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RkWjt'-tj yeb 41 Ca#J3U) CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify 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, 2019 LICENSE FEES: Dog or Cat: $16.00 Owner Name: James Rador Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 735 N 15th Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008 Operator Inspection Program Phone #: (402) 658-0777 W� � r Drivers License #: ' 1 _ or Date of Birth: i l cI ci _ Subtotal licensed pets from below:,,_ Replacement Tags from below: Name: Boone Color: Brown Spayed/Neutered: False Mirochip # Vaccination Date: 1/25/2018 DOB: Not on File Sex: Male Breed: Labrador Retriever Duration .,,T year vaccine Vaccine Exp: 11-2512"0 ti License Fee $ Replacement: ❑Y ON City Tag # 2276 Total: 05/07/2019 10:44 4024260101 HOLSTEIN VET CLINIC PAGE 02/02 2019 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE: IN BLAIR CITY LIMITS AND OWN A DOC(5)'AND /OR CAT(S), COMPLETE THIS FARM AND klEtURN WITH A CHECK PAYABLE To: CITY OF BLAIR — 218 S. 16yt' 8T — GLAIR, NE 68008 YOU MAY LFGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT. *"PLEASE READ CAREFULLY*** YOU ARE REQUIRED BYLAW TO LICENSE YOUR PETS. Failure to do so i5 a violation of City Ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet, PET LICENSE RENEWALS ARE DUE BY 3/1512019. The city shall recognize a microchip ID number as the license number. It shall be unlawful for any dog or tht to wear any license or other city ID other than that issued by the City,of Blair far such dog or eat. 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 Lassie Ragan Spouse Dane Pedersen Owner Address 2104 Lincoln Street city/rstate/zip Blair, HE 68008 phone # 402-800-8864 DL # or DOB H13473773 Oet Name; Tessa Aga: 3Y DOB. 04-26-16 hex- Female color: Blue Merle I greed. Aussie Declared Dangerous/Potentially Dangerous Dog L NO YES microchip # City Tag # 4tal�ies Tag # 16929 in�,a, I a•�ic'iPc�h In c 't' ' or r' Rabies Descrlptlon: I YE 3 YEAR. blstein Veterinary Clinic 'Dr -..Lisa Schrum DVM & Dr. Krista Holstein DV1V,1 " 18 South 19th Street Blair, NE 68008 402-.426-7887 402-426-0101 Fax holsteinclinic@gmaii.com LICENSE FEES e 16. 0 Dog or cat: $11.00 Replacement Ta'g $ 5.00 Tote, g_ 1(0�; b D FAXED' OS-07-19 BY {(\ p ��l\ TOTAL PAGES 05/07/2019 18:44 4024260101 HOLSTEIN VET CLINIC PAGE 01/02 2019 PET LICENSE VERIFICrATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG($) AND /OR OAT(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, 5VT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT. 'PLEASE READ CAREFULLY' YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS, Failure to do so is a violation of City Ordinances 6,1.03 and carries a penalty of a fine up to $150,00 per pet. PET LICENSE RENEWALS ARE aLIE BY 3/15%241�J. 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 Crisis Ragan Spouse Dane Pedersen Owner Address 2104 Lincoln Street City/State/Zip 131Bir, NE 68008 402-800-8864 Phone # DL # or DOB H13473773 Feet Name: Alice Age; 3Y 04-26-16 Sex: Female Colon Tri Breed: Aussie Declared Dangerous/Potentially bangerous Dog NO YES Microchip # I City Tag # f �ti: _ ° �" q V.:�!ti'S' ��I171L,il4,ii�� � j nl�r� !.I ljj x;f S i � � . • h. lll ". � j51T1 t0 rR.abies Description: YEA Rabies Tag# 16925 3 YEAR Holstein Veterinary Clinic I r'. Lisa Schrum DVM & Dr. ,Krista Holstein DVNf 118 South 19th Street Blair, NE 68008 402-426-7387 402-426-0101 Fax hoisteinclinic@gmall.com LICENSE FEES Intact or Cat: $1&0 Altered Crag or cat: $11.OD Replacement Tag $5.00 Total lam FAXED 65-07-19 J BY T�]TAL PAC�1yS ,I CITY OF BLAIR - 2019 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:�/ March 15, 2019 Owner Name: Owner Address: City/State/Zip: Blair, NE 68008 Phone # Drivers License # or Date of Birth LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/15/2018. 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. An additional State Fee of $1.25 is being collected to fund the Nebraska Dog & Cat Operator inspection Progii PET # 1 Dog ❑ Cat Spa e*eute License Fee$Pet N e A eex Color Breed * Replacement $ ** Declared Dang r k orotentially Dan erous Dog: ❑ Y Q'N MICROCHIP # 1' ((If applicable) SUBTOTAL: $ 100 0 RABIES VACCINATION DATE: I (3 yr) (1 yr) _ City Tag # Z� * PET # 2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Aye 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 Aye Sex Color Breed * Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ M (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.) Donation to care for animals: $i $3 $5 $10 Other ***SEE BACK OF FORM FOR BREED SPECIFIC LICENSE REQUIREMENTS VISA / MC # Signature Do Not Send Cash by Mail TOTAL ENCLOSED $ Expires Security Code: If you have questions, please contact City Hall at (402) 426-4191 or by Fax: (402) 426-4195 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15late fee date not applicable for newpets/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. T 10 N -,� I M121-1 01-F A, r 11111 11:• f1r.