ownership w Must register pets within 10 days of ® <OR> at 6 months of age if puppy/ldtten residency. � 'QI�2 �Ll';_z f I - 2022 PET LICENSE APPLICATION 4 &,9a 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 fo: City of Blair ! 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: (73 Z & 0 City/state/zip: Blair, NE 68008 Phone# +D:L-6PA-A-367 LICENSE FEES: Dog or Gat: $16.00 Altered noor 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 3/1.5/2022. 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 ❑ Ca t Spayed/Neutered License Fee $ 0 Pet Name i_,v.o_�I Birthdate Sex _ ColorBreed** t Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y A N 0c2 MICROCHIP # _ (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: 1(3 yr) (1 yr) ,_ City Tag # 4- PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee Pet Name tt- _ Birthdate Sex Color Breed** _ Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VAC�IN TION DATE; (3 yr) (1 yr) City Tag # 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) W (1 yr) License Fee $ Replacement $ SUBTOTAL: $ 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 applicable fornewpet5lnewresidents) 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/ldtten residency. 6 FAX NO. :402-533-2722 Feb. 01 2022 04:21PM P1 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 • 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: a, . , tJ1 &J d N Owner Address: city/state/zip: Blair, NE 68008 Phone # t-�J Q S v �'� LICENSE FEES: Doll or Cat: $16.00 Altered Dog or Cat: 111.00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. failure to do so is d wiolation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/15/202L The City shall recognize a microchip identiflcatlon number as the license number. Tt shall be unlawful for any dog or cat to wear any ilcenso 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 PET # J D o g U C a t payed/Ne te,d License Fee $ _ Pet Name B' hdate /GSex _ Color: Breed** Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: C) Y MICROCHIP # (If applicable SUBTOTAL- $ RABIES VACCINATION DATE: TTg_..., a ,;(3 yr) (I yr) City Tag �_ r .. ...,._...._.. _ PET # 2 Wrliog 0 Cat Spa / eutered License Fee $ Pet Name Color Birthdate ad Sex Breed** Replacement $ Declared dangerous or Potentially Dangerous Dog: 0 Y,,O N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE; as v (3 yr) (1 yr) City Tag PET #3 D Dog 0 Cat Cl 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 CM TAN 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 ENCLOSED $ If you have questions, please contact Blair Police Department at (402) 426-4747 ................ *....++++++++++d•.......*+ ...................... *.+4.... F...... NEW PET/NEW RESIDENT LICENSING REQUIREMENTS(maro�1.5la&, fee date not apWablefor new pets/newresldent_s) New Residents to 131a" ri R Must be kffised WHn 10 days of mnetshfp ■ Must register pets within 10 days of ■ <OR> at 6 months of age If puppy/kltten residency. APPLICATION\ -A) CITY OF BLA�'I -4622 PET LICENSE 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 RENEWALS ARE DUE: March 15, 2022 Owner Name: Owner Address: ' s ` 4 A _A city/state/zip: Blair, NE 68008 Phone #- LICENSE FEES: Dog or Cat: $16.00 Alt ed Do or Cat- $11 00 ***PLEASE 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, er 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 ET #1 ❑ D o g 1:4_. Cat Spayed/Neutered License Fee $ 11 Birthdate Sex Colo Breed** Replacement $ ecl red Dangerous or Potentially Dangerous Dog: ❑ Y Q N MIC OCHIP # tis'') i �I I Lo ° '> ' L �- `= (If applicable) SUBTOTAL: $ RA TES VACCINATION DATE:>6 (3 yr) (1 y City Tag n 1-#2 ❑ Dog �3 Cat Spayed/Neutered License Fee $ P t Name �- Birt date Sex'` C for 0! C 1") c- Breed** Replacement $ ** D clared Dangerous or Potentially Dangerous Dog: ❑ Y N TCROCHTP # applicable) SUBTOTAL: $ BIES VACCINATION DATE: s "I ; _(3 r ( 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) (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 $ Z. 