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L`OVA 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 dog$: or three (3) adult cats per residential or dwelling unit. -� LICENSE RENEWALS ARE DUE: Larch 15, 2022 Owner Name:'" d 6 Owner Address: ` -t City/State/Zip: Blair, NE 68008 Phone # l / ***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 LICENSE FEES' Dog or Cat' $16.00 cat. The City of Blair requires proof of rabies vaccination. Altered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET #1 0 Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Cro�r i c = i< �, Birthdate ,� ,4 Sex Color r i0' k � Ls' V. ; 1 Breed** Replacement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y 91 N MICROCHIP # (If applicable) SUBTOTAL: $. RABIES VACCINATION .DATE (3 yr) " (1 yr) City Tag # PET #k2 ' ❑ 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 Mari TOTAL C LOS D $ If you have questions, please contact Blair Police Department at (402) 426-4747 +.+++++++¢+-............+++.++++++++.....+++++¢¢....++++++.................+. NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15late fee date not app/icab/efornewpets/new residents) Newly Acquired Pets: New Residents to Blair: • Must be licensed within 10 days of ownership is Must register pets within 10 days of • <OR> at 6 months of age if puppy/kitten residency. PPLICATION )PE�' I EC)NGSEA 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 check made payable to: City of Blair e 218 S 16th St a Blair, NE 68008 You may legally own a combination of four (44) adult pets, but no more thane ,three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March15, 2022 Owner Name: Owner Address: city/State/zip: Blair, NE 68008 Phone #fi 1\ - "�s `� rI 1 \-�- LICENSE FEES: Dog or Cat- $16.00 ***PLEASE READ FULLY*** 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 $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET #1 �d Dog ❑ Cat 12 Spa�ed/Neutered License Fee�� • o Pet Name\ n V\_Y Birthdate Z),o Sex `,�_ Color \- �; I Breed** Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y -4 N MICROCHIP # — (If applicable) SUBTOTAL: $-- RABIES VACCINATION DATE: �� -\ \ - �.e"Z�2 (3 yr) ,,--__ (1 yr) ':W V City Tag # T # 2 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate _ Sex Color _ Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: _ (3 yr) _ m (1 yr) License Fee $ Replacement m 'f #3 ❑ Dog ❑ Cat, ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # I (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: 1 (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 .....++.+++...................--x....+.++.+..........++++++.++.+++.++++........ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS(March 15late fee date not applicablefornewpets/newre5idents) Newly Acquired Pets: New Residents to Blair: • Must be licensed within 10 days of ownership w Must register pets within 10 days of • <OR> at 6 months of age if puppy/kitten residency. CITY OF BLAIR - 0 2� ')ET 'E�NSE 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 City of Blair ® 218 S 16th St e Blair,, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three. (3) adult dogs or three (3) adult cats per reside ntial or dwelling unit. [-- A \ 1� I i '� A A - —, ('V I LICENSE RENEWALS ARE DUE: March IS, 2022 Owner Name: 1�h,4( Owner Address: City/State/Zip: Blair, NE 68008 Phone # YP2- 441110-53y — to: I I IA-r, � ***PLEASE READ CA4FdLL , �* "I % YOU ARE REQUIRED BY LAW TO LICENSE YOLittE1. Failure to do so is a violation of City ordinances 6,103 and ca,rils' a penalty of a fine up to $150.00 per pet. 11k, PET LICENSES RENEWALS ARE DUE BY 3/151262. The City shall recognizea 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 I f t-r Replacement Fee for host Tag: $son Included is a State Fee of $1.2S being collected to fund the Nebraska Dog Sc Cat Operator Inspection Pr9gram PET #1 Z Dog LJ Cat W Spayed/Neutered License Fee $ Pet Name bl/ Birthdate 21;411C. Sex olor ."V- - Breed" bkftz Replacement $ TOTAL: 1� ' eclared Dangerous or Potentially Dangerous Dog: J Y 4 N - A— — I I Ii V R CROCHIP # 7 -r le o6 # poll ;t 1/0 7,14 (If applicable) SUBTOTAL: BIES VACCINATION DATE: N y/ 2?,._ (3 yr) — (1 yr) _ City Tag # i, PET #2 LJ Dog LJ Cat LJ Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Replacement $ Declared Dangerous or Potentially Dangerous Dog: D Y LJ N MICROCHIP # (If applicable) SUBTOTAL:$ RABIES VACCINATION DATE: (3 yr) _ (1 yr) — City Tag # PET #3 0 Dog LI Cat J Spayed/Neutered Pet Name Birthdate Sex Color Breed" Declared Dangerous or Potentially Dangerous Dog: LJ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: — (3 yr) — License Fee $ Replacement$ LJ 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.) DoNot Send Cash by Mail TOTAL ENCLOSED $ k kok 777-7 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 newpets/neW re5ldel&) Newly Acquired Pets: New Residents to Blair: • Must be licensed within 10 days of ownership ® Must register pets within 10 days of • <OR> at months of age if puppy/kitten residency. If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City Of Blair ® 218 S 16th St 0 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 c; Owner Name: �h et 1'*��.All- /J- 6 : �—' 0) C vt Owner Address: �Tz 7 5—"' ° 2. 3 4 y ' City/State/Zip: Blair, NE 68008 Phone # Rio., - 7qO -- 0 z 3 3 c s,VU 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 W Dog ❑ Cat 3 Spayed/Neutered License Fee $ 1( � 0c' Pet Name �(-o bo Birthdate N 3ca, to Sex i� Colora�uL' t tJ(Breed** G� ®� Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # J 0t o aooc) 5 3 (If applicable) SUBTOTAL: $ 0 tABIES VACCINATION DATE: 1 (3 yr) ✓ (1 yr) _ City Tag # PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate _ Sex _ Color Breed** _ Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) _ (1 yr) City Tag # PET #'3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** 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 $ 11, 06 If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++.....++++++.....++++++......¢.........++++++++++++++++++...............+ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date not applicable fornewpets/new residents) Newly Acquired Pets: New Residents to Blair: • Must be licensed within 10 days of ownership N Must register pets within 10 days of • <OR> at 6 months of age if puppy/kitten residency. 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: Mwarch 15. 2022 Owner Name: Owner Address: �� (�� A�� Sh_i_Y�-� Z�► _5� city/state/zip: Blair, NE 68008 Phone # q l a -- Ll 90 -31 y �1 LICENSE FEES: Dog or Cat: $16.00 1 d D or Cat° $i 1 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. A tere og 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 TT .## 1 Dog ❑ Cat JA Spayed/Neutered License Fee $ 11_ O C`� Name e r Birthdate Sex F ** I r (�[i�T ►�� C� Breed** ��ric c1��rn,_ ►`� r; < Replacement $ De lared Dangerous or Potentially Dangerous Dog: ❑ Y W7 N \4 R.00HIP # l �� J �� (If applicable) SUBTOTAL: $ IES VACCINATION DATE: (3 yr) �S,— (1 yr) City Tag # 5 T #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ t Name Birthdate Sex _ ** Color Breed** s 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 ❑;,Ca t ❑ Spayed/Neutered License Fee $ Birthdate Sex Pet Name � Breed** Replacement$ ** Color 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 ENCLOSE If you have questions, please contact Blair Police Department at (402) 426-4747 .....