-MV; Mil 111714 wi Kelims U233��� Certificate No: 0 • t7of "Eft e.U&I71I OWNER OF ANIMAL 2018 Dodge Cty Humane Society 787 S Luther Rd Fremont, NE 68025 County: Dodge 1117741 -.4 1 :1 Patient information... IENT: Blacky2 TAG NO: 022865 SPECIES: Canine WEIGHT: 9.80, SEX: Neutered Male AGE: 6M Color and markings: Grey And Black Signed MATT TALBOT License: 3220 Vaccinations done... = �14 111111 MFG BY: NOBIV SER.NO: 288171, LOT EXP: 09/27/19 ADM: SQ 4,A4 43 1q3 CITY OF BLAIR - 2019 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 �A'' �-- e-or three (3) adult cats per residential or dwelling unit. LICENSE RENE ALS ARE nijlr: mmrrh 15 2019 Owner Name:— ` Owner Address: City/state/zip: Blair, NE 68008 Phone # :52,3- V �� Drivers License # or Date of Birth 2)-e5� LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 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 3115/2019. 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. Induded is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection_ Program PET # 1 M Dog ❑ Cat payed Neutered License Fee $ l� Pet Name An �-- ex _ Color Breed * Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y N _-� MICROCHIP # (If applicable) SUBTOTAL: $ r RABIES VACCINATION DATE: (3 yr) i (1 yr) City Tag # PET #2 dDog ❑ Cat Spayed/Neutered License Fee $�� Pet N me — A?e � ex _ Color Breed * Replacement $ Declared Dangerous or Potentially Dangerous og: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag ia PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name An Sex Color Breed * Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ License Fee $ Replacement $ ❑N SUBTOTAL: $ _ (1 yr) City Tag # ** * *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Donation to care for animals: $1 $3 $5 $10 Other ***SEE BACK OF FORM FOR BREED SPECIFIC LICENSE REQUIREMENTS y Do Not Send Cash by Mail TOTAL ENCLOSED $ 0 VISA / MC # Signature Expires: Security Code: If you have questions, please contact City Hall at (402) 426-4191 or by Fax: (402) 426-4195 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS(March15late fee date not applicablefor newpets/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 niontfis of age if puppy/kitten residency. I- , CITY OF BLAIR - 2019 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: -Karch 15. 2019 Owner Name: C � Owner Address: \\j S-Q S City/State/zip: Blair, NE 68008 Phone # `7 D�`p ., �)--) V . Drivers License # or Date of Birth C? a _ 9 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 ***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 3/15/2019. 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. & Gat PET #1 Dog ❑ Cat U" payed/Neutered License Fee $� Pet Name Y--or Aye L 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 #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Aye Sex Color Breed * Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Aye Sex Color Breed * Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ ■W ME (1 yr) (1 yr) License Fee $ Replacement $ SUBTOTAL: $ City Tag # 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.) Donation to care for animals: $i $3 $5 $10 Other ***SEE BACK OF FORM FOR BREED SPECIFIC LICENSE REQUIREMENTS VISA / MC # Signature Do Not Send Cash by Mail TOTAL ENCLOSED $ Expires: Security Code: If you have questions, please contact City Hall at (402) 426-4191 or by Fax: (402) 426-4195 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date not applicable fornewpets/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. CITY OF BLAIR - 2019 PET LICENSE APPLICATION %— /0 "l 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, 2019 Owner Name: Owner Address: City/State/Zip: Blair,, NE 68008 Phone # 'An- rl I.P(1, 01 2U/ Drivers License # or Date of Birth V 0o D(--m2l ), T ),] ` (D3 LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Included is a State ***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 3/15/2019. 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. collected to fund the Nebraska host & Cat PET # 1 a Dog ❑ Cat :14 Spayed Neutered License Fee $ I Pet Name r h _ Age i Sex F Color l i (X0 w Breed * Replacement $ Declared bangerous or Potentially Dangerous D g: ❑ Y lit N MICROCHIP # 01-M (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # PET #2 ❑ Dog Cat ❑ Spayed/Neutered —�� License Fee $ It - 0_J f1t� Pet Name SAgge ''I Sex Color "V ' Breed * • oo_. "uv t Nm V Replacement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (WG 1 QOV1r 5 01 (If applicable), SUBTOTAL: $ RABIES VACCINATION DATE: Il�>' I cl (3 yr) (1 yr) City Tag PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Aye 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.) Donation to care for animals: $1 $3 $5 $10 Other ***SEE BACK OF FORM FOR BREED SPECIFIC LICENSE REQUIREMENTS VISA / MC # Signature Do Not Send Cash by Mail TOTAL ENCLOSED $ Expires: Security Code: If you have questions, please contact City Hall at (402) 426-4191 or by Fax: (402) 426-4195 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS(March 15late fee date not applicablefor newpets/new residents) Newly Acauired 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. 05/09/2019 16:22 4024260101 HOLSTEIN VET CLINIC PAGE 01/01 2019 PET LICENSE VERIFICATION,/,APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR - 218 S. 16TH ST BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDEM11AI, OR DWELLING UNIT. ***PLEASE READ CAREFULLY*** YOU ARE BEfQUTAED BY LAW TO LICEN52 YOUR PETS. Failure to do so is a violation of City Ordin�nge.,; (5,103 and carries a penalty of a fine up to $M.00 per pet, (SET LICENSE RENEW L$ ARE pIJE BY 3 15 2019. 