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/newre5ldent5) 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/Idtten residency. 6 CITY OF BLAIR - 2022 PET LICENSE APPLICATION If you live in Blair City limits and own a clog(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 LS ARE D E: March 15, 2022 Owner Name: I+Vi Owner Address: Zia City/State/Zip: Blair, NE 68008 Phone # -10 2- 00 gr.ri 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 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. 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 #11 Dog ❑ Cat Spayed/Neutered License Fee $ Pet NamBi hdate Irim Sex Colorer Breed** Rep/acement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) -X— (1 yr) City Tag # 22�?1 PET # 2 , Dog ❑ Cat ❑ Spay/Neutered License Fee $ Pet Name _ Birthdate I Sex 1" Color Breed** it ReplacementICA- $ ** 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. Date of Rabies Vaccination: 03-26-21 Next Rabies Vaccination On: 03-25-24 VETERINARY CLINIC Thone Animal Hospital 902 S Hwy 30 Blair, NE 68008 402-426-3630 This is to certify... Certificate No: 2440 Previous Rabies Vaccination: OWNER OF ANIMAL Britni Gothier 2304 Nebraska St Blair, NE 68008 -71 County: qo�, 0 THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW. Patient information... PATIENT: Tim SPECIES: Canine SEX: N Color and markings... Bk Tig/Org Signed Dr. Joe DiMari Vaccinations done... TAG NO: 006573 WEIGHT: 56.00 AGE: 15 months License: 3258 03-26-21 JRD Rabies Vaccination (3 Year), #006573 03-25-24 03-26-21 JRD DA2PPV 03-26-22 03-26-21 JRD Bordetella Injectable 03-26-22 07-29-20 KF Rabies Vaccination (I Year), #005972 Rabies Vaccine Information... MFG BY: ZOETI SER.NO: 446459 11,E rt 7� l V9 Thone Animal Hospital 902 S Hwy 30 Blair, NE 68008 402-426-3630 FOR: Britni Gothier 2304 Nebraska St Blair, NE 68008 (402) 332-9576 INVOICE ,3,17-J - Printed: 07-13-21 at 11:27a Date: 07-13-21 Account: 9927 Invoice: 101318 Date For 4ty Description 1 Puppy/Kitten Exam 07-13-21 Sid 1 DA2PPV 07-13-21 b u e�,� 1 Complimentary Nail Trim 07-13-21 O IV\0yl+�3 1 Boosters in 1 Month 07-13-21 1 Iverhart Max Puppy Pack #23236 07-13-21j.-1 Thank Youlll 07-13-21 07-13-21 Visa payment Merchant ID: 4445046763017, Approval code: 112636, Transaction ID: 1912060753 Ref #: 18920, Act #: ************8220, Exp: XX/XX, Entry: Contacticc, Card: VISA Your card balance is not available I AGREE TO PAY.ABOVE TOTAL AMOUNT ACCORDING TO CARD ISSUER AGREEMENT X Old balance Charges Payments 0.00 43.60 43.60 Last done Reminders for: Sid 05-16-22 Hwt Dog (Heartworm Test) 09-15-21 Rabies Vaccination (1 Year) 07-13-21 08-10-21 DA2PPV You Can Order Your Pet Supplies On animalcareofblair.com. Like us on Facebookl I Net Price 20.40 23.20 0.00 0.00 0.00 0.00 -43.60 New balance 0.00 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 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, 202 Owner Name: �\AlIf al-OZ6 Owner Address: \ o c)- 1--2 c_Zr 4 City/state/zip: Blair, NE 68008 ----��-��.� Phone * 4 � `K ~ S�� LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 ***PLEASE READ CAREFUU.Y*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so Is a violation of Clty ordinances 6.103 and caries a penalty of a fine up to $150.00 per pet PET LICENSES RENEWALS ARE DUE BY 311512022. The City shall recognize a microchip Identification number as the license number. It 5ha11 be unlawful for any dog or Cat to wear any license or other city Idendficatlon other than that Issued by the City of Blair for such dog or cat. the aw of Blair roquirtm proof of rabies vaaclnodon. Replacement Fee for Lost Tag: $5.00 bxkK d is a Stabs Fee of $1.25 being eolkx eed to fund the Nebmaslca Dog & Cat Operator Inspection Program PET #1)�Pog O Cat ,.Spayed/Neutered License Fee $ L \ , �'''0 Pet Name Birthdate�• - Sex Color T-� kc c.