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Tt tj p tp 3 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. 161h 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, 2019 Owner Name: Owner Address: iAi t G city/state/zip: Blair, NE 68008 Phone # L� U, /, . Z- ?) 1 o () ( d Z-, Drivers License # or Date of Birth 1� b-, \ y, ;)- 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. Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat PET # 1 Dog ❑ Cat Spayed/Neutered License Fee $ `} Pet Name \ Age i °d L Sex k Color Breed" `n ys Replacement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y N MICROCHIP # i I ` �. j 1 I- C )10 1 ci tc o"'i 1i (If applicable) — 1-6,ne SUBTOTAL: $ ' . 00 RABIES VACCINATION DATE: 0 i i I i � (3 yr) (1 r y) � City g �-' Ci Tag # 1 r � /-2 PET # 2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name An 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 CI 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 Do Not Send Cash by Mail TOTAL ENCLOSED $ 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 (Mamc 15late fee date not applicablefor newpeWnewresidents) Newly Acquired Pets: New Residents to Blair: ■ Must be 11ensed within 10 days of mmership ■ Must register pets within 10 days of ■ <OR> at 6 months of age if puppy/fatten residency. 1UN/28/2019/FRI 07:12 AM Forest Lawn Cemetery Countryside Small Animal '1306 Stevenson PO 13DX 119 Fort Calhovil, NE 68023 402-468-4060 Printed- 06-26-19 at 1-1;20,9 UENT INFORMATION Name Tuesday Tatum (2064) Address -7-1,8-M-onro-e5-D 9 PJ r- �) 1',q j Ff:-(Wfi-6U-n-,NE"-08023--- a t< w /- Phone 402 278-2241 PATIENT INFORMATION Name Darla (4637) Sex Fernale, Spayed Dirthday 12-01 -13 (unknown) 0 ID 986112005989632 Gcjor Gray Reminded 12-16-18 Reminders For: Darla 03-10-20 Feline Rabies, I Y 03-10-20 Feline FVRCP Vaccination (CVRC MEDICAL HISTORY - Vaccination View Data By Code 03-11-19 KNP RV1 F CVRC 01-27-18 KNP RVI F CVRC 01-14-17 JJS RVI F CVRr, 01-28-16 JJ$ RVI F CVRC (Additional history not shown) ,S,/- -2, Species Feline Breed Damestio5horthair Age 5y (unknown) Rabies 19-0244 Weight 1 O.QQ ft Codes Last done 03-11-19 03-11-19 Description tatty (Variance) Photo Feline Rabies Vacon, 1 Yr, #19-0244 Feline FVRCP Vaccination (CVRC) Feline Rabies Vacon, 1 Yr, #1 B-0098 Feline FVRCP Vaccination (CVRC,) Feline Rabies Vaccn, 1 Yr, #17-0036 Feline FVRCP Vaccination (CVRC) Feline Rabies Vaccn, I Yr, #10-0109 Feline FVRCP Vaccination (CVRC) M JUN/28/2019/FRI 07:12 AM Forest Lawn Comete'ry FAX No.402-451-8960 P.001 TO: City of Blair FAX 4: (402)-426-4195 FROAC Tuesday N Tatum 2509 Nebraska St, Apt 3 Blair NE, 68008 PHONE: 402-278-2241 FKAJL: TOTAL NUMBER OF PAGES, INCLUDING COVER: 2 RE: Shot records for Cat - 1,iceme for Darla Please call to make payment over phone and email licerise paperwQvk, if possible. Thank you, Tuesday N Tatum 2019 PET LICENSE VERIFICATION /APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND JOP, 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 ARC BY LAW TO LICENSE YOUR PETS. Pallure to do so is a violation of City Ordinances 6.103 and carries a penalty of a fine up to $150.00 per pat. PET LICENSE RENEWALS ARE DUE 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 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 Brooke Taylor spouse Gavin Shallberg Owner Address City/State/Zip Blair, NE 68008 Phone # 402- i7-3787 DL # or DOB ' PET# Pet Name: Nash Age� 14M Sex: Male color: Gold Breed: Golden Retriever Declared Dangerous/ Potentially Dangerous Dog YES microchip '# 985112010030947 City Tag # r IN 11" "'I"N"101100 Rabies Tag # 16621 144 rNlm, E Rabies Description: 1 YEAR Holstein Veterinary Clinic Dr. Lisa Schrum DVM & Dr. grista Holstein DVM 718 South 191h Street Blair, NE 68008 402-426-7387 402-426-0101 Fax hoisteinclinic@gmail.com LICENSE FEES pc qQ,g Altered Dog or cat: $11.00 Replacement Tag $5,0o Total $ ' � w FAXED 01-09-19 11:36a BY TOTAL PAGES To Tog j7 To/To 39vd OINI-10 13A NIEI.LS-101-1 'VZop 60:ZT 6TOi7,/60/TO Lry 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: TAYLOR, ERIC J Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 2955 WESTRIDGE DR Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: BLAIR, NE, 68008--0000 Operator Inspection Program Phone #: (402) 278-0565 Drivers License #: Name: Skye Color: Blue Merle Spayed/Neutered: True Mirochip # 986112001610787 Vaccination Date: 02/28/2018 or Date of Birth: I I _1 — i q 8`s Subtotal licensed pets from below: Replacement Tags from below: DOB: Not on File Sex: Female Breed: Australian Cattle Dog Duration: 3 year vaccine Vaccine Exp: 02/28/2021 License Fee $ Replacement: ❑Y l City Tag # 2377 Total: 4 