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 atMi- 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 kitton NEW RrSIDENTS TO BLAIR Must rgEister pets within 10 days of residency Owner Name Rick Rasmussen Sprouse Robbin Owner Address 2053 Grant Street city/state/zip Blair, NE 68008 Phone # DL # or DOB r T# Pet Name: Tinker Age: q q (ZS DOB. - Sex: Splayed Female color: Porn Tabby Breed: VCH1 eStic Longhair (M a( VA6 f �� Declared 0anngerous/ Potentially Dangerous Dog yes Microchip #' City Tag # LLf —) a` �Rabies Tag,i � tit; o Rabies Description:, YEAR' 3 YEAR Holstein Veterinary Clinic Dr. Lisa Schruwn DVM & Dr. Kristo Holstein DVM 1.8 South 19th Street Blair, NE 68008 402-426-7387 402-426--0101 Fax holsteinclinic@gmail,com FAXED d5-09-1� BY TOTAL PAGES LICENSE FEES !rr#act Dog or Cat: $16.00 A! +are Dog or cat: $1I,,00 Replacement Tag $5.00 Total s i„� C CITY OF BLAIR - 2019 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. 161" 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. 2019 t , ; a itt �,J w, t : ViI Owner Name: Owner Address:. city/state/zip: Blair, NE 68008 3' Phone # L Drivers License # or Date of Birth i :.z, I i i Iv LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 Replacement Fee for Lost Tag• $5 00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/1512019. 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. Included is a State Fee of $1.25 being collected to fund the Nebraska Don & Cat PET #1 � Dog ❑ Cat Spayed/Neutered License Fee $ ~Y Pet Name i IiIAV i4 i Acie Sex t ". t Color P- !Tj i a _ wed" e a , �W V. Replacement $ * * Declared Dangerous or Potentially Dangerous Dog: ❑ Y P N MICROCHIP # �� �� i 4, � � L `1) _) I I G (If applicable) SUBTOTAL: $ RABIES VACCINATION DAT� :2 i 40 (3 yr) . (1 yr) City Tag # i; ,) � PET #2 Dog ❑ Cat l Spayed/Neutered License Fee $_ Pet Name Acie _ Sex �t€` Color �� ,i � : Zvi,-iii __ ii Breed * 7 i4c; „ k,, � i , 4_ Replacement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y �, N MICROCHIP #' :' � )t / i f (If applicable) SUBTOTAL: $ RABIES VACCINATION DA f" itj- 1 (3 yr) X (1 yr) City Tag #.d PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Age 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 # *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.) Donation to care for animals: _ $1 $3 $5 $10 _ Other ***SEE BACK OF FORM FOR BREED SPE I IC LICENSE REQUIREMENTS Do Not send Cash by Main' TOTAL ENCLOSED $ VISA / MC # i i ` , Ili(. i i ". Expires: i i I Security Code: ") i Signature <�$ �_g° .� If you have q ons, please con act ity Hall at (402) 426-4191 or by Fax: (402) 426-4195 +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Mato115/ate fee date not appl/cablefornewpets/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/kitben residency. FROM :BSAC FAX 1,10. :402-533-2722 1,1ay. 02 2019 02:03Ph1 P1 CITY OF BLAIR - 2019 PET LICENSE APPLICATION If yoU IEvo in Blair City limits and ovVli a dog(s) and/or cet(5), complete this form and return with check made pay6ble to: city of mallr * 218 S.' 16a' St. * Blair, NE 68008 You may legally own a combination of four (4) adult pets, but not more than three (3) adult dogs or three (3) adult cats per residential or dwaliing unit. LICENSE RENE7mnn owner Nome: owner Address: citv/state/ziw Eclair, NE 68008 Phone # Privers License # or Data of Blab LICENSE FEES: Dog or Cat; $16.00 Altored Dog or Cat: $11.00 Replacement fee for Lost Tag: $S.00 included is a SU to Fee of.$1.25 being 0011lected to fond the *.y.*pLOM p4D EFULLY"* YOU ARE REQ41REG BY LAW TO i-I gNSE YOUR PETS. ti allure to do So is a vlalht1011 of City 4rdlnant" 61103 and �prrlas tj penalty or a nme up to $150.01) per pet. PET l-ICENSES RENEWALS ARE DUE BY aLISL=. The City 411e11 recollnl2a a microchip identification number as the llcaytse number. It: shall bo Unlawful for ally dog or Gat to wofar 811y license or other city IdentificaMn other thou that issued by the city of Blair for such dog or rat. The City of Blair Mulres proof of robleG YACClnadon. PEA' #1 Dog ❑ Coat '� Sprayed/Neutered License Fee $ Age Sex 1 Pet lorame Breed y i i V Replacement $— ** Declared Dangerous or Potentially Dangerous bog: ❑ Y A, N MICROCHIP # (If applicable) SUSTOTAL: $ t ._ RABIES VACCINATION DATE (3 yr) ,,. (I yr) City Tag # PET #2 El Dog ❑ Cat U Spayed/Neutered License Fee $ Pet Name — Age _,_,— SeX Re ** Color mm Breed Replacement _ _ p $ Declared Dangerous or Potentially Dangerous Dog: » Y C3 N° MICROCHIP # (If applicable) SUBTOTAL, $ RABIES VACCINATION DATE: (3 yr) (I yr) City Tag # �* PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ - pet Name A e Sex Color reed _ —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 CITYTAG NUMBER IF THIS IS A RENEWAL ** (This Pee is due along with License Fee If rAtlutaiiting at the time of license renewal.] Donation to care for 0111mals: _ $ _ $ $S $10 Other,_ ***SEE BACK OF FORM FOR BREECH (SPECIFIC LICENSE REQUIREMENTS R Do Not send Caswh by Mail TOTAL ENCLOSED $ VISA I MC # Signature Expires: security Code: If you have questions, please contact City Wall at (402) 426.4191 or by Fast: (402) 426-41JS NEW PET/NEW RESIDENT LICENSING R4QUIREMENTS (Mon i t , lar