& Breed** q, Rep/acement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y''p N MICROCHIP # A\/ 10 a 1 lQ a Sy cad 40 (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE:',) U,-,) (3 yr) " (1 yr) City Tag #6 r__�4* 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 0 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 # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS LS 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 $ 1 0� If you have questions, please contact Blair Police Department at (402) 426-4747 +++++++++++++++++**++++++++++++++++++++++++++++++++++++++++++*++++++++.+++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (MroXSlatefee oel not aoirableJ6rneivpe 11xwA!&da&) Newly Aloouired Pam• lygwj&% idents to Blair._ is Must be ficer� within 10 days of ohmtTship ■ Must regisWr pets within 10 days of ■ COR> at 6 mon is of age if puppy/Idttw residency. 03/18/2022 16:34 4024260101 HOLSTEIN VET CLINIC PAGE 01/01 2022 PET LICENSE VERIFICATION/APPLICATIONA FOR CITYiOR cOF) BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND O COMPLETE THIS FORM AND RETURN WIT A CHF-CK PAYABLE TO: CITY OF BLAIR — 218 S. 16T" S — BLAIR, N6 68008 YOU MAY LEGALLY OWN A COMBINATION F FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADL LT CATS PER RESIDENTIAL OR DWELLING UNIT. ***PLEASE READ CAR FULLY';" YOU ARE RE IRED BYLAW TO LICENSE Y UR PETS. THE ITY OF BLAIR REQUIRES PROOF OF RA81E5 VACCINATION. Failure to do so is a violation of City Ordinances GA03 and ca ries a penalty of a fine up to $150,00 per pet. PET LICENSE RENEWALS ARE D E BY 15 2022. The city $hall recognize a microchip ID n mber as the license number, it shall be unlawful for any dog or cat to wear any license or other city 1D ther than that issued by the City of Blair for such dog or NEW PET LICENSING Must be licensed within 10 days of ownership (Oft) at 6 months of age if puppy or kitten NEW RESIDENTS TO BLAIR Must register pets within 10 days of resi ency owner Name Jane & LeRoy Graml�e-Stevens Spouse Owner Address :75 South 16 St. City/Stafie/Zip lailr, NE 68008 Phone -------------- # 402-278-2652 Pet Name: Dawson � � , � LIE FEE~;$ Age: I I Sex: Neutered Male olor: Whlte Intact DOB:—01-01-11 Dog or Cat: $16A Breed: Mix cat; $11.0Q Microchip # Rabies Tag # 17764 �. Rep/acemeA PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AV ILASLE): # $5,00 RABIES VACCINATION DONE ON 03-02-20 Total $ Rabies Description: 1 YEAR { 3 Holstein Veterinary Clinic Dr. Lisa Schrum DVM : Dr. Krista Holstein DVM 718 South 19111' Street Blair, NE •68008 402-426-7387 402-426-0101 Fax holsteinclinic@ gM6il.com PETS TNATARE ON THE AUIVE POTENTIALLY AANGERQ S OR DANGEROU OG LIST NEt O TD REGISTER DIRECTLYAr ITY HALL FAXED 03-18-22 M 01/29/2022 10:4 E BUT NO 4024260101 HOLSTEIN VET CLINIC PAGE 01/01 2022 PET LICENSE LIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG($) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE T0: CITY OF BLAIR — 218 S. 16TH ST — BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL. OR DWELLING UNIT. ***PLEASE READ CAREFULLY*** Fail re 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 RENEWg1S ARE DUE RY 3/15/2pz2 The city shall recognize a microchip Ip 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 JO OLAIR Must register pets within 10 days of residency Owner Name Spouse Owner Addres City/State/Zip Phone # Pet Name: Bear Age: 3Y DOB: 0617-18 Breed: Pomsky Microchip # PLEASE INCLUDE C11 RABIES VACCINAIT Rabies DescXiptio4: Holstein Dr. Lisa Schr m 718 South 1 neakes Sex: Neutered Male NUMBER IF THIS IS A DONE ON ' 1 70�23-19 MIA;] (eterinary Clinic VM ; ,Dr. Krista Holstein DVM :h Street Blair, NE 68008 187 402-426-0101 Fax clinic@gmail.com Anna Grant Sean 1244 S. 13th Ave Blair, NE 68008 402-616-1672 Color: Black and White Rabies Tag # 17342 (IF AVAILABLE): c YEAR LICENSE FEES Intact Dog or Cat: $16.00 Do or ca�.00 Replacement rag $6.00 Total PETS THATARE ON THE ACTIVE POTENTIALLY bANGEROUS QANGEROUS DOG LIST NEED %0 REGISTER DIAECTLYAT CITY HALL FAXED 01-29-22 BY %^ �� .f lily, lll_'� = .I�Jt�" �Ili'.