X-Y-Z7 6, ,
CITY OF L 02"LL C a ,
If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to.
City of Blair a 218 S 16th St 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: h LAC r (` r41
Owner Address:55-2
r
City/State/Zip: Blair, rNE 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 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 Identlflcation 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.
®: wla;-Mr.crit Fee for Lost i0-9-: $3.V-0
Included is a State Fee of $1.25 being collected to fund the Nebraska Dog 6c Cat Operator Inspection Program
T 1, d Dog ❑ Cat * Spayed Neutered License Fee $ A o0
Pet Name i i _ Birthdate i `` S x
Color Breed** Replacement $ _ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y ih N
MICROCHIP # tS (If applicable) SUBTOTAL: $ /.0(%
RABIES VACCINATION DATE: ' _ (3 yr) �L— (1 yr) City Tag #
ET #2 Pog ❑ Cat Spayed Neutered License Fee $ nh
Pet Name _ Bi , date • ex
Color i�hite. Breed** -p .(--- 5 Replacement$ **
Declared Dangerous or Potentially Dangerous Dog: ❑ 4 N /
MICROCHIP # (If applicable) SUBTOTAL: $ A1a 06
RABIES VACCINATION DATE: (3 yr) _!s,/— (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 # I (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 duc along with License Fee if requesting at the time of license renewal.)
Do Not Send Cash by Mail TOTAL ENCLOSED 0� c 00
If you have questions, please contact Blair Police Department at (402) 426-4747
....++++++.....+................++++++.....++++++.....+++++.....+++++++. ++++++
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March15/ate fee date not applicable for newpets/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/kitten residency.
If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to:
City of Blair a 218 S 16th St ® 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 PE (March15 2022
1 " � Owner Name: a.lry A 1�I cl fvl l extwo
Owner Address: `!K-) c'? 11 It-
t b'1 S 1
City/State/Zip: Blair, NE 68008
Phone # L( n - GI ' o Gl
LICENSE FEES: Dog or Cat: $1fs U
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: Fe or Lust Tag: $5.00 ._Y 0 0
Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program
ET #1 ❑ Dog � ( C at Spayed/Neutered ram- License Fee $
Pet Name �')}►1� e VV! n Bir hdate 11 Sex
Color ►'c .e_ - � c Breed" b C t41 —Replacement $ G * *
Declared Da gerous r Potentially Dangerous Dog: ❑ Y W N
MICROCHIP # _(If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: rM
0` CiZ _ ( yr) (1 yr) City Tag # '5 }'*
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 ENCLOSE®
If you have questions, please contact Blair Police Department at (402) 426-4747
..... .....+++++...... .....+++...............................................
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date notapplicable fornewpets/newresldents)
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.
CITY OF BLAIR ® 2022 PET LICENSE APPLICATION Q
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: Ln V- V-/ A "4_ 1 rj�',i I I
Owner Address:
City/State/Zip: Blair, NE 68008
Phone #
LICENSE FEES." Dog or Cat: $16.00
Aike"d-.10001 or cat -
***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 0 Dog A Cat 2i Spayed/Neutered License Fee $
Pet Name Birthdate4-V�- IF5. Sex
Color 6A i,- Breed" Replacement $
j
Declar6d Dangerous or Potentially Dangerous Dog: L3 Y N
MICROCHIP # (If applicable) SUBTOTAL:$
RABIES VACCINATION DATE: j)-b (3 yr) -?<- (1 yr) - City Tag #
PET #2 Ll Dog LJ Cat 0 Spayed/Neutered License Fee $
Pet Name Birthdate Sex
Color Breed" Replacement $
Declared Dangerous or Potentially Dangerous Dog: LJ Y LJ N
MICROCHIP # (If applicable) SUBTOTAL:$
RABIES VACCINATION DATE: (3 yr) — (1 yr) _ City Tag #
PET #3 LJ Dog Ll Cat LJ Spayed/Neutered
Pet Name Birthdate Sex
Color Breed"
Declared Dangerous or Potentially Dangerous Dog: LJ Y
MICROCHIP # (If applicable)
RABIES VACCINATION DATE: (3 yr) —
MER
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 Mail TOTAL ENCLOSED $
If you have questions, please contact Blair Police Department at (402) 426-4747
..............................................................................
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS
Newly Acquired Pets:
• Must be licensed within 10 days of ownership
• <OR> at 6 months of age if puppy/kitten
(March 15 late fee date not applicable for ne w pet5lne w re5ldenly)
New Residents to Blair:
N Must register pets within 10 days of
residency.
12/30/2021 15:07 4024260101. HOLSTEIN VET CLINIC PAGE
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
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.