feed`atenotapplitablert�rl7eivpehs/r+ wrc �rlenrs) Na�nliy A011 Q] d PeW R Mint be qci Within 10 days of ownership ■ MuSt register peeks within 14 days of 0 <OR> at 6 months of age 9IupCylwten residenw. y CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify 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, 2019 LICENSE FEES: Dog or Cat: $16.00 Owner Name: Gary & Alicia Ray Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 713 N 16th St Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008--0000 Operator Inspection Program Phone #: (402) 619-9966 Drivers License #: or Date of Birth: Name: Starsky Color: Black Spayed/Neutered: True Mirochip # Vaccination Date: 3/1/2017 Subtotal licensed pets from below: Replacement Tags from below: DOB: 6/1/2005 Sex: Male Breed: Domestic Shorthair Duration: 3 year vaccine Vaccine Exp: 3/1/2020 License Fee $ Replacement: ❑Y ❑N City Tag # 274 Total: CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify 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, 2019 LICENSE FEES: Dog or Cat: $16.00 Owner Name: Gary & Alicia Ray Spayed/Neutered Dog or Cat: $11.00 Owner Address: 713 N 16th St Replacement Fee for Lost Tag: $5.00 Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008--0000 Operator Inspection Program Phone #: (402) 619-9966 Drivers License #: or Date of Birth: Name: Hutch Color: Tri-Color Spayed/Neutered: True Mirochip # Vaccination Date: 3/1/2017 Subtotal licensed pets from below: Replacement Tags from below: DOB: 7/1/2007 Sex: Male Breed: Domestic Shorthair Duration: 3 year vaccine Vaccine Exp: 3/1/2020 License Fee $ Replacement: ❑Y ON City Tag # 273 Total: CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify 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, 2019 LICENSE FEES: Dog or Cat: $16.00 Owner Name: Rondald & Janice Rech Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 360 Baronage Cir Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008--0000 Operator Inspection Program Phone #: <NO PRIMARY PHONE> Drivers License #: Name: Mika Color: Tri-Color Spayed/Neutered: True Mirochip # Vaccination Date: 06/22/2017 or Date of Birth: Subtotal licensed pets from below: Replacement Tags from below: DOB: 01/01/2016 Sex: Female Breed: Australian Cattle Dog Duration: 3 year vaccine Vaccine Exp: 06/22/2020 License Fee $ Replacement: ❑Y ON City Tag # 1991 Total: FROM :BSAC FAX NO, :402-533-2722 May. 08 2019 04:32PM P1 �. ENSE APPLICATION CITY OF BLA,II� �019 I��T' L�� If you live in Blair City limits and own a dog(s) and/or cat(s), complete this tone and return with check made payable to; City of Blair 9 218 S.16th St..* Blair, NE 68008 You may legally own a combination of four (4) adult pets, but kiln more then three (3) adult dogs or three (3) adult cars per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2019 Owner Name:' Owner Address: )n CltylState/z►pl Blair, NE 68888 Phone brivem License # or bate of Birth � LICENSE FEES: Dog or Cat: $1f,.00 Altered bog or Cart: $11.00 Replacement Fee for Lost Tog: $5.00 is ***PLWE READ ICARERJLLY**,* YOU AIM REQUIRED By LAW TO LICENSE YOUR PETS, r'allura to do so Is n wlnlation of City ordinancen 6.103 and carries a penalty of a fine up to $160.00 per p6ht. PET 410ENSE5 RENEEWA0 ARE DUE BY A 11go18, The City shall iowgnize a mlaochip Identification number Us the Ilcen9e numper- It shall be unlawful for any dtig or Cat to wear any license or other city Itlentificatlun other than that Issued by the City of blalr for smh dog or cat. The City ar Barr raqulres proot of rabies vaccination. & Cat PET 1 C o g ©Cat ( Spaye Neutered License Fee $� Pet Name Color Replecefnent $ Declared Ianglro�is or Potentially Dangerous Dotj: ❑ Y CI N MICROCHIP # I ,� l (If applicable} S TOTAL: $ RABIES VACCINATION DATE; (3 yr) -_ _- (1 yr) �1Wlty Tag #� — * PET # 2 CN Dog © Cat © Spayed/Neutered Pet Name__..,,, A�e ........ — Sex Color Breed?* Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # __.__- (If applicable) RABIES VACCINATION DATE: (3 yr) — PET #3 U Dog ❑ Cat 0 Spayed/Neutered Pet Name W Abe - Sex Color Breed * Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # I _(If applicable) RABIES VACCINATION DATE:. -_.... (3 yr) — 0 N HE (1 yr) License Fee $ Replacement $_ ** SUBTOTAL: $ — City Tag........` License Fee $ — Replacement $ ** SUBTOTAL; $ (1 yr) _ City Tagk _* *PLEASE INCLUDE THE D'n Y TAG NUMBER IF THIS IS A RENEWAL ** (This fee Is due along with License.Fee if requesting at the time of license renewal.) Donation to care for animals: $1 $3 — $5 $10 Other ***SEE BACK OF FORM FOR BREED SPECIFIC LICENSE REQUIREMENTS VISA / MC.,,,� Signature DoNot Send cash bymail TOTAL ENCLOSED $ Expires: Security Cade: If you have questions, please contaot City Hall at (402) 4216.4191 or by Fax: (402) 420-4195 .l..N.H..*..+.**.E..+..H...*+......r.1.........*...++++++.....+......-ra-... ................. NEW PET/NEW RESIDENT LIOENSINO REQUIRPMPNTS (M,7tth.I5lat*ft date notapplicableiormwpe1!VnewmsidMts) Newly Acaulmd Pam. _-__---- . New Residence to . 0Must belice . within 10 days Vow nembip W ■ Must register pets withinAD days of 0 <OR> at 6 months of age if Plappy/14rretl residency. /)-,; - I � CITY OF BLAIR - 2015 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: March 15. 