•�.i. af. �•?�;,', �.,�y,n �•�4•�fJ'r �:1k,: kJ Y;li��i�,p�i':"„�iPi�, ��i�}..^ yy,;ri�A�);•,y�,.+',I`pp..1'�,R�y"�,�`��p �/(�y�/�� B�,v: ?i f� A'I:I�tsn? .YrA,'1iCYl.. �-A�711iill�`��fV 'd? llf •.l. �.il ^,F; ji 1�•: r"";i.' !?.Jli. rti,;.;1�� d i u 4'.r : • I'un�..�iiE1,7 I' � ;? �,i +{.��•� YIaiP� ' :,elf;>? i�Jl1'� f ;., J�:im<y�:il{.,j.,:�a�,RYr .1�(,i�.,�1�)?54�.m �? ,n(i i!�11K';'il�;'i 'n15• �`�� rubV' 1 �j iJ.r; ,M�. 01/21/2022 17:03 4024260101 HOLSTEIN VET CLINIC PAGE 02/02 2022 PET LICENSE VERIFICATION/APPLICATION AFOR CITY OOR FF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AOWN COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR — 218 5, 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*** p� U ARE REQUIREp_BY LAW TO LICEN51 YOUR PETS THE CITY OF BLAIR R" IMES PROOF Or 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 AItE DUE 8Y 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: Bailey Age: 14Y Sept: Spayed Female DOB: 06-03-07 Breed: Dach Mix Anna Grant Sean 1244 S. 13th Ave Blair, NE 68008 16.1672 IN Color; White/Tan Microchip # Rabies Tag # 19069 PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): # RABIES VACCINATION DONE ON 104-13-21 Rabies Description: (1 YEAR ) . 3 YEAR Holstein Veterinary Clinic Dr. Lisa Schrum DVM : Dr. /Crista Holsteln DVM 718 South 1911 Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteinclinic@gmail-com LKEN&E FEES Intact Dog or Ca4$16.00 A/ red p g or cat: $11 Replacement, Tad $5.00 Total PETS THAT ARE ON E AC POTENTIALLY DAN6 U5 OR _QA NGEROU DOG LIST EED Td EGISTER D ECTLY AT CITY HAL 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: 7r (� Owner Address: \� ��e- city/state/zip: Blair, NE 68008 � Phone # — LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PATS. rptium to do to Is a vlolatlon of CItV ordinances 6.103 and carries a p*nalty of a fine up to $150.00 Per PeL PET LICENSES RENEWALS ARE DUE BY,3f151jQ2j. The City shell recognize a microchip Identification number as the Ilcense 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 or Blair for such dog or cat The City of Blair requires proof of tables vaccination. Replacement Fee for Lost Tag: $5.00 Included is a StM a Fee of $L25 being coilected to fund the Nebraska Dog & Cat Operator Iron Program PET #1 ❑ `§fig ❑ Cat .,,Spayed/Neutered License Fee $ \ ,QQ Pet Name Birthdate -Ixoll Sex N--_ Breed**s Replacement $ Color 16 � - Declared Dangerous or Potentially Dangerous Dog: ❑ Y PN MICROCHIP # '�;�S U:1 CC�G 3" a�q(lf applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) Y.(1 yr) City Tag # t PET # 2 ❑ D o A ❑ C a t Jq Spayed/Neutered License Fee $ Pet Name'-SyN". N e\ k Birt date OSex _ Golortay�� t S,�F Breed**A Replacement $ Declared Dangerous or Potentially Dangerous Dog: Y 1�tN MICROCHIP # c,,11'aC��ulc�ac��t (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag #m PET #3 0 Dog O Cat ❑ Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: 0 Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ El 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.) Do Not Send Cash by Mal/ TOTAL ENCLOSED If you have questions, please contact Blair Police Department at (402) 426-4747 +++++++++++*+++++++++++++++++++++++++++++++++++++*++++++++++++++++++++++++.... NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Matdh YS /ate lee date not appJ/table for new peWnew re0wW Nsw ReAftntsz to Blair: ■ Must be Heaved vuit h 10 days of ovunetsrdp ■ Must register pets within 10 days of ■ <OR> at 6 months of age If puppy/W= n werq. -A EN LICATION CITY OF BLAIR - 2022 Pi E 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 * 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. 