+++++++.++++...............4...............+++++++++++..........++++++... NEW PET/ NEW RESIDENT LICENSING REQUIREMENTS(March15late fee date not applicablefor newpe&lnewle5/dents) NewlyAcquired Pets: New Residents to Blair: • Must be licensed within 10 days of ownership m Must register pets within 10 days of • <OR> at 6 months of age if puppy/kitten residency. WESTGATE Westgate Animal Clinic 8258 HASCALL ST OAIAHA, Nebraska 68124 402-769-0377 - contact@westgateomaha.coni Rabies Certificate 13-Nov 2021 Client ID; 6989 Patient ID; 13913 Client Name: Sherri Levers Patient Name; Meeka Address: 2103 Washington St Species; Canine Breed: Yorkie Color. Tri-color Blair, NE 68008 Sex; Spayed Female Spayed/Neutered: Y Microchip: 043.076.537 Phone: 712-490-3147 / / Birthday: 2012-11-17 Weight; 5.2lb Tag Number. 212391 Vaccination Date: 13-Nov 202 i Batch Number. 231150 Vaccination Expiration Date; 30-Jun 2022 Rabies Vaccination Rabies Vaccination - 3-Year (Canine) Vaccination Due Date: 13-Nov 2024 Manufacturer: Mena) K / MLV I R: KILLED Veterinarian: Dr. Amy Grant License Number: 3134 CITY OF BLAI 2 PE6 NSE A�O(�PLICATION- 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 9 218 � 16th St e Blair,, NE 68008 Y6u'mziy 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, 202 Owner Name: Owner Address: 0, 1A (,L City/State/Zip: Blair, NE 68008 Phone # LA L" -1— LICENSE FEES: Dog or Cat: $16.00 Alf- A nn or rnil-- itil oo LAj A 00-1 t14 ***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 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 _W Dog L1 Cat LJ Spayed/Neutered License Fee $ 0 -PetName Birthdate 110)114 Sex % Repla olor Breed" cement $ i eclared Dangerous or Potentially Dangerous Dog: L1 Y L4 N I ISUBTOTAL:$ CROCHIP # (V2,'v,-'-)A]L4J, ' (If applicable) City Tag # I BIES VACCINATION DATE ) —,-L (3 yr) yr) r, - ff ET #2 CA Dog 121 Cat Spayed/Neutered License Fee $ !t Name Birthdate 1 r-3 iAj Sex t$ n, ci r Breed" Replacemen n F-1 V V1 N1 aclared Dangerous or Potentially LJCIHyr-IUU,) Ug ROCHIP #,'-,I %'I L-1 L) 1,3"1 1, VT,�, (If applicable) SUBTOTAL:$ BIES VACCINATION DATE: —31-�,, (3 yr) — (1 yr)—fL City Tag # 4 % 6 PiT #3 Ll Dog �!, Cat Q, Spayed/Neutered License Fee $ 5'A Pet Name iSex , Birthdate 1-i-1A -7--cf-7% % L Color " 7- Breed** 4,,�Replacement$ r-1 V FA KI IV ' it': E Declared Dangerous or Potentially Dangerous Dogs MICROCHIP # I Li i 0-) - I 1 -"),0 1 (If applicable) SUBTOTAL:$ 2 RABIES VACCINATION DATE: -7 J,--m�:j (3 yr) — (1 yr) 7 City Tag *PLEASE INCLUDE THE crr1 IAGAUMBEft IFTHIS 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 $ Al� 0It If you have'questio'ns, ple'6se contact Blair Police Department at (402) 426-4747 .............................................................................. NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15 late fee date not applicable formJwpelylnew residents) Newly Agguired Pets: New Residents to Blair: • Must be licensed within 10 days of ownership m Must register pets within 10 days of • <OR> at 6 months of age if puppy/kitten residency, rrry 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 I h check made payable to: City of Blair e 218 S 16th St 0 Blair, NE 68008 4j, adult but no more than three (3) adult or three (3) adult cats per residential or dwelling u—niF— LICENSE RENEWALS ARE DUE: M-a—rc—h-15, 2022 Owner Name:cc- Ownermdres-s— City/State/Zip: Blair, NE 68008 Phone LICENSE FEES". Dog or Cat: $16.00 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 311512922. 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. I-t-cluded is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat operator Inspection Program Ah PET #1 Dog 0 Cat Spayed/Neutered License Fee $ --Lnoo —, Pet Name C-;<% Biate bfttV0r\ Sex Breed** Lv- Replacement Color V�,To — — — — — — I 2-=4— � =x\ 1A N Declared Dangerous or Potentially Dangerous Dog: LJ Y SUBTOTAL: $ MICROCHIP # 9S:) applicable) RABIES VACCINATION DATE: X (1 yr) _City Tag# PET #2 Dog Cat Spayed/Neutered License Fee $ L Sex F Pet Name.. (!V-1-0 Birthdate !L-i-,—ntn0wT\ Replacement$ Color Breed—, Cc-, * . Y No N Declared Dangerous or Potentially Dangerous Dog: L3 f applicable) SUBTOTAL: $ MICROCHIP # 1—C (I1 RABIES VACCINATIONE: 0, k2j,1a (3 yr) — (I yr) K City Tag #-2--9S' PET #3 0 Dog *Cat )i Spayed Neutered License Fee $ Pet Name �x-cozi(PAk Birthdat**e Sex Replacement $ Color VL-6y-0 �? 7>-ki--i Breed Declared Dangerous or Potentially Dangerous Dog: Ll Y rVN MICROCHIP # (it applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) _,YL_ 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 ............................................................. t ................ NEW PET/ NEW RESIDENT LICENSING REQUIREMENTS (March 15 late fee date not aPPIIMble fOrnewXtylnew residents) Newiv Acquired Pets: New Residents to Blair:--, In Must be licensed within 10 clays or owne'5111P w Must register pets within 10 days of In <OR> at 6 months of age if puppy/Wen residency. � ��m��Km/�� ..~~.~~~~—'~ -_- Clinic 71OSouth 10hStreet Blair, NE 88008 402'426-7387 Printed: O3-08'22at4:04p CLIENT INFORMATION Name Heidi Livermore (2274 Address 1408Perk Street Blair, NE 68008 Phone 402 426-8241 Work-4U2-42O'0185 Cell 402'216-2931 ` PATENT INFORMATI Name 0uinnoy . Species Canine ` Sex Male, Neutered Breed Beagle Birthday 02-29-12(unknown) Age 10y(unknown |D Rabies 3O155 . Color Bnown8Nt Weight 30.90!bo Reminded (none) Codes Reminders for: Quincey Lax\done � 11'01-20 BrwnchiShield-onml Boroezn/ 11~02-1= . v 03-22-20 H%vtDog (HearbmormTest) 03-23'9 0 MW M*� me MOM s ,T1'ETEKfA-A-T<T-UZN Holstein Vet Clinic 718 South 19th Stree Blair, NE 68008 402-426-7387 Certificate Previous Rabies Vaccination - OWNER OF ANIMAL Heidi Livermore 1466 Pavk Street Blair, NE 68008 County: This is to certify... THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW. Signed Lisa Schrum, DVM Rabies Vaccine Information... MFG BY: ZOETI SER.NO: 553917A LOT EXP: 04/25123 ADM: SQ Holstein Vet Clinic 718 South 19th Street Blair, NE 68008 402-426-7387 Check out our online store at www.IAOLSTEINVET.com for home delivery! Printed: 03-10-22 at 4:13p FOR: Heidi Livermore Date; 03-10-22 1466 Park Street Account: 2274 Blair, NE 68008 Invoice: 126343 (402) 426-8241 Date For City Description Net Price 03-10-22 Cleo I Your Receptionist is Sadie 0.00 03-10-22 1 Vaccinate& Mini Exam 18.00 03-10-22 1 Defensor 1 ( 1Y RABIES) 26.50 03-10-22 1 Felocell 3 { Feline Distemper 25.25 03-10-22 Visa payment -69.75 Old balance Charges Payments 0.00 69.76 69.75 Reminders for: Cleo (Weight: 5.7 lbs - 19y) Last done 03-10-23 Defensor 1 (1 Year Rabies) 03-10-22 03-10-23 Felocell 3 03-10-22 Thanks for choosing us to take care of your pet's health care needs! New balance 0.00 Holstein Vet Clinic 718 South 19th Street Blair, NE 68008 402-426-7387 Printed: 03-10-22 at 4:14p CLIENT INFORMATION