2016 Owner Name: 0 A - owner Address: City/State/Zip: Blair, NE 68008 Phone# Drivers License # or Date of Birth b4 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 3/15/201t& Ttle 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 An additional State Fee of $1.00 is being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET #1 nk Dog 0 Cat `,Spayed/Neutered License Fee $ Pet Name k-f\ -k< Age Sex vIf\ Color P—o—'Cj t 0-�" I ) Breed**O Replacement Declared Dangerous or Potentially Dangerous Dog. 0 Y K N MICROCHIP # - Vuo (If applicableSUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (I yr) _ City Tag it PET #2 [1 Dog [I Cat 0 Spayed/Neutered Pet Name Age Sex — Color Breed" Declared Dangerous or Potentially Dangerous Dog: [I Y 0 N MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ PET #3 [1 Dog Ej Cat [I Spayed/Neutered Pet Name Age Sex — Color Breed" Declared Dangerous or Potentially Dangerous Dog: El Y 11 N MICROCHIP # (if applicable) RABIES VACCINATION DATE: (3 yr) _ Replacement $ — ** SUBTOTAL: $ (I yr) _ City Tag # 2015 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.) Donation to care for animals: a $1 $3 ® $5 _ $10 _ Other ***SEE BACK OF FORM FOR BREED SPECIFIC LICENSE REQUIREMENTS VISA / MC # Signature Do Not Send Cash by Mal/ TOTAL ENCLOSED $ Expires: Security Code: If you have questions, please contact City Hall at (402) 426-4191 or by Fax: (402) 426-4195 . . .. . . . . 4 . . . . . . 4 . . . .... . . 4-++4 . . . . . . 4-++++++4 . . . . . . 4 . . . . . . . . . 4-++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15 late fee date not applicable for new pets/new residents) Newly Acquired Pets: New Residents to Blair: . 0 Must be licensed within 10 days of ownership 0 Must register pets within 10 days of 0 <OR> at 6 months of age if puppy/kitten residency. V I 1 *9141 P: yy murn H 1 "2 now, 4 W i , , 1— Wo urr, ;-a' -t I I I " 'j �'i' � � 1" -11 - j Ks TIM f P MH F A 111 "'Ai "7j "" UO:-- T711'- I - L," L "-, , '?.1 ��fl � I ; !l- V � P'�i " ! '.:' ',I FAIMI- Q Am h ". GFITITO TdAT - IJAIII�" L 11-1 Ti line 1) 10111 0 1 11 j A; A to F-I 71fi, L7- Jul Mar 13 19 10:31 a Thone Animal Care 4024265808 P.1 CITY OF BLAIR - 2019 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 clogs or three (3) adult rats per residential or dwelling unit. LICENSE RENEWALSAREDUE: March 15, 2019 Owner Name; �.��1,^yJ I ( e Owner Address: I�( City/state/zip: Blair, NE 68008 Phone # Drivers License #t or Date of Birth LICENSE FEES: Dog or Cart: $16.00 Altered Dog or Cat: $1.1.0o Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund th( ***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 $150.00 per pet, PET LICENSES RENEWALS ARE DUE BY 3l15/2018. The City Shall recognize a microchip ldentlFlcatlon number as the license number, It shall be unlawful for any dog or cat to wear any license or other city Identification other than that Issued by the City of Blair for such dog or cat. The City of Biair requires proof of rables vaccination. & Cat PET #1 Dog Cat Spayed/Neutered License Fee$ ii-��% Pet Name_ Q jel , A e 2`�— Sex )� color _ JAI oU A' Breed ,� (�,. Replacement $ Declared Dangerous or Potentially Dangerous Dag: ❑ Y NI MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: 5 S - 6 (3 yr) {1 yr) X City Tag # * PET #2 ❑ Dog ❑ Cat Cl Spayed/Neutered Pet Name Color Breed" —Sex Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) License Fee $ Replacement $ ** ❑N SUBTOTAL, $ (1 yr) City Tag # PET #3 ❑ Dog ❑ 'Cat ❑ Spayed/Neutered License Fee $ Pet Name Acie Color Breed* Sex 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 due along with License Fee if requesting at the time of license renewal.) Donation to care for animals: $1 $B $5 $10 Other ***SEE BACK OF FORM FOR GREED SPECIFIC LICENSE REQUIREMENTS Do Not Send Cash by Mail TOTAL ENCLOSED $ VISA / MC # Expires: Security Code; Signature If you have questions, please contact City Hall at (402) 426-4191 or by Fax: (402) 426-4Y95 +4-++++++++++++k+-1•++++.....+++k+i•-I-+++....+•F+++a-+++++++i•++++++*+++++•b� NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Mamh15late fee date notapplicablelbrneivpetslnewresidents) Newly Acquired Pell• New Residents t0 Blair• _ ■ Mtist be ILarsed v�ithin 10 days of ownership L ■ st register pets within 10 days of ■ <OR> at 6 montfts of -age If puppy/kitten Thone An imal Care of rnc (402) 426-3830 -002 S. Hwy ^0 Blr,41- i,!r- ' ,3 -1„ CERTIFICATE OF VACCINATION Date of Rabies Vaccination: 07-13-19 Certificate No: 0 Next Rabies Vaccination On: 07-12-20 Previous Rabies Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Countryside Small Animal Steve Roberts 1306 Stevenson 706 N. 11 th St. Fort Calhoun, NE 68023 Blair, NE 68008 ` ~ 402-468-4060 County: This is to certify... THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW. Patient information... PATIENT: Lucy TAG NO: 19-0686 SPECIES: Canine WEIGHT: 43.00 SEX: F AGE: 3 years BREED: Spaniel, Springer Color and markings... Brown and White Signed Kaycee Points Vaccinations done... License: 07-13-19 KNP Canine Rabies Vaccn, 1 yr, #19-0686 07-13-19 KNP Canine Bordetella Oral 07-12-20 07-13-19 KNP Canine DA2PPL 07-12-20 Rabies Vaccine Information... MFG BY: ZOET SER.NO: 306872 LOT EXP: 4FEB20 ADM: Sq t CITY OF BLAIR - 2019 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: March 15, 2019 Owner Name Owner Address:% .. City/state/zip: Blair, NE 68008 Phone #('. i Drivers License # or Date of Birth - 1 _ LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/15/2018. 