1% "- 1, f1\11 " - LICENSE RENEWALS ARE DUE: March 15, 2022 ***PLEASE READ CAREFULLY*** Owner Name: (X'\ A �Z C- 0 V- YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. owner Address: Lry- c yX 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 3/1512022. The City shall Phone # 0 9 9 1 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 T #1 Dog Ll Cat Spayed/Neutered License Fee $ 0 0 Name 113a xNNr" % C, n Birthdate lo--�',Io\XSex F P t C I or Breed** I eA V K0 Ack- Replacement $ 4. D clared Dangerous or Potentially Dangerous Dog: LJ Y N ROCHI p # /0(.)o (If applicable) SUBTOTAL:$ M C _ BIES VACCINATION DATE: q- aq - IS (3 yr) (1 yr) City Tag # N TT T #2 LJ Dog L] Cat LI Spayed/Neutered License Fee $ Pe Name Birthdate Sex Col r Breed" Replacement $ —Declared Dangerous or Potentially Dangerous Dog: LI Y LJ N MICROCHIP # (if applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) -- (1 yr) — City Tag PET #3 LI Dog Ll Cat LJ Spayed/Neutered License Fee $ Pet Name Birthdate —" Sex Replacement $ Color Breed Declared Dangerous or Potentially Dangerous Dog: Ll Y L3 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 fbrnewpets/new 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/kitten residency. N INVOICE Countryside Small Animal 1306 Stevenson PO Box 119 Fort Calhoun, NE 68023 402-468-4060 Printed: 07-01-21 at 4:26p FOR: Mike Green Date: 07-64-21 2382 Grant Circle Account: 1342 Blair, NE 68008 Invoice: 59165 (402) 573-1883 Date For Qty Description Price Discount Price 07-01-21 Sammie 1 Examination/Consult, Brief/Return 30.00 30.00 0.00 ** 07-01-21 1 Cytology, otic 20.50 Total charges, this invoice... 20.50 **Total discount included: 30.00 Your old balance... 0.00 Total payment(s) received... 20.50 07-01-21 Visa payment 20.50 Your new balance... 0.00 Your invoice total reflects our Good Clients discount. Reminders for: Sammie (Weight: 71.6 Ibs - 3y) Last done 09-23-22 Canine Rabies, 3 y 09-24-19 05-20-22 Heartworm Test, Antigen 05-20-21 09-03-21 Canine Bordetella Vaccination 09-03-20 09-03-21 Canine DA2PP-L 09-03-20 09-03-21 Lyme Disease Vaccination 09-03-20 Sammie's weight history (in Ibs) 06-07-21 71.60 09-03-20 84.00 06-02-20 75.00 02-25-20 77.00 09-24-19 71.20 08-13-19 73.60 06-11-19 63.80 03-04-19 60.00 12-28-18 45.80 12-01-18 41.00 NEW To Countryside Small Animal 02/14/2022 17:02 4024260101 HOLSTEIN VET CLINIC PAGE 01/02 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 0r 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 BY LAW TO LICENSE KWR PETS. THE CITY OF BLAIR REQUIRES PRqQLQEIARIKES VACCINATION. Failure to do so is a violation of Clty Ordinances 6.103 and carries a penalty of 0 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 IO days of ownership (OR) at 6 months of age if puppy or kitten' NEW RESIDENTS TO BLAIR Must register pets within 1.0 days of residency Owner Name Spouse Owner Address lag City/State/Zip Blair, NE 68008 Phone # C"I -A-A, Pet Name: Age. DOB: Sex: M ,n 1..� Color: Breed: Microchip #��—� Rabies Tag # PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): $t RABIES VACCINATION DONE ON 3 — � (In, — 0 0 Rabies Description: . 1 YEAR 3 YEAR —(� Holstein Veterinary Clinic Or, Lisa Schrum DVM ; Dr. Krista Holstein DVM 718 South 191h Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteinclinic@gmail.com LICIENSF—FEES Intact Dog or Cat: $16.0 Altered Dog or cat: $11'.00 Replacement Tag $5,00 4� f Total $ V 1a� — PETS THAT E ON THE ACTIVE POTENTIALLY N EROUS OR DANGERO S DOG LIST NEED TO REGISTER DIR LV T CITY HALL. CITY OF BLAIR - 2022 PE` 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 RENEWALS ARE DUE: March 1S, 2022 Owner Name: _K(-"C-.