Name Heidi Livermore (2274) Address 1466 Park Street Blair, NE 68008 Phone 402 426-8241 Work:402-426-6135 Cell 402-216-2931 PATIENT INFORMATION Name Scarlet Sex Female, Spayed Birthday (none) ID Color Flame Pt Reminded (none) Reminders for: Scarlet 11-03-22 Defensor 1 (1 Year Rabies) 11-03-22 Felocell3 MEDICAL HISTORY Date 11-03-21 Species Feline Breed Dmh Age Rabies Weight 10.80lbs Codes Las(done 11-03-21 11-03-21 By Code Description KKH 1 EXAM Examination - Office Visit 8CAP11.4 Capstar 11.4 MG -Feline PER TAB 2DEPO Depo-Medrol Inj < 1 CC 420001 Felocell 3 { Feline Distemper) 4RAB1 Defensor 1 { 1Y RABIES ) Patient Chart Qty (Variance) Photo ICATION CM[YOT-SLAIR-U2 ETL11CSE*AP1PL51q3 If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair ® 218 S 16th St e Blair, NE 68008 You may legallyown 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 LICENSE RENEWALS ARE DUE: March M 2022 ***PLEASE READ . CAREFULLY*** Owner Name: Li Kj�"I�t YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Owner Address: NJ,f Failure to do so is violation of City ordinances 6.103 and carries a penalty of a fine up to siso.00 per pet. City/State/Zip: Blair,, NE 68008 PET LICENSES RENEWALS ARE DUE BY 3115/2022. The City shall Phone # 7-1 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 ' 11 ET #1, Dog Ll Cat dSpay /f euterSd License Fee $ &,� [��e , Birthdi eex F- et Name ite $ -I' V V Replacement olor Ir Breed- 0 1A -'I 01 jeclared Dangerous or Potentially Dan rQ Y LJ N ca SUBTOTAL: ICROCHIP e) # [�J- If BIES VACCINATION DATE-� jr��,�� (3 yr) - (1 yr) City Tag $ET #2 LJ Dog Ll Cat LJ Spayed/Neutered et 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 Ll Cat L1, Spayed/Neutered Pet Name Birthdate Sex Color Breed" Declared Dangerous or Potentially Dangerous Dog: LJ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: i (3 yr) - M License Fee $ Replacement $ SUBTOTAL: $ - (1 yr) _ City Tag # License Fee $ - Replacement$ Ll IN 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 151ate fee date notapplicable for newpetylnew residents) Newly Acquired Pets: New Residents to Blair: • Must be ljoensed within 10 days of ownership m Must register Pets within 10 days of • <OR> at 6 months of age if puppy/kitten residency. 03/12/2022 09:24 4024260101 HOLSTEIN VET CLINIC PAGE 01/p1 2022 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOGS) AND /OP CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR, — 218 S. 16TH ST — BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT. ***PLEASE READ CAREFULLY' YOU ARE REQUIRED BY 4AW TQLIQN$E YOUR PETS THE CITY OF BLAIR REQUIRES PROOF OF RABIES VACCINATION. Failure to do so is a violation of City Ordlnances 6.103 arid carries a penalty of a fine up to $150,00 per pet. PET LICENSE RENEWALS ARE DUE BY 3/1512022. 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 Diane Logemann Spouse Shirley Owner Address 736 South 13th St Apt 25 City/State/Zip Blain, NE 68008 Phone # 402-870-7149 3 Pet Name: Buddy Age: cjy,l- ? DOB: (none) Sex: Neutered'Mele Color: Breed: Dlh Microchip # Rabies Tag # PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): # RABIES VACCINATION DONE ON 03-12.22 Rabies Description: 1 YEAR 3 YEAR Holstein Veterinary Clinic Dr. Lisa Schrum DVM ; Dr. Krista Holstein DVM 718 South 19t' Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteinclinic@gmail-com LICENSE FEES Intact' Dog o'r Cat: $16.00 ere D g or cat: $11. 0 R atom ag $5.00 �-vVp Total $ PETS THAT ARE ON THE ACTIVE POTENTIALLY DANGEROUS OR DANGEROUS DOG LIST NEED TO REGISTER DIRECTLY AT CITY HALL. FAXED 03-12-22' E ('E �,7y�:��:Yi�3:��I;:: J,r.��1. rt,: •soA„ ir,�,.,, s,. r,,•,I.: �i2�:s,'. rra�• i�N i1:�:GYl1 n }rfi elx� I I ® 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 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:-Tee''e — Owner Address: 3 -) re i` 1 ar City/State/Zip: Blair, NE 68008 Phone # ?�62'1" 3 S-10 -A D 6 3 LICENSE FEES: Dog or Cat: $16.00 d D 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. Altere og or 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 Spayed Neutered License Fee $ Pet Name / Birtl�ida*e - _&_-A _u_ Sex � Re lacement$ ** Color w . / An Breed � dais _ p Declared Dangerous or Potentially Dangerous Dog: ❑ Y Id N MICROCHIP # qy5' dal (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) >< (1 yl') City Tag #' PET # 2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name__ _ Biithdate Sex _ ** Color Breed** Replacement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # _(If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name — Birthdate Sex ** Color Breed** Replacement $ 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.) 60 Do Not Sena Cash by Mail TOTAL ENCLOSED If you have questions, please contact Blair Police Department at (402) 426-4747 ............... a ....+++.++++++++.........++++++............ .... a+++-r..+.+.... NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date notapplicable fornewpets/newre5idenls) Newly Acquired Pets New Residents to Blair: • Must be lioansed within 10 days of ownership w Must register pets within 10 days of • <OR> at 6 months of age if puppy/kitten residenqt. 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 RENEWALS ARE DUE: March 15, 2022 A Owner Name: t � 1 I V- T�j Owner Address: t City/State/Zip: Blair, ( r, N E�68008 Phone # Lk)a - _ 101 aLj L 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 #1 Dog ❑Cat Spa d/Neutered License Fee $�% Pet Na e — Birthdate •1 Sex ** Color Breed** Rep/acement $ Declared Dangerous or Potentially Dangerous Dog: Y ❑ N MICROCHIP # (If applicable) ' SUBTOTAL: $ RABIES VACCINATION DATE: 0.11.-QM1 (3 yr) _,_ (1 yr) City Tag # �' 3 PET # 2 Dog ❑ Cat pa ed Neutered �-^ ��- -1Sex 1� License Fee $ C 1 CQ Pet Name Color Bi hdate Breed** Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N i MICROCHIP # (If applicable,) SUBTOTAL: $ City Tag #k RABIES VACCINATION DATE: ��- (3 yr) (1 yr) 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 (March15late 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. Blair Small Animal Clinic PC David E, Johnson DVM 1734 Front Street Blair, Nebraska, 68008 (402) 533-2722 Page 1 / 2 3 Mindy Logston Client ID: 875 208 Jackson Street Invoice #: 164957 Blair, NE 68008 Date: 10/11/2021 10/11 /2021 Reminder 01 /12/2022 06/11 /2022 10/11 /2022 1 /2024 10/11 /2021 Reminder 07/15/2022 10/11 /2022 03/02/2024 Patient ID: 10472 Weight: 32.60 pounds Patient Name: Rudy Birthday: 09/13/2016 Species: Canine Sex: Neutered Male Breed: Cocker Spaniel Description Examination General Rabies Vaccination - Canine Syr Intranasal Bordetella/Parainfluenza Distemper Hep Lep Parvo-Annual Interceptor Heartworm Prev. Reminder Heartworm Test - Snap RT Distemper Hep Lep Parvo-Annual Intranasal Bordetella/Parainfluenza Rabies Vaccination - Canine Syr Staff Name Quantit Total David E. Johnson DVM 1.00 $26.28 1.00 $29.66 1.00 $33.30 1.00 $38.10 Patient Subtotal: $127.34 Patient ID: 1104 Weight: Patient Name: Dazzly 01 Birthday: Species: Canine r Sex: Breed: Mixed Breed Description Staff Name Quanti Examination General David E. Johnson DVM 1.00 Distemper Hep Lep Parvo-Annual 1.00 Intranasal Bordetella/Parainfluenza 1.00 Patient Subtotal: Heartworm Test - Snap RT Distemper Hep Lep Parvo-Annual Intranasal Bordetella/Parainfluenza Rabies Vaccination - Canine Syr 55.50 pounds 03/01 /2007 Spayed Female Total $26.28 $38.10 $33.30 $97.68 Order your pets supplies online now through our website www.blairsmallanimalclinic.vetsfirstchoice.com For questions contact us at 402-533-2722. Jan 06 22 10:32a Thone Animal Hospital (402) 426-3630 002 S Hwy 30 Blair, NE 68008 CITY OF BLAIR - 202J 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: ('►'larch 15. 