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. Included is a State Fee of si.25 beina collected to tuna the Nebraska Doa & Cat PET # 1 El -Dog ❑ Cat LJ-S� yed�Neutered License Fee $ � Pet Name l-kO , Agie Sex '��`� t / f * Color _ t. g . Breed er ar 1 "�'i Rep/acement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑-N MICROCHIP # (If applicable) SUBTOTAL: $ ., ��� RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # Z41' _w PET #2 [J—D'og ❑ Cat ❑- Spayed/Neutered License Fee $ _ Pet Name I iA Aye Sex Color; �,tiuj� ,;._ Breed* Rep/acement $ _ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag #' PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Aye Sex Color Breed * Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ m (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.) Donation to care for animals: $1 $3 $5 $10 Other ***SEE BACK OF FORM FOR BREED SPECIFIC LICENSE REQUIREMENTS Do Not Send Cash by Mail TOTAL ENCLOSED $ VISA /',MC ## , - , Expires: Security Code: Signature If you have questions, please contact City Hall at (402) 426-4191 or by Fax: (402) 426-4195 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS(March 15late fee date not applicable for newpets/new residents) Newly Acquired Pets: New Residents to Blair: ■ Must be lioensed within 10 days of ownership ■ Must register pets within 10 days of ■ <OR> at 6 months of age if puppy/ldtten residency. 03/23/2019 10:02 4024260101 HOLSTEIN VET CLINIC PAGE 01/01 2019 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY L%MITS AND OWN A DOG(S) AND /oR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR — 218 S. 16TH ST — BLAIR,, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIOENTIAL OR DWELLING UNIT. "*PLEASE READ CAREFULLY"* YOU ARE REQqLRgY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City Ordinances 6,103 and carries 2 penalty of a fine up to si%oo per pet, PET LICENSE RENEWALS ARE DUE DY 3/15/7019. 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 P5T 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 Narne Ann Robins Spouse Luke Leehy Owner Addreso 1348 Nebraska St. city/State/Zip Blair, NE 68008 Phone # 402-960-8383 DL # or DOB Pet Name; Winstyn Age" SM sex: Male ----1--Co'or Black and White Breed: Blue Hir X Declared Dangerous/ Potentially Dangerous Dog NO YES Microchiip # j City Tag v 5011"At Rabies Tag # 16756 Rabies Description., YEAR Holstein Veterinary Clinic Dr. Lisa Schrum DVM & Dr. Krista Holstein DVM "18 South 191h Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteindinic@gmall-corn LICENSE FEES 0 Altered Dog or cat: $11.00 Replacement Tog $5.00 Total FAXED 08-23-19 9:31a BY VITAL PAGES -7 t/ �' CITY OF BLAIR - • PET LICENSE APPLICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair • 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, 2019 Owner Name: '0aaa Owner Address: r-)i 24;77 LJ, I h a ti,�-J City/State/Zip: Blair, NE 68008 Phone # go a- 0/ U- l a A C) Drivers License # or Date of Birth �J ' LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet PET LICENSES RENEWALS ARE DUE BY 3/15/2019. 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. is a State Fee of $1.25 being collected to fund the Nebraska Doci & Cat PET # 1 Dog ❑ Cat a Spayed/Neutered License Fee $ 0� Pet Name rax k-i Age 5 Sex F Color t6 /&c /6 �T2Ln Breed * :MR (xi-e i 12—r Replacement $ * * Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # q 9611 21 C>DS- o 39� (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: 5 - 'L;�o- 19 (3 yr) (1 yr) City Tag # PET # 2 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name An Sex Color Breed * Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ W (1 yr) PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Ave Sex Color Breed * Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) (1 yr) License Fee $ Replacement $ * * SUBTOTAL: $ City Tag # 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.) Donation to care for animals: $1 $3 $5 $10 Other ***SEE BACK OF FORM FOR BREED SPECIFIC LICENSE REQUIREMENTS VISA / MC # Signature Do Not Send Cash by Mail TOTAL ENCLOSED Expires E Security Code: If you have questions, please contact City Hall at (402) 426-4191 or by Fax: (402) 426-4195 ++++++++++++++++++.....++++++++++++++++++++++++++++++++++++++++++++++++.....+ NEW PET/ NEW RESIDENT LICENSING REQUIREMENTS(March 15late fee date not applicablefor newpets/new residents) Newly Acquired Pets: New Residents to Blair: ■ Must be licensed within 10 days of ownership ■ Must register pets within 10 days of ■ <OR> at 6 months of age if puppy/kitten residency. Date of Rabies Vaccination: 05-30-19 Certificate No: 0 Next Rabies Vaccination On: 05-29-20 Previous Rabies Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Countryside Small Animal Dana Roe 1306 Stevenson 725 N. 1 Oth Ave Fort Calhoun, NE 68023 Blair, NE 68008 402-468-4060 County: This is to certify... THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW. Patient information... PATIENT: Frankie TAG NO, 19-0560 SPECIES: Canine WEIGHT: 94.40 SEX. S AGE: 5 years BREED: Rottweiler Color and markings... Black