\.Cn, _ r <- '-=1 r — Owner Address. \'Qa5 N. �► ��( City/state/Zip: Blair, NE 68008 Phone # ��-S2 ,>z: '.) � 1:k I 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 ordlnanem &103 and carries a penalty of a fine up to $150.00 per pet PET LICENSES RENEWALS ARE DUE BY 31151Z022. The Clty 5hall recognize a microchip Identification number as the license number. It shell be unlawful for any dog or cat to wear any iieen5o or other city Identification other than that Issued by the City or Blair for such dog or rat. The Ctty of Mir requires proof of rabies vaodnatlon. Replacement Fee for Lost Tag: $5.00 Included is a state Fee of $1.25 being collected W fund the Nebradca Dog & Cat Operator Irq*c0on Program PET # 1 l� Dog ❑ CatSpayed/Neutered License Fee $� Pet Name Ey'�.i (�:�� r Birthdate - ,1 1. Sex M _ Color J� NS -,► �r Breed**y.�.:::ir.; -� 'T'r , r< Replacement $�,,,. ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # C)253!�5� =?,�k 1 (If applicable) SUBTOTAL: RABIES VACCINATION DATE: cl -moo ao (3 yr) _ __ (1 yr) City Tag # `,' fj * PET #2 Q Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name _. Birthdate Sex Color Breed** Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y U N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Feet Pet ,Name Birthdate Sex Color Breed** Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # Of applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS 13 A RENEWAL ** (This fee Is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mall TOTAL ENCLOSED $ U �- If you have questions, please contact Blair Police Department at (402) 426.4747 ++++++***.F.+++++++++*.++*++++++++++++++++++++*.r*++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Mardh 154& &e date not ap#14able (or mew pets bew msrrl nt ) Ney&Aodnulirrd PdS: New Residents to.0laln ■ Must be immd within 10 days of w"rshp ■ Must register pets within 10 days of 0 COR> at 6 mor2t'ty of age K puppy/ �• 02-1QPCT LICENSE VERIFICATION/APPLICATION pOR CITY OF BLA.IFr IF YOU LIVE IN F LAZR CITY LIMITS AND OWN A DOG(5) AND /OR CAT(5), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO; CITY OF BLAIR -- 218 Sa 16TH ST -- BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION or 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 A ERE U RED OY LAW TO LICENSE YOUR PETS, Failure to do %) Is a violation of City OrdinanCas 6.103 and carries a penalty of a flee up to A50A0 per pet. PET LICENSE RENEWALS ARE DUE BY 3 15 2021. The city shall recognize a microchip la number as the license nUMber. it shall be unlawful for any dog or cat to Wear any llcf�nsy or other city ID other than that issS of ay h� City of or kitten for r S ch dog or cat. NEW.PT LICENSING Must be licensed within 10 days of ownership (OR) p ppy NEW RELIDENTS TQ BLAIR Must register pets within 10 days of residency Owner Name Spouse owner Address City/state/zlp Rhone # .�L#orDOB Holstein Veterinary Clinic Dr, Lisa Schrum DVM : Dr. Krista Holstein DVM 718 South 19th Street Blair, NE. 68008 402-426-7887 402-426-0101 Pax holsteindinicftmail,cOm Ann Grinborgs Tim 2130 Jackson St Blair, NE 402-426-3517 629000498 FBY ED05-22.21 13 LICENSE. FEES Intact Dog or Get: $16.00 Dag ar cat; $11-00 Replacement TO $,5.00 Total $„� C (A - CITY OF BLAIR - 20 2 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 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. uluo' LICENSE RENEWALS ARE DUE: March 15, 2022 - ***PLEASE READ FULLY*** Owner Name: 1YAV 1lS Nit A00 I YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Owner Address: I Uo P� n n1wo(A LV 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 # 0 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: $1.1.00 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 K Dog Ll Cat Birthdate Spayed/Neutered License Fee $ Pet Name I rthdate '2-12,oil Sex t 1) Color t(AL Breed" lWVVA Replacement $ Declared Dangerous or Potentially Dangerous Dog: LI Y % N MICROCHIP # (If applicable) UBTOTAL:$. RABIES VACCINATION DATE: 7-1 _ (3 yr) — (1 yr) /S City Tag # PET #2 LJ Dog FJ Cat U