2021 Owner Name: C(ty-o t Lon 4 Owner Address: "y a Lov76SplI N J City/state/zip: Blair, NE 68608 Phone # Ll (! 7- - q o 0) — 33 —4-U, LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 ***PLEASE READ CARERJLLY*** 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 BY3r18r207_,j. The City shall recognize a microchip Identificatfon 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 smch dogs or cat. The City of Blair requires proof of rabies vaccination. Included is a Sty Fee of $1.25 berg collected to fund the Nebraska Dog & Cat Operator Inspection Program PET # 1 ❑ Dog Z Cat IJ Spayed/Neutered License Fee $ 11 • 00 Pet Name i3u �4 Birthdate io-iii-dq Sex Color L 2:1 a,r V- Breed" is s,l Replacement $ * * Declared Dangerous or Potentially Dangerous Dog: ❑ Y , E1 N MICROCHIP # - (If applicable) SUBTOTAL: $'c_� RABIES VACCINATION DATE: r (� z 2 (3 yr) (1 yr) x City Tag # PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (I yr) City Tag PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (I yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED $ If you have questions, please contact Blair Police Department at (402) 426-4747 +++++++++++++++++t.++++++++++*++++.++++++.++.+++++++++.+++++++i-++*+++++*++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15late fee dale notappllcaNe lornewpet51newre9(6h9t5) Newly Acquired Pets: New Residents to Blair: • Mist ne licensed "win io days orownersnip ■ Must register puts within 10 days of ■ <OR> at 6 monUis of age if puppy/WdEn residency_ CITY OF BLAIR - 2022 PET LICENSE APPLICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair ® 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 RENEINA ARE DUE: March 15, 2022 ***PLEASE CAREFULLY*** Owner Name: YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Owner Address: Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. City/State/Zip: lair, NE 6808 PET LICENSES RENEWALS ARE DUE BY 3/15l2022. The City shall Phone # I✓ �� 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 og ❑ Cat Spayed/Neu rl License Fee $ Pet Name L Birt date I _ ** Color Breed** eplacement $ . Declared a gerous or Potentially Dangerous Dog: ❑N MICROCHIP # If a�Y'le) SUBTOTAL: $ RABIES VACCINATION DATE: (1 yr) City Tag # PET #'2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex ** Color Breed** Replacement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # PET ##3 ❑ Dog ❑ Cat ❑ Spayed/Neutered 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 # *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 ........+.++.+.....++++++dr.+++++++++.........+.++++++.+++..... •I ..............+ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15late fee date not applicable for newpets/new residents) Newly Acaulred Pets: New Residents to Blair: • Must be licensed within 10 days of ownership E Must register pets within 10 days of • <OR> at 6 months of age if puppy/kitten residency. CM 0 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 6800$ Phone # 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 T # i Q Dog ❑ Cat �'Q Spayed/Neutered License Fee $ x' Pet Name. Birthdate Sex r ' dolor Breed** �' Replacement $ !Declared Dangerous or Potentially Dangerous Dog: ❑ Y P N i applicable) SUBTOTAL: $ ;MICROCHIP # _(If ;RABIES VACCINATION DATE: (3 yr) (I. yr) City Tag # =7 _ PET #2 ❑ Do ❑ Cat t3 Spayed/Neutered License Fee $ -Pet Name 9 Birthdate Sex ** Color Breed** Replacement $ Declared Dangerous or Potentially Danger©us Dog: ❑ Y U N MICROCHIP # (if applicable) SUBTOTAL: $ RABIES VACCINATION DATE: s: _� (3 yr) (1 yr) City Tag # L L3 PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate �. Sex ** Color Breed**Replacement $ Declared Dangerous or Potentially Dangerots Dog: ❑ Y ❑ N MICROCHIP # (if applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS4 RENEWAL ** (This fee is due along with License Fee if requeliting at the time of license renewal.) F �. Do Not semi gash by Mail 1'®1'AL ENCLOSE If you have questions, please contact Blair Police Department at (402) 426-4747 .....++++++.....++++++++++++....t.............++++++.....++++++.+++++++++++..+ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March15/ate feedatenotaP // blefornewpets/newresidents) 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. FROM :BSAC FAX NO. :402-533-2722 Jun. 11 2021 05:21PM P1 CITE" OF BLAIR - 2021 PET LICENSE APPLICATION If you live in Blair City limits and own a dog(s) and/or cat($), 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 j, r_aQ21 owner Name, `::a'�C Owner Address; ,. r� D City/State/zip: Blair, NE 68008 Phone # ( (r•1 l) Z� � a LICENSE FEES: Dog or Cat; $16.00 Altarlud Dog nr Cat'. $11.00 ***PLgW READ CAREFULLY*** YOU ARE REQUIRELI BY LAW T4 LICENSE YOUR PETS. Failure to do so is a violation of city ordinances 6.1031 and carri"O a penalty of a fine up to $150.00 per pat. POET LXCENOM RENEWALS ARE DUE BY of is/2021. The City shall reeagnlxo a microchlp identificatlon number as the licQnse number. it shall be unlawful for any dug or cet 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. Replalcernerit Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to furild the Nebraska Dog & Cat operator Inspection Program PET # 1 Dog ❑ Cat tWSpayed/ eu red License Fee $�— Pet Narne Birthdate 61 Sex N rY)al e Color Breed** U7 �, Replacement $. Declared Dangerous or Potentially Dangerous Dog: ❑ Y ,� N MICROCHIP # — "" (If applicable) SUBTOTAL. $ l RABIES VACCINATION DATE: z It I 1,16a.W1 (3 yr) _. (I yr) .�.�. City Tag #��.e ��* PET # 2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fuse $� (yet Name Birthdate � Sex Color Breed** Replacement $. ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # Of applicable) SUBTOTAL., $ RABIES VACCINATION DATE: (3 yr) — (I yr) City Tag #�* PET #3 © Dog Q Cat l•::I Spayed/Neutered License Fee Pet: Name Birthdate Sex Color _. Breed** Replacement$ Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # Of appllcable) 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 it requesting at the time of license renewal.) Do Not Send Cash by mall TOTAL ENCLOSED $ � If you have questions, please contact Blair Police Doplalrtment at (402) 426-4747 +++*++++++++++++++++**++++.++*++++++++*++++++++++++++.+++t+**+++a.