and Tan Signed Jeri Sill License: 1986 Vaccinations done... 05-30-19 JJS Canine Rabies Vaccn, 1 yr, #19-0560 Rabies Vaccine Information... MFG BY: ZOET SER.NO: 306872 LOT EXP: 4FEB20 ADM- Sq Sep 0419 03;20p Thone Animal Care 4024265808 p,1 CITY OF BLAI R - 2019 PET LIC ENSE APPLICATION y . If you live in Blair City limits and own a dog(s) and(or cat(s), complete this form and return with check made payable to: City of Blair • 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, 2019 Owner Name, L), ` Q ,Ys Owner Address:=-- Cityl5tate/Zip: Blair, NE 68008 Phone # Wd z 2.3 ,4 Drivers License # or Date of Birth l r� 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 $125 being collected to fundth, ***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 BY 31151201 8. The City shall recognize a microchip Identification number as the 11cense number. It shall be unlawful for any dog or cat to wear any Ilcense or other city identification other than that Issued by the City of Blair for such dog or ,at. The City of Blair requires proof of rabies vaccination. Cat PET #1 V!, Dog ❑ Cat 0 Spayed/Neutered License Fee $ Pet Name mft x>c Agge �`1-- Sex n If /,tt. eV' tveA ** Color t` ,�lpfA1t0 / In Breed** xne 514, ri Trf1YKie.y- Replacement$ Declared Dangerous or Potentially Dangerous Dog: ❑ Y 5f N MICROCHIP # (if applicable) SUBTOTAL: $ RABIES VACCINATION DAT6(r ► 61 (3 yr) (i yr) _ City Tag # PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Aye Sex Color Breed * Declared Dangerous or Potentially Dangerous Dag: ❑ Y ❑ N MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) (1 yr) License Fee $ Replacement $ ** SUBTOTAL; $ City Tag #_ * r T #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License FeePet orameBreed** SexReplacement$lared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ NCROC}-iIP # (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.) Donation to care for animals: $1 $3 $5 $10 Other ***SEE. BACK OF FORM FOR BREED SPECIFIC LICENSE REQUIREMENT'S Do Not Send Cash by Mail TOTAL ENCLOSED $ VISA / MC # Signature Expires: Security Code: Imu ,je If you have questions, please contact City Hall at (402) 426-4191 or by FaX: (402) 426-4195 +-+++++++++.+++++++++ +++....................................................... NEW PETINEW RESIDENT LICENSING REQUIREMENTS(March15late fee datenot appllcablefnrnewpets/newresidents) Newly Acquired Pets: New Residents to Blair., ■ Must be Va-ised v thin 10 days of m&nershlp ■ Must register pets within 10 days of a <03i> at6monthofageifpuppy/kitten residency, Thone Animal Hospital (402) 426-3630 902 S Hwy 30 Blair, NE 68008 02/12/2019 15:52 4024260101 HOLSTEIN VET CLINIC FACE 01/01 2019 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR — 218 S. 16TH ST — BLAIR, NE 68008 YOU MAY LLGALLY 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 LAW TO L01NISE YOUR PETS. Failure to do so is a violation of City Ordinances 8,io) and carries a penalty of a fine up to $150.00 per pot. PET LICENSE RENEWALS AIDE DUE eY $—I-SJ2019. The city shall recognize a microchip ID number as the licen5e 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 4r cat. NFW PET LICENSING Must be licensed within I0 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 Towner Name Julie Rohifing Spouse Charles owner Address 1270 South 16th Street city/State/Zip Blair, NE 66003 Phone # 402-426-8339 DL # or DOB i7 Pet Name: Sammie Age: JY hex: S dyed Female color: Black Breed: Aussie X Declared Dangerous/Potentially Dangerous Dog NO YES Microchip # 4A37'6FOISi4 City Tag # ybabies a is i..;* tI• I, ayif niPir''r,� r(i!X' diY •I1 wJ)`d. y 4I �'"9•E1'� .>1:r. ,.: � Ia�xMl�:�.l. f .Il 1 �rLii, !: :��d Rables Description: 1 YEAR. Tag It 14936 3 YEAR Holstein Veterinary Clinic Dr. Lisa Schrum DVM & Dr. Krista ,holstein DVM 1.8 South 1.0th Street Blair, NE 68008 402-426-7387 402-426-0101 Fax hoisteinciinic@gmaiI.com LICENSE FEES Intact Dog or Cat: $16= Dog or cat: $11 Replacement Tag $5.00 Total FAXED 02-12-19 3:43p BY TOTAL PAGES �j 9 jp CITY OF BLAIR - , PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify 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, .Orl`5 LICENSE FEES: Dog or Cat: $16.00 Owner Name: Penny Rolf Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 758 South 16th St, Unit 193 Fee includes $1.00 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008 Operator Inspection Program Phone #: (402) 218-0720 Drivers License #:Not on file or Date of Birth: Not on file Subtotal licensed pets from below: Replacement Tags from below: Name: Goofy DOB: Not on File Sex: Female License Fee $ Color: White/Black Breed: Domestic Shorthair Replacement: Spayed/Neutered: True Dangerous Dog: OY ON Mirochip # Potentially Dangerous: City Tag # 1367 Vaccination Date: 1/13/2017 Duration: 3 year vaccine Vaccine Exp: 1/13/2020 Total: FROM :9SAC FAX NO. :402-533-2722 Mar. 12 2019 12:51PM P1 CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or oat(s), complete/verify this form and return with check made payable to; City of Blair * 218 S 16th St. * Blair, NE 80008 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. LICENSIE RENEWALS ARE DUE: March 16, 2019 LICENSE FEES: Dog or Cat: $16.00 Owner Name: Janie Rowswell Spayed/Neutered Dog or Cat: $11.00 Owner Address: 