Spayed/Neutered 0J Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: L1 Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) — ME Replacement $ 11,00 SUBTOTAL: $ (1 yr) City Tag # PET #3 LJ Dog U Cat LJ Spayed/Neutered License Fee $ Pet Name Birthdate Sex Replacement Color Breed" — Declared Dangerous or Potentially Dangerous Dog, Cl Y U 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 newpet5lnew resIdents) Newly Acquired Pets: New Residents to Blair: ® Must be licensed wM!n 10 days of Ownership ® Must register pets within 10 days of ® <OR> at 6 months of age if puppy/kitten residency. , _-__-_-----------� | - _� ______ ___=_'--_-------------------------- �__----- --' � Animal S�~��pn Neuter — Clinic— \ 4970 NW Radial Hwy. NE 68104 � 402��,�^~~~~~ ) Street city state Zip THIS CERTIFIES THAT i / Name of Pet r | ` Date of Birth El Intact Breed Sex Itered color of Markings Date / . WAS VACCINATED AGAINST` ao�/w________-nw � ^ nume ��m�o /�u nume ==. 'Ell �v�x�oam ` []oyear Rabies Vaccination Expiration Date � �I Canine Distemper [] Feline Distemper . An «un/no *opm`.m» Feline nmov/m: vma i mm��m�mym ummm �] Feline mu / Canine porainouunm [] Feline Leukemia . � ` cumn p�mvw�m O3 Stool Exam ' ^' Canine omumolla ' Test By Veterinarian CITY F BLAIR — Y .< 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 Owner Name: st k t ,r1 C u. d ex sn n Owner Address: 9 0 Cl cl. City/State/Zip: Blair, NE 68008 Phone # 4 OD_ q 6 " 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 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 PET #1 .4 Dog ❑ Cat bi Spayed/Neutered License Fee , 06 Pet Name RoA L , LD ! f,Q, Birthdate 0-aOIS Sex F Color r oo O N Breed** P(A Q Replacement $ Declared Dangerous or PotentialNa ngerou Dos g: ❑ Y AN MICROCHIP# 9 q 5) 1c�oicoo (If applicable) SUBTOTAL: RABIES VACCINATION DATE: o ` - (3 yr) _� (1 yr) City Tag # / 7 PET #'2 Dog ❑ Cat Spayed/Neutered License Fee Pet Name Birthdate - f v Sex Color Breed** ' Replacement $ ** Declared Dangerous or Potentially Dangerous og. ❑ 4N MICROCHIP #1 +r rra.a (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: J--`�,L ,m � (3 yr)(1 yr) City Tag # 4. 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) _ (1 yr) Replacement $ * * *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 ENCLOSE v . 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 newpet5/newre5ldent7) Newly Apguired 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. J III IS 69J 62 1 WA M' Date of Rabies Vaccination: 03-24-20 Certificate No: 0 Next Rabies Vaccination On: 03-24-23 Previous Rabies Vaccination: 15112 VETERINARY CLINIC OWNER OF ANIMAL Holstein Vet Clinic Esther Gunderson 718 South 19th Street 909 N 26th Ave Blair, NE 68008 Blair, NE 68008 4,02-426-7387 County: This is to certify... THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW. Patient information... PATIENT: Puga SPECIES: Canine SEX: S Color and markings... Black Signed Lisa Schrum, DVM �--o U Fj-cjzquw� License: 2310 Due Date I Vaccinations 03-24-21 Vangard Plus 5 L4 03-24-23 Denfensor 3 (3 Year Rabies) Rabies Vaccine Information... MFG BY: ZOETI SER,NO: 358351 LOT EXP: 10/20/20 ADM: SQ CERT IF I CATIE QFAACC IN AT ION VETERINARY CLINIC Holstein Vet Clinic 718 South 19th Street Blair, NE 68008 402-426-7387 Certificate No: 0 Previous Rabies Vaccination: 14473 OWNER OF ANIMAL Esther Gunderson 909 N 26th Ave Blair, NE 68008 County: This is to certify... THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW. I m U4 wa RUOTE 717TTOT, 10 ?�ATIE-NT: Bella Mae TAG NO: 1699-6 SPECIES: Canine WEIGHT: 21.50 SEk S AGE: 4 years mwrsmm,fit ' MFG BY. ZOETI SER.NO: 3225' LOT EXP: 04-20-21 ADM- SQ I CITY OF BLAIR- 2022 PIET 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 f Blair e 218 S 16th St e BlairFNE 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 U arch 15, 202 Owner Namei -1 e.o l 7 t+ h er SI o Owner Addre . 