++++++++++++.r NEW ITT/NEW RESIDENT WENSINO REQUIREMENTS (114ara91510te fw date notaolcapl' for iiewpiets/newresft ts) N"viy A ilUlmd pram, lNew e Residents R Must be iIr d within 10 days of p�Nlll�tlip R Must p'Inter pets within 10 days of Al <OR> & 6 mmtiu of age if puppy/lditn residency. FROM :BSAC FAX NO. :402-533-2722 Jun. 11 2021 05:21PM P1 CITY OF BLAIR - 2021 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 18th St 0 Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more then three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 1S._2921 Owner Name, owner Address: l� .. r� City/Stalte/zip: Blair, NE 618008 LICENSE FEES: Clog or Cat: $16.00 Altered Dog or Cht: $11.00 ***PLEAStE READ CAREFULLY*** YOU ARE REQUIRED 0Y LAW To LICENSE YOUR PETS. Failure to do So is a violation of city ordlnancaa 6.103 and carries a penalty of a fine up to 050,00 per pat. PET LICENSE.$ RENEWALS ARE DUE BY aLLJ 2021. 'rho City shall recognize a mlcrochlp Identification number as the llcense number. It shall be unlawful for any dog or Cnt 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 vaccinattom Replacement Fee for Lost Tag: $5.00 Included Is a Spate Fee of $1.25 being colleted to fund the Nebraska Dog Sic Cat Operator Inspection Program PET # 1 �yuy J Dog ❑ Cat a Spayed/ eu red License Fee Pet Name Birthdate C' ..` Sex N rr,c,le Color 6 Breed** Replacement$_ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y .4 N MICROCHIP # (If applicable) SUBTOTAL: $ ,, RABIES VACCINATION DATE:. U a 11.1 E - .na 1 ( Yr) _�. (1 Yr) .--�-.- Ciiy Tad # '." PET #2 ❑ Log ❑ 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: _ (� yr) _ (I yr) _. _.... City Tag #�'� PET #3 ❑ dog Q Cat U Spayed/Neutered License Fee $ Pet Name Birthdate-- Sex Color _ Breed** Replacement $ Declared Dangerous or Potentially Dangerous Dag: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL. $ RABIES VACCINATION DATE: (3 yr) (1 yr) ,,,� __. City Tag # *PLEASE INCLUDE THE CTN'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 $sod Cooh by Mail TOTAL ENCLOSED $ �. If you have questions, please contact Blair Police Department at (402) 426-4747 +++*..+++++++++++++++++++++++.*+++++++*..+++++++++....*++t+++.++.+++++*+++++++ NEW PIT/NEII RESIDENTUCLNSINGREQUIREMENTS(Malch151alefw date notapplIcapofor 04?wpets/newo?sloenfs) N&Mv Acwls fonts to Blair; e Must be kvved within 10 days Wc1Mlahip N Must recpisber pets within 10 days of a <0R> at fi mmft of age W puppy/Idtben residency, CITE OF FLAIR 2®x1` ' � 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 RENE S ARE DUE: March 15 2022 ®weer Name: sir V�, Owner Address: Z U 0 9 Ay g o94�- city/state/zip: Blair, NE 68008 Phone # /Z-o,-�- 4 --So` 7 LICENSE FEES: Dog or Cat: $16.00 Alt d Do or Cat" $] 1 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. ere g . Replacement I•ea 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 iJ Dog ❑ Cat Or"Pi Pet Name i I i,� Birth ate Color Breed** Declared Dangerous or Potentially Dange MICROCHIP # `M - l a-606 RABIES VACCINATION DATE: ' W yred Neutered License Fee $ v' Sex r rn.a,l-c-- eZ�d l- Replacement $ -ous Dog: ❑ Y ❑ N (If applicable) SUBTOTAL: $ (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) _ M License Fee $ Replacement $ SUBTOTAL: $ (I 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 15/ate fee date not applicable fornewpets/newresidenis) Newly Aouired Pets: New Residents to Blair: • Must be licensed within 10 days of ownership m Must register pets within 10 days of ® <OR> at 6 months of age if puppy/kitten residency. -76()s_� ,, W W 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, 2022 Owner Name: Owner Address: -L city/state/zip: Blair, NE 68008 Phone # 16, 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 # 1 Dog ❑ Cat ,If Spayed/Neutered License Fee $ Pet Name L-, t Birthdate /- / IA I t- Sex r_ Color 41zh-I-, Breed** "�-. Ct, "-fl o�;w —Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y 1�1 N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: 3 `3 a Z 2 (3 yr) _ (1 yr) _ City Tag # J" 61 11 PET #2 �f Dog ❑ Cat Pk Spayed/Neutered License Fee $ Pet Name° Birthdate fj • �+? Sex Color fteA Breed** _ � - — Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y LO N—�— MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: 3 61.7- 2- (3 yr) _ (1 yr) Y City Tag 1 5 1 PET #3 09, Do ❑ Cat ❑ Spayed/Neutered License Fee $ (ec- c, Pet Name ,h,- Birthdate 6-I-ZO Sex t Color Breed** z- L-S,2 Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: I - Z.. Z Z_ (3 yr) X_ (1 yr) City Tag' # 0 * *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 +++++++¢++++...................r++.....+++++.....++.++++++.++.....++++++.....s• NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15late feedate not applicable fornewpets/new residents) Newly Acquired Pets: New Residents to Blair: Bil Must be licensed within 10 days of ownership w Must register pets within 10 days of <OR> at 6 months of age if puppy/kitten residency. CITY OF BLAIR - 2022 PET LICENSE APPLICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair a 218 S 16th St o Blair, NE 68008 You may legally own, a combination of four (4) adult pets, but no. more than. three (3,).adult dogs . or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2022 Owner Name: Z 5-0�� Owner Address: City/State/Zip: Blair, NE 68008 Phone # W" ,�6 s 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 T #1 f� o g ❑ Cat ❑ Spayed/Neutered License Fee $ ,l n I Pet Nam . Birthdate Sex Color R Breed**Replacement$ ** Declared Dan erous or Potentially Dangerous Dog: ❑ Y I ,,,N 06 MICROCHIP # _ � (If a able) SUBTOTAL: $ _ RABIES VACCIN � � ON DATE: - 'C - 3. r) r�(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) _ (1 yr) License Fee $ Replacement $ SUBTOTAL: $ City Tag # PET #'3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Replacement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (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 ENCLOSE® , , If you have questions, please contact Blair Police Department at (402) 426-4747 .... r+++++++++.+..+.++++++++++++++.+.+.+++.+++++++.+++++++.....++.++........++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15late fee date not applicablefornewpets/new residents) Newly Acquired Pets: New Residents to Blair: • Must be licensed within 10 days of ownership N Must register pets within 10 days of ® <OR> at 6 months of age if puppy/kitten residency. 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' t) A 1 b�A Xy YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Owner Address: ' �� V V v) T)C ' 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 I i . I ( r— � r ,. PET LICENSES RENEWALS ARE DUE BY 3/1512022. The City shall Phone # t} �[ 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: o or Cat: $16.00 A ered Dog or Cat: $11.00 Replacement Fee for Lost Tara: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program # `)t- ❑ Cat 'YSpaye Eeu red I . License Fee $ Pet Na e t�og K Birth —date ddateSex �""Y for ' _Breed**� Replacement$ ** 10 Pk lare Dangerous or Pote, ti II D� nf9erous Dog: ❑ Y DEN (� a MICRO IP # q g� lizo (If applicable) UBTOTAL: $ ,A RABIES ACCINATION DATE;-'LO (3 yr) (1 yr) City Tag # ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Birthdate Sex ColoNa Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ 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) _ License Fee $ Replacement $ ❑N W 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.) Do Not Send Cash by Mail TOTAL ENCLOSE® ** If you have questions, please contact Blair Police Department at (402) 426-4747 .....