773 N 10th St Replacement Fee for Lost Tag: $5.00 Fee includes $1.25 for the Nebraska iaog and Cat City/State/ZIP: Blair, NE 68008 Operator Inspect! onProgram Phone M (402) 707-6816 Drivers License #:GQ1347506 or Date of Birth: 6/3/1061 U _.._...., - .. -Subtotal- iicensed pets from below...f . Replacement Tags from below: Nor • Getto Color: Black Spayed/Neutered: True Mirochip # Vaccination Date: 3/10/2017 DOB: 3/16/2012 Sex: Female Breed: Domestic Shorthair Duration: 3 year vaccine Vaccine Exp: 3/10/2020 License Free $� Replacement: 1. DYFN City Tag # 1669 Total; stir: CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify 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, 2019 LICENSE FEES: Dog or Cat: $16.00 Owner Name: Danial & Keala Roy Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 2535 Colleg Dr Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008--0000 Operator Inspection Program Phone #: (402) 427-5031 Drivers License #:H12594614 or Date of Birth: 3/22/1982 Name: Lilo Color: Black/Tan Spayed/Neutered: True Mirochip # Vaccination Date: 11/22/2017 Subtotal licensed pets from below: ,$ Replacement Tags from below: DOB: Not on File Sex: Female Breed: Dachshund Duration: 3 year vaccine Vaccine Exp: 11/22/2020 License Fee $ / Replacement: ❑Y C N City Tag # 246 Total: CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify 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, 2019 LICENSE FEES: Dog or Cat: $16.00 Owner Name: Danial & Keala Roy Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 2535 Colleg Dr Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008--0000 Operator Inspection Program Phone #: (402) 427-5031 Drivers License #:H12594614 or Date of Birth: 3/22/1982 Name: Tinkerbell Color: White/Black/Tan Spayed/Neutered: True Mirochip # Vaccination Date: 2/9/2046- Subtotal licensed pets from below:} � Replacement Tags from below: DOB: Not on File Sex: Female Breed: Mix B Duration: 3 year vaccine Vaccine Exp:,.2 212019 License Fee $_ Replacement: ❑Y ON City Tag # 1790 Total:' Feb 1519 09:45a Thone Animal Care 4024265808 p,1 CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), completeNerlly 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, 2019 LICENSE FEES: Dog or Cat; $1.6.00 Owner Name: David & Gay Rush Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5,00 Owner Address; 1040 State St Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008--0000 Operator Inspection Program Phone #: (402) 426-4420 Drivers License #: or Date of Birth: 6/3/1960 Name: Buster Color: Tabby Spayed/Neutered: True Mirochip # Vaccination Date: 2/2312018 Subtotal licensed pets from below: Replacement Tags from below: DOB: Not on File Sex: Male Breed: Domestic Shorthair Duration: 3 year vaccine Vaccine Exp. 2/2312021 License Fee $ Replacement: COY ❑N City Tag # 75 Total: Thole Animal Care of Blair (402) 426-3630 902 S. Hwy 30 Blair, NE 68008 y CITY OF BLAIR - 2019 PE ICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify 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, 2019 LICENSE FEES: Dog or Cat: $16.00 Owner Name: Douglas & Jill Russell Spayed/Neutered Dog or Cat: $11.00 Owner Address: 22-82_Jec-kson-Si ._ V� L -31"1 D- Replacement Fee for Lost Tag: $5.00 Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008--0000 Operator Inspection Program Phone #: (402) 426-3997 Drivers License #: or Date of Birth: Subtotal licensed pets from below: UO Replacement Tags from below: Name: Filbert DOB: 3/15/2011 Sex: Male License Fee $ Color: Black/White Breed: Domestic Longhair Replacement: Spayed/Neutered: True DY MN Mirochip # City Tag # 1027 *Vaccination Date: 7/24tM-6 Duration: 3 year vaccine 1L/nLZ0113 '� Vaccine Exp: -7/34/201-& Tota l : it CC) skill CLO yc)ycf CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify 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, 2019 LICENSE FEES: Dog or Cat: $16.00 Owner Name: Douglas & Jill Russell Spayed/Neutered Dog or Cat: $11.00 _ Replacement Fee for Lost Tag: $5.00 Owner Address: 2363 Jackson gt ���G { 1�. 11 i Di . Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008--0000 l-� Operator inspection Program Phone #: (402) 426-3997 Drivers License #: or Date of Birth: Subtotal licensed pets from below: Replacement Tags from below: Name: Maggie DOB: 3/15/2008 Sex: Female License Fee $ E, Color: Black Breed: Labrador Retriever Replacement: Spayed/Neutered: True ❑Y EIN Mirochip # City Tag # 545 Vaccination Date: 3/21/2017 Duration: 3 year vaccine Vaccine Exp: 3/21/2020 Total: ud) CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify 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, 2019 Owner Name: William Eugene Ryan Owner Address: 1243 Colfax St City/State/ZIP: Blair, NE 68008--0000 Phone #: <NO PRIMARY PHONE> Drivers License # Name: Shadow Color: Black Spayed/Neutered: False Mirochip # Vaccination Date: 10/10/2018 LICENSE FEES: Dog or Cat: $16.00 Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Fee includes $1.25 for the Nebraska Dog and Cat Operator Inspection Program or Date of Birth: Subtotal licensed pets from below: �t Replacement Tags from below: DOB: 02/05/2017 Sex: Female Breed: Labrador Retriever Duration: 3 year vaccine Vaccine Exp: 10/10/2021 License Fee $ Rep acement: ❑Y N City Tag # 2466 Total : t