7 5 .:-11 Phone # 4y LICENSE FEES: Dog or Cat., $16.00 „d •ia !1 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 . If s . . ter.''^ :� i+ i ►� =• .<� i� . . ,. �r ► •. �� ti �(� Proaram PET # 1 hDog ❑ Cat ElSpayed/Neutered License Fee $ Pet Name V ck,' Birthdate -/ -, 6Sex M Color ,A ,l c� r . Breed** � , cv<1 � e�� Replacement $ ** Declared Dangerous or Pot e tially Dangerous Dog: ❑ Y eq N MICROCHIP # VA / / � b� � Gr l— (If applicable) SUBTOTAL: 0 0 RABIES VACCINATION DATE: 0,-- )a1 (3 yr) (i yr) City Tag # a4iv 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, U TOTAL: RABIES VACCINATION DATE: (3 yr) (i yr) City Tag PET #3 L3 Dog L1 Cat L1 Spayed/Neutered License Fee Pet Name Birthdate Color Breed** Replacement $ Declared Dangerous or Potentially Dangerous Dog: Ll Y L1 N MICROCHIPapplicable)OTAL:$ RABIES VACCINATION DATE: *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 / / ' 0 0 If you have questions, please contact Blair Police Department at (02) 26-4747 ..........++++++++++++.++*+.....++++++++++.+.....++++++.....++++++............ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Marah15late fee datenot appl/cablefornewpetVnewresldents) Newly ftulted PON, New Residents to Blair' Must be licensed within 10 days of mnership 0 Must register pets within 10 days of <OR> at 6 months of age if puppy/Wen residency. N V 0 1 C E Holstein Vet Clinic 718 South 19th Street Blair, NE 68008 402-426-7387 Check out our online store at www.HOLSTEINVET.com for home deliveryl Printed, 09-08-21 at 10:26a FOR: Jeff Gunderson Date: 09-08-21 758 S 16th St APT 192 Account: 10272 Blair, NE 68008 Invoice: 121711 (402) 426-5914 Date For Qty Description Net Price 09,08-21 Yoda 1 INTERCEPTOR PLUS 8-25# 12 DOSES (GREEN) 72.00 09-08-21 Visa payment -72.00 Old balance Charges Payments Now balance 0.00 72,00 72.00 0.00 Reminders for: Yoda (Weight: 16.6 lbs - 14y) Last done 05-07-22 Denfensor 3 (3 Year Rabies) 05-08-19 03-31-22 Vangard Plus 5 03-31-21 03-31-22 Bronchi Shield - Oral Bordetel 03-31-21 Thanks for choosing us to take care of your pet's health care needs! LZ 0 Aliz 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 RENEWALS ARE DUE: March 15, 2020 Owner Name. Owner Address: City/state/zip: Blair, NE 68008 3 _ 1 Phone # Drivers License # or Date of Birth LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 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 3/15/2020. 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. bnciutaeti is a State Eee of !i;s.zS being couecten to tuna the Nenrasaca Log & c:at uperator tnspecoon Frograi� PET # 1 ` D o g ❑ Cat Spay d/Neutered License Fee $ Pet Name ( .: ix - `�� , Birthdate 0Sex Color Breed** —Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable SUBTOTAL: $ RABIES VACCINATION DATE: l lzI a9-1 (3 yr) (1 yr) City Tag # 4' PET # 2 D o g ❑ Cat Spayed/Neutered License Fee $ t �" Pet Name Bi hdate ``�L l ✓S Sex Color T (\, Breed** i t16�P, ei,n cs'c- Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: l ? -aft (3 yr) (1 yr) City Tag # oZ * PET #3 ❑ Dog' Cat Spayed/Neutered License Fee $ Pet Name&j Birthdate Sex Color VNk,, c 1 ._ Breed** r)"Vy Replacement $ ** Declared bangerous or Potentially Dangerous Dog: ❑ Y (N MICROCHIP # I (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # 3376 *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.) VISA / MC # Signature Do Not Send Cash by Mail TOTAL ENCLOSED $ Expires Security Code: If you have questions, please contact City Hall at (402) 426-4191 or by Fax: (402) 426-4195 ++++++++++++++++++++++++++++++++++++++++++++++.+++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15late fee date not applicable fornewpets/new residents) Newly Acquired Pets: New Residents to Blair: ■ Must be licensed within 10 days of ownership it Must register pets within 10 days of s <OR> at 6 months of age if puppy/kitten residency.