+.++++++++++.....++++++.... w......................................++++ 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 m Must register pets within 10 days of • <OR> at 6 months of age if puppy/kitten residency. GERTTFICATE OF VACCINATION Date of Rabies Vaccination: 06-25-20 Next Rabies Vaccination On:06-25-23 VETERINARY CLINIC Fort Street Veterinarian 14345 Fort St., Suite 500 Omaha, NE 68164 402-884-3383 This is to certify... OWNER OF ANIMAL Darby Loudner 15555 Reddick Plaza Omaha, NE 68116 County: Douglas THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW. Patient information... PATIENT: Stella TAG NO: 151272 SPECIES: Canine SEX: S AGE: 3Y BREED:Shiba Inu WEIGHT: 18.40 COLOR: Red MICROCHIP: 985112011433588 Signed Shauna TordrUp DVM License: 3350 Vaccinations done... 11-22-21 TEC LeptoVax (Annual) 11-22-22 06-12-21 CBA Bordetella 06-12-22 06-25-20 SE Rabies Vaccination 3yr, #151272 06-25-23 06-25-20 SE DA2PP 2 year 11-04-19 SE LeptoVax (Initial) 06-17-19 SE Rabies Vaccination 1 yr, #149443 06-17-19 SE Last Puppy DA2PP Rabies Vaccine Information... MFG BY: NOBIV SER.NO: 04/02/21 LOT EXP:38535613 ADM: SQ .- ark Street- Vetennanan- Spay Certificate Date 03-01-22 Owner's Name:. Darby Loudner Case No: 8931 Street: 15555 Reddick Plaza City: Omaha Zip Code: 68116 Phone: 71.5-3686 Pet's Name: Stella ---._ - - - - � - - - - - - - - - - - -- - ---- -- - ----- - - -� � - - -- �----�--- Sex: S Age: - ......__. _._. _..— _-.--- Color: Red � 1, the -undersigned, do hereby certify that I have perfonned an ovariohysterectomy..- . -- '--- -- - - - - (spay operation) on Stella, and --that both ovaries and the uterus have been-surgicAy - removed. during this surgical procedure. 0VM Clip OF BLAIR ® 200122 ET LICENSE APPLI Af i If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair a 218 S 16th St o Blair, NE 68008 You may legally,own a combination of four (4) adult pets, but no more than. three (3) adult dogs. or three (3) adult cats per residential or dwelling unit. eN � LICENSE RENEWALS ARE DUE: March 15, 2022 ***PLEASE READ CAREFULLY*** Owner Name: �� / .I Lind YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Owner Address' I /' Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. city/state/zip: Blair, NE 68008 � `� /�, PET LICENSES RENEWALS ARE DUE BY 3 15 2022. The City shall 1 Phone # `i 122, �"-70 V C-' 9-Z 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 LICENSE FEES: Dog or Cat: $16.00 cat. The City of Blair requires proof of rabies vaccination. 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 Ens 'on Program PET #1 lA® Dog ❑ Cat 4Spayed/ Neutered � License Fee $ Pet Name es.�Birthdate 0 v� Sex Color -.) ,L •,� & Breed** l 1 ! Replacement $ * * I Declared Dangerous or l5otentially Dangerous Dog: ❑ Y W N MICROCHIP # (If applicable) SUBTOTAL: $ I ( • o I RABIES VACCI ATION DATE: _�� (3 yr) (1 yr) X City Tag # • PEl #2 54 'Dog ❑ Cat Spayed/Neutered License Fee $ Pet Name 0076y— Birthdate Sex M n Color too , 4Y.4,lc Breed** Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y W N MICROCHIP # _(If applicable) SUBTOTAL: $ II • r� RABIES VACCINATTQ,R DATE: I - 21- X2. (3 yr) _ (1 yr) City Tag #j t4 PET #'3 Cl 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) _ El 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.) Do Not Send Cash by Mail TOTAL ENCLOSE® ' 1.00 If you have questions, please contact Blair Police Department at (402) 426-4747 .... r++.++..................•a++.....+++++++¢+.++++++++....++++++..........+.+ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15late fee date not applicable fornewpets/newresldents) Newly Acquired Pets: New Residents to Blair: ® Must be licensed within 10 days of ownership 0 Must register pets within 10 days of • <OR> at 6 months of age if puppy/ldtten residency. Date of Rabies Vaccination: 01-28-22 Next Rabies Vaccination On: 01-28-23 VETERINARY CLINIC Thone Animal Hospital 902 S Hwy 30 Blair, NE 68008 402-426-3630 Certificate No: 3140 Previous Rabies Vaccination: 002046 OWNER OF ANIMAL Cherilyn Lund 556 South 16th St Blair, NE 68008 County: This is to certify... THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW. Patient information... PATIENT: Parker TAG NO: 007461 SPECIES: Canine WEIGHT: 35.40 SEX: N AGE: 7 years Color and markings... Blue Merle Signed Dr.Kamala Freeman License: 3894 Vaccinations done... 01-28-22 KF Rabies Vaccination (1 Year), #007461 01-28-22 KF DA2PPV+L 01-28-23 06-06-16 LL Rabies Vaccination (3 Year), #002722 01-28-23 06-06-16 LL Check up, DA2PPV+L 01-28-23 04-24-15 ILL Annual Checkup, DA2PPV+CV Rabies Vaccine Information... MFG BY: ZOETI SER.NO: 542135 LOT EXP: 02-14-23 ADM: SQ CERTIFICATE OF VACCINATION Date of Rabies Vaccination: 01-28-22 Next Rabies Vaccination On: 01-28-23 VETERINARY CLINIC Thone Animal Hospital 902 S Hwy 30 Blair, NE 68008 402-426-3630 This is to certify... Certificate No: 3141 Previous Rabies Vaccination: OWNER OF ANIMAL Cherilyn Lund 556 South 16th St Blair, NE 68008 County: THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW. Patient information... PATIENT: Penny SPECIES: Canine SEX: F Color and markings... Bay Signed Dr.Kamala Freeman Vaccinations done... TAG NO: 007462 WEIGHT: 0.00 AGE: 10 years License: 3894 01-28-22 KF Rabies Vaccination (1 Year), #007462 01-28-22 KF DA2PPV+L 01-28-23 04-24-15 LL Annual Checkup, Rabies 3YR, #001968 01-28-23 Rabies Vaccine Information... MFG BY: ZOETI SER.NO: 542135 LOT EXP: 02-14-23 ADM: SQ CITY OF BLAIR - 2022 PET LIC NSt AP LICATION 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 o Blair,, NE 68008 You may legally own a combination of four (4) adult pets,'but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. c>If LICENSE RENEWALS ARE DUE: March 15, 2022 Owner Name: a, re"h - �- (JI) a Owner Address: f-"L""LJz'1 city/state/zip.. Blair, NE 68008 Phone # q o )_ --- ), 3 17 — 0 z- 9L LICENSE FEES: Dog or Cat. $16.00 apF,*,.,*ej nt% or Cat: t11 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 3/1512022. 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 Fi-e 'or Lost Tag: 1*6.00 le Included is a State Fee of $1.25 ![j.ing collected to fund the Nebraska Dog & Cat Operator Inspection Program PET #1 LJ Dog �kdat kSpayed/Neutered License Fee$ Pe 1, t Name t. 0 fa" IBirthclate I-3/-1 Sex Color Lp� _,l Breed, 640J-1- Replacement$ Delared Dangerous or Potentially Dangerous Dog: D Y a N MIJROCHIP # AZo (If applicable) SUBTOTAL:$ Pi,,IES VACCINATION DATE: '?_ -,k:L, Z—__ (3 yr) _Z_ (1 yr) X City Tag # ),7) 2 -Z*- T #2 Dog J Cat ASpayed/Neutered License Fee $ ,t,Name F) U'l, V Birthdate _L�Sex I Col r r-ye 4t- -'wh; Breed*", Replacement $ Dec ec ared Dangerous or Potentially Dangei'ous Dog: LI Y PL N Yff'CROCHIP # AJo ---(If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: yr) - (1 yr) L== City Tag PET #3 171 Dog L3 Cat 0 SpayEd/Neutered License Fee $ Pet Name Birthdate Sex Color Breed" Replacement $ Declared Dangerous or Potentially Dangerous Dog: Ll Y LJ N MICROCHIP # f 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 Sena 6sh ey Ma;l TOTALENCLOSED$ .0-00 If you have questions, please 4ontact Blair Police Department at (402) 426-4747 ......................... I ...... 