01/03
***PLEASE READ CAREFULLY***
YOU ARE REQUIRED BY LAW TO LICi:NSE VO R PETS. THE CITY F (AIR RE UIRES PR OF 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 V15 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 Bair 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
Lisa Yost
Spouse
Owner Address
2242 Colfax St.
City/State/Zip
Blair, NE 68008
Phone #
402-426-4817
Pet Name. Scout t CA
Age: 7Y
DOB: 06-04-14
Sex: Neutered Male
C010r: CtioI
Breed: Lab
Microchip # 985112001612395
Rabies Tag # 19708
PLEASE INCLUDE CITY TAD NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): #
RABIES VACCINATION DONE ON
09-01-21
Rabies Description: 1 YEAR ri YEAR
Holstein Veterinary Clinic
Dr. Lisa Schrum DVM : Dr. Krista Holstein DVM
718 South 1911 Street Blair, NE 68008
402-426-7387 402-42670101 Fax
holsteinclinic@gmail.com
LICENSE FEES
Intact
Dog or Cat: $16.00
or cat: $11.00
Rep a & Tag
4S 00
Total $
PETS THAT ARE ON THE ACTIVE POiNTIALLY DANGEROUS OR
DANGEROI�$ DOG UST NEED TO REGI �TT'R DIREGTLYAT CITV HALL ,
V, z
3T
CITY OF BLAIR ®2 2 SET LICEI PP'LICA I WN
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 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. I
LICENSE RENEWALS ARE DUE: March 15, 2022
Owner Name: � �-�.l uqw a y a�A-
Owner Address:( Y
City/State/Zip: Blair,, NE 68008
(4C5-L--)`-1Dct-
Phone #
***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.
LICENSE FEES: Dog or Cat: $16.00
Altered Dog or Cat: $11.00
Replacement Fee for Last Tag: $6.00
Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program
PE+#l,�—Dpg
❑ Cat
❑ Spayed/Neutered .
License Fee $ ,00
Pet
arm+Yn' iP_
Birthdate 1 Sex ( t
Colo
_
```` uwn
Breed** �y> l ` r)crAN1 '
Rep/acement $
red Dangerous or Potentially Dangerous Dog: ❑ Y • N
w�ecl
IC
OCHIP #
(If applicable)
SUBTOTAL: $
RAB
S VACCINATION DATE:
§rr .." (3 yr) _ (1 yr)
City Tag #
ET 2 ❑ Dog ❑ Cat ❑ Spayed/Neutered
Pet dame Birthdate Sex
Color Breed**
Declared Dangerous or Potentially Dangerous Dog: ❑ Y
MICROCHIP # (If applicable)
RABIES VACCINATION DATE: (3 yr) _
ME
(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
** (Thisfpe is due along with License Fee if requesting at the time of license renewal.)
®o Not Send Cash by Mail TOTAL ENCLOSED $ I W
If you have questions, please contact Blair Police Department at (402) 4.26-4747
++.+.+++++++.....++++++.....+++++++++++++++++.++++++................++++.+++++
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15late fee date not applicable fornewpets/new residents)
Newly Acguired Pets: New Residents to Blair:
• Must be licensed within 10 days of ownership a Must register pets within 10 days of
® <OR> at 6 months of age if puppy/kitten residency.
P
A"
Jan 26 22 04:07p p.1
Thane Animal Hospital
(402) 426-3630
902 S Hwy 30
Blair, NE 68008
CITY OF BLAIR - 2021 PET LICENSE APPLICATION
If you live in Blair City limits and awn 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, 2021
Owner Name: V•t.Y\ p,P ' �(1y e,\
Owner Address: a�n2 S . 11 !p On 2-(fl 1
city/state/zip; Blair, NE 68008
Phone# L- %j[). � (DW-5
LICENSE FEES: Dog or Cat: $16.00
Altered Dog or Cat; $11,OD
Replacement Fee for Cost 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 13YAL151 , . 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 Blalr for such dog or
cat. The City of Blair requires proof of rabies vaccination.
Included is a Stabe Fee of $1.25 being oolkxt+ed to fund the Nebraska Dog Fc Cat Operator Inspection Program
PET #1 14 Dog ❑ Cat )I Spayed/Neutered License Fee $
Pet Name — Birthdate 32•bl • ZO Sex
Color �,� Breed** Replacement$ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y
MICROCHIP ## (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: 5 (p 2l (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: CI 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.)
AO)VOt Send Gash by Mail TOTAL. ENCLOSED $ �
If you have questions, please contact Blair Police Department at (402) 4264747
.+t++ t..... . f ..... •I-+t......+t+f...*++++++.+++++++.++......I................++++
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Mama 151dIV fie date notappleaNe harnewp?Gs/newravdents)
Newly AMuired Pets: New Residents bo Blair:
■ Mt tst be iio� wPhn 10 days crop nerafiip ■ Must register pets w thin 10 days of
■ <OR> at 6 months of age if puppy/wen residem:y,