44 ............................................. NEW PET/ NEW RESIDENT LICENSING REQUIREKNTS (March 151ate fee date not applicable for newpetslnew residents) Newly Acquired Pets: New Residents to Blair: • Must be lioensed within 10 days of ownership In Must register pets within 10 days of • <OR> at months of age if puppy/ldtten residency. Red Barn Veterinary Clinic & Farmacy, PC 101 E. 10th Oakland NE.68045 (402) 685-5202 Rabies Certificate Client ID: 10678 Client Name: Karen & Ray Lund Address: 1204 Fairview Dr Blair NE 68008 Phone: (402) 237-0282 Rabies Vaccine Information: Vaccine Date: 2/2/2022 Date Due: 2/2/2025 Tag Number: 220171 Lot Number: 12667 MFG By: Merial - IMRAB 3 Lot Exp: 2/18/2023 ADM: Subcutaneousl Patient ID: 118603 Patient Name: Lola Species: Feline Breed/Color: Domestic Short Hair, Sex: Spayed Female Date of Birth: 1/31/2017 Weight: 9.03 Microchip ID: I have vaccinated against Rabies for the specified animal as described above. Drs. Stewart Hartwell, James Unwin, pat Maline, Kellie Wise & Robin Schroeder Client ID: 10678 Client Name: Karen & Ray Lund Address: 1204 Fairview Dr Blair NE 68008 Phone: (402) 237-0282 Rabies Vaccine Information: 101 E. 10th Oakland NE.68045 (402) 685-5202 Rabies Certificate Patient ID: 117093 Patient Name: Buddy Species: Canine Breed/Color: Mix, blk/wht Date of Birth: 10/27/2020 Microchip ID: Sex: Neutered Male Weight: 53 Vaccine Date: 2/2/2022 Date Due: 2/2/2025 Tag Number: 220172 Lot Number: 12667 MFG By: Merial - IMRAB 3 Lot Exp: 2/18/2023 ADM: Subcutaneous) I have vaccinated against Rabies for the specified animal as described above. I- &- ut"Wt- Drs. Stewart Hartwell, James Unwin, Pat Maline, Kellie Wise & Robin Schroeder � i 9u6. ��✓ "e �i i"^y CITY OF BLAIR ® I 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 * 216 S 16th St e Blair® NE 66006 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 "t � ***PLEASE READ CAREFULLY*** Owner Name: i sqc YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Owner Address: va Lw 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 66006 Phone # � � PET LICENSES RENEWALS ARE DUE BY 3/15/2022, The City shall LA 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 LICENSE FEES: Dog or Cat: $16.00 cat. The City of Blair requires proof of rabies vaccination. 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 ET # 1 Dog ❑ Cat Spayed/Neutered License Fee $ Pet Name Bi h ate Sex Color EcZjBreed** Replacement $ ** Declared Dangerous or Potentially Dangerous : ❑ Y ❑ N MICROCHIP # If applicable) SUBTOTAL: $ RABIES VACCINA ON DATE: (3 yr) _ (1 yr) City Tag # --� * PET # Dog ❑ Cat ❑ Spayed/Neutered License Fee $ \ b, Pet N irthda _ e Se Color FBreed** _Replacement $** Declared Dang rows or P ntia ly Dangerous Dog: ❑ Y ❑ N MICROCHIP #! (If appli ble) SUBTOTAL: $% RABIES VACCIN -ION DATE: '` yr) (1 yr) _ City Tag —# i # 3 ❑ Dog ❑ Cat 0 Spayed/Neutered Pet Name Color a e Declare'd � Q M CR C. ' *PLEASE INCLI **-,(This fee is e Birthdate Sex Breed** Dangerous or Potentially Dangerous Dog: ❑ Y I�IIP # (If applicable) CCINATION DATE: (3 yr) _ ■W License Fee $ Replacement $ * * SUBTOTAL: $ (1 yr) ICity Tag # THE CITY TAG NUMBER IF THIS IS A RENEWAL along with License Fee if requesting at the time of license renewal.) � 1 4 Do Not Send Cash by Mail TOTAL ENCLOSED i. i_ t If you have questions, please contact Blair police Department at (402) 426-4747 NE PET/NEW RESIDENT LICENSING REQUIREMENTS(March 15late fee date not applicablefor,newpets/newresidents) 14fewly Acouired 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/ldtten residency. �D CITY r ; PETLICENSE 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 ARC DUE: March 15 2022 n . 1 _ ***PLEASE READ CAREFULLY*** Owner Name: (--,AWN-" ° '� Imo'_► SG� ^�� YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Owner Address: / c Q .ly �� i�).�_ Failure to do so is a violation of City ordinances 6.103 and carries a a penalty of a fine up to $150.00 per pet. city/state/zip: Blair, NE 68008 % Phone # �I � PET LICENSES RENEWALS ARE DUE b r as the lice 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. LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 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 ET #1 0 Dog ❑ Cat &f Spayed/Neutered License Fee $ Pet N1�1�CYlCa Birthdate Colore_ — Breed" Replacement $ ** Declare Dangerous or Potentially Dangerous Dog: ❑ Y N MICROCHIP # _ (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: �r _ (3 yr) (1 yr) City Tag #Z(41* P EET # 121"D o g ❑ Cat ,dSpayed/Neutered License Fee $ Pet Name _ Birthdate Sex \_ Color I�t-Q� Breed** _Replacement $** Declared Dangerous or Potentially Dangerous Dog: ❑ Y UdN MICROCHIP # (If applicable) / SUBTOTAL: $ ,�, RABIES VACCINATION DATE: (3 yr) r/ (1 yr) City Tag #_U1�T PE'T ##3 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate''. Sex Color Breed" _ Declared Dangerous or Potentially Dangerou Dog: ❑ Y MICROCHIP # v _(,if applicable) RABIES VACCINATION DATE: _ _ (3 yr) _ i License Fee $ Replacement $ SUBTOTAL: $ — (1 yr) City Tag # m* *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesdng at the time of license renewal.) i Do Not Send Cash by Mail TOTAL ENCLOSED $ I If you have questions, please contact Blair Police Department at (402) 426-4747 •h•ft+t-I-i•+.^h•F.i•i•.-M-F•F+•h•I•-F•...I....-Hsi-i'•F+....°h-h....^F°h.....d .......................... NEW PET/NEW RESIDENT LICENSING REQUIREME14TS (March 15/ate fee date not applicable fornewpets/new residents) Newly Acquired Pets: New Residents to Blair: ® Must be lioensed within 10 days of ownership IN Must register pets within 10 days of • <OR> at 6 months of age if puppy/kitten residency. ■r/17/2022 2:06 PM FAX 4025332723 BLAIR SMALL ANIMAL a 0001/00 CITY OF BLAIR W 2022 PET LICENSE APPLICATION ■■ If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and retum with check made payabl City of glair • 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 1 or three (3) adult cats per residential or dwelling unit LICENSE REN Owner Name: Owner Address: City/state/tip: Blair,, NE 68008 Phone # a- i( 3� 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 : $16.0o �t the City of Blair requires proof of rabl" vaWnvuon. LICENSE FEES: Clog or Cat Altered Dog or Cat: $11,0o Replacement Fee for Lost Tag: $5.00 Included is a Sbte Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program ***PLEASE READ CARERILLY*** J to: i1 1'4' YOU ARE REQUJRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a v1014lition of city ordinances 6.103 bnd CatHes a penalty of a fine up to $150,00 per pet PET ml dCDog U Cat Bir daeay J.itered License Feelgetor7ffik�� Declar Breed** 6 Replacement $ ** d D e angerous or Potentially Dangerous Dog: Li Y ❑ N MICROCHIP # , �(If applicable SUBTOTAL; $ RABIES VACCINATION DATE: (3 yr) (1 yr) —. City Tag #�t* ;Ta— _. _ _ PET #2am og ❑ Cat Spaye /Neutered Pet Na e � Birt date qjPdtj Sea Color Breed** Declared Dangerous or Potentially Dangerous : Q Y MICROCHIP # (If applicable' RABIES VACCINATION DATE: 1 (3 yr) T1 License Fee $ Replacement $ N SUBTOTAL: $ (1 Yr) City Tag —#:,J± PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License [Fee $ Pet Name Birthdate Sex Color Breed** Replacement $* Declared Dangerous or Potentially Dangerous Dog: ❑ Y O 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 IlCense renewal.) DO Not Send Cash by Mall TOTAL ENCLOSED $ 2° If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Abrc* 151at� fee date Mtap,yi®b* f0rrxWPe 1nM fsid 7t9) ■��8oertsed whin 10 days c ownersw eat�tQ Blair, ,. _ ■ <OR> at 6 month of if p ■ Must register pets wit111n 10 days of � puPPY/k1tOr?n may. l CITY OF BLAIR - 1 0 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 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: L--12 l W V-1 C 1-4 Owner Address: -76 0 K) .3 v 4 city/state/zip: Blair, NE 68008 Phone # Ll 0,)— L] 2 67 0 0 ***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 I a City of Blair requires proof of rabies vaccination. LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 Replacement Fee for 1_ost Tag: $s.nn Included is a State Fee of $1.25 being collected to fund the Nebraska & Cat Operator Inspection Program ilk ' ET # 1 ❑ Dog 0 Cat 4 Spayed/Neutered License Fee $ :1 P t Name �U �,jCCj i— K) " Birthdate Sex C fort_�c:, Breed** Replacement $ ** D clared Dangerous or Potentially Dangerous Dog: ❑ Y N ICROCHIP # ) rig'% (If applicable) SUBTOTAL: $ BIES VACCINATION DATE: I�, (3 yr) (1 yr) City Tag # a ET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ -�"et Name Birthdate Sex _ "� Col r Breed** Rep/acement$ ** ared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N ,.k4CROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # PET #3 ❑ Dog ❑ Cat I ❑ Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # _ (If applicable) RABIES VACCINATION DATE: I (3 yr) _ (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.) Do Not Send Cash by Mail TOTAL ENCLOSED $ lit If you have questions, please contact Blair Police Department at (402) 426-4747 .....++.+++++.+++++++++++++++....++++++++++++.....++++++.....++..............+ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Marchl5/ate fee date not applicablefornewpetr/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 Is <OR> at 6 months of age if puppy/ldlten residency. M INVOICE Thone Animal Hospital 902 S Hwy 30 Blair, NE 68008 402-426-3630 Printed: 08-15-19 at 3:13p FOR: Liz Lynch Date: 08-15-19 760 N 3rd St Account: 803 Blair, NE 68008 Invoice: 87520 (510) 423-5398 Date For City Description Net Price 08-15-19 Lincoln 1 Checkup, FE-4way 36.00 08-15-19 1 Rabies VaccZpa.yment nation (3 Year) 28.00 08-15-19 Mastercar -64.00 Merchant ID: 4445046763017, Approval co, : 01567W, Transaction ID: 2144985721 Ref #: 6607, Act #: ************9499, Exp:, XtX/XX, Entry: Contacticc, Card: MASTERCARD Your card balance is not available I AGREE TO PAY ABOVE TOTAL MOUNT ACCORDING TO CARD ISSUER AGREEMENT X d nce arges Payments New balance 0. 64.00 64.00 0.00 e in ers for: n ( eight: 3.2 Ibs - 19m) Last done 8-1 2 R bi s Va ination (3 Year) 08-15-19 08- -2 F 4 ( hino/Call/Pant/C(1a 08-15-19 r YoWPet Su animalcareotlair.com. Like us on Facebookll 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: OwnerAddress: atv/staate/zip: Blair, NE 68008 r Phone #`(- 3L —1 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. Fallure to do so Is a violation of City ordinances 6,103 and carries a penalty or a fine up to $250.00 per pot. PET LICENSES RENEWALS ARE DUE° BY 241542.022, The City shall recognize a mlc=hlp Identlfleatlon number as the license number. It shall be unlawful for any dog or cat to wear any Ilcense or other city Identifleatlon other than that issued by the City of Blair for such dog or c4t. The OW of Blob mquiro proof of rablos voalnotfon. Replacement Fee for Lost Tag: $5.00 Included is a Stabs Fee of $1.25 being aoilected to fund the Nebraska Dog & Cat Operator Lt4mction Program PET # 1 Dog ❑ CatSpayed/Neutered License Fee $,� Pet Na t-1 \ Birthdate _� Sex Color Breed** _2��; ��rcr� Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # WR (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) C (1 yr) City Tag # PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex ---._... Color Breed** 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.) 00Not Send Cash by Mall TOTAL ENCLOSED $ If you have questions, please contact Blair Police Department at (402) 426.4747 +++++++++++++++++*++*.+.++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS(Mafd�15late2sdatenctfbrrovpels/ncwres(en&) NAYA IAMOem; New -Residents to. Main ■ Must be ka*ised wft 10 days of mrped ip ■ Must reglsber pets w[thln 10 days of ■ <OR> at 6 months of age if puppy residency T000/T000[A 'IVNINV 11VNS HIV19 C%ZCCSZOV XVJ KVRO:TT ZZOZ/6T/ ■ "A X 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 U, 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: 30- 70 WeSkid 1) 6 City/State/Zip: Blair, NE 68008 T Phone # L40 a - q 4 �- _7q A ***PLEASE READ CAREFULL 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/I5/2022. 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. 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 I PET #1 Dog LJ Cat XSpayed/Neutered License Fee $ U4,00 Pet Name R",2gice' Birthdate te 21 Sex qe1e_ Color ReA :-je whAe, Breed** i f V4e'1gV') Replacement $ J Declared Dangerous or Potentially Dangerous Do Lj_Y lif N MICROCHIP 0165 141003 30 SOS (If applicable) SUBTOTAL: $J&-Q.`Q RABIES VACCINATION DATE: (3 400 yr) L )JqJ2 (1 yr) City Tag # ft PET #2 LJ Dog Lj Cat Li Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: EJ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) — W License Fee $ Replacement$ —** SUBTOTAL:$ (1 yr) — City Tag # PET #3 0 Dog Ll Cat Ll Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed" Replacement$ Declared Dangerous or Potentially Dangerous Dog: LJ Y LJ N MICROCHIP # I (If applicable) SUBTOTAL-$ RABIES VACCINATION DATE: _ (3 yr) — (1 yr) _ city:Rlig # *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$ If you have questions, please contact Blair Police Department at (402) 426-4747 ....................................... 11 ...................................... NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March,151ate fee date not applicable for newpe&lnew re5ldent5) Newly Aouired Pets: New Residents to Blair: • Must be lioansed within 10 days of ownership N Must register pets within 10 days of • <OR> at 6 months of age if puppy/kitten residency. Client ID: 7950 Client Name: Taylor Karls Address: 3070 Westridge Drive Blair, NE 68008 Phone: (402)943-7968 Tag Number: 6715 Lot Number: 18508 Imrab Rabies Vaccine Producer: Merial K / MLV / R: Killed Virus Blair Small Animal Clinic PC David E. Johnson DVM 1734 Front Street Blair, Nebraska, 68008 (402) 533-2722 Rabies Certificate Patient ID: 12796 Patient Name: Ryder Species: Canine Breed: Welsh Corgi Sex: Female Color: Tri-Color Markings: Birthday: 06/08/2021 Weight: 8.00 pounds on 9/9/2021 Microchip ID: Vaccination Date: Expiration Date: Staff Name: David E. Johnson DVM License Number: 1893 ;tk 9/9/2021 9/9/2022