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 # 1J/ — Drivers License # or Date of Birth —5 ;-5- - S r� LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 z) 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. inciivaw is a smote Fee of si.Z5 l;einci collected to tuncl tsne NeuiasKa L)oq & cat PET # 1 ,el Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name S:c h6lJC�lr. i Z� Agge Sex ,A Color 0�c_i a h'_ Breed** - Replacement $ Declared Dangerous or Potentially Danger us Dog: ❑ Y J❑-N MICROCHIP #..AM h o ^ o 6 (If applicable) SUBTOTAL: $ RABIES VACCINA ION DATE: (3 yr) 7`-- (1 yr) City Tag # TTn T17 ** PET #2 a Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name JA )� I S s e, Acie Sex Color i)v.yyE lw.rr • Breed" Dc� PO n e o-- Rep/acement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # -/C 3-5-3Y5 C '7 ze? (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) 1< (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) _ ■W (1 yr) License Fee $ Replacement $ SUBTOTAL: $ City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Donation to care for animals: $i $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: m 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. &��- # aj- �s 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: TEACH, FREDRIC M & MARILYN A Spayed/Neutered Dog or Cat: $11.00 Owner Address: 1344 FAIRVIEW DR 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) 426-5355 Drivers License #: Q 60 f& or Date of Birth: 3/10/1947 Subtotal licensed pets from below: 0& 00 Replacement Tags from below: ` K--0 Name: Frances DOB: Not on File Sex: Female License Fee $ 1 t 00 Color: Black/White Breed: Mix Breed Spayed/Neutered: True Mirochip # Vaccination Date: 2/ i42 Replacement: ❑Y ON City Tag # 11 Duration: 3 year vaccine Vaccine Exp: 2l ',01tr Total: I ltoo FROM :BSAC FP NO. :402-533-2722 Mar. 13 2019 02:34PM P1 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 doge or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE-. March 15, 2019 LICENSE FEES: Dog or'C t; 16.00 Owner Name: Rodney & Ann Thiemann Spayed/Neutered pogo Cat: $11.0 Replacement Fee for Lost ag. 5.00 Owner Address: 1124 Stillmeadow Crir Fee includas $1.25 for the Nebraska dog and Cat City/8tate/ZIP: Blair, NE 68008.1175 operator Inspection Program Phone #: (402) 426-9670 Drivers License #:G29008524 or Date of Birth: 11/$/1959 Subtotal licensed pets from below! Replacement Tags from below, Name: Calile Color: Cream Spayed/Neutered: True 1Vlirochip # 44673F6129 Vaccination [late, 3/1 11616 DOB. 8/1/2003 Sex: Female Breed: porxtestic Shorthair R Duration: 4 year vaccine Vaccine Exp. 3/ 131201-9 �t License Foe $ Replacement; Air I%N City Tag 4 1318 Totaf_t r Client ID: Client Name Address: Phone: 655 Rodney & Ann Thiemann 1124 Stillmeadow Circle Blair, NE 68008 (402)426-9670 Tag Number: 00 Lot Number: 18398 Imrab Rabies Vaccine Producer: Merial K / MLV / R: Killed Virus Fair Small Animal Clinic PC David E. Johnson DVM 1734 Front Street Blair, Nebraska, 68008 (402) 533-2722 Rabies Certificate Patient ID: Patient Name Species: Breed: Sex: Color: Markings: Birthday: Weight: Microchip ID: Vaccination Date: Expiration Date: Staff Name: David E. Johnson DVM License Number: 1893 19 655-1 Callie Feline Domestic Shorthair Spayed Female Cream 07/01 /2003 18.70 pounds on 3/13/2017 44573F6129 3/13/2019 311312021 FROM :BSAC FAX HO. :402-533-2722 Mai-. 13 20t9 02:3410M P2 CITY OF BLAIR - 2010 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), eornplete/verify this form and return with check made payable to: City of Blair * 218 S 16th ft * Blair, NE 68008 You may logaliy own a combination of four (4) adult pots, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE., March 16, 2019 LICENSE FEES. Dog or Cat: 16.00 Owner Name: Rodney & Ann Thiemann SpoVed/Neutered Dog a Gist: $11.00 Replacement Fee for Lost ag: 5.6o Owner Address: 1124 Stillmeadow Ci I' Fee includos $7.25 fqr the Nebraska Dog and Get City/State/ZIP: Blair, NE 68006-1175 Operator Inspection Program Phone 4; (402) 426-9670 Drivers License #:G29008524 or Date of Birth: 11/$/1959 .. Subtotal licensed pets from kaalnv�i: ., Yc c.ry Replacement Tags from below:_ Name: Bitay Color: Tabby Spayed/Neutered: True Mlrochip #p 985111000282393 Vaccination Date: 3/1"V, 016 DOE, 6/1/2011 Sex: Female Breed: Domestic longhair Duration: # year vaccine Vaccine Exp: 3/1 /209' license pee $ Rep] cement: EIYN City tag #!~ 1317 i POOB|air Small Animal Clinic PC David E.Johnson DVM 1734Front Street Blair, Nebraska, 68008 (402)533-2722 Rabies Certificate Patient ID: 6200 Client ID: 655 Patient Name: Bitev Client Name: � Rodney Species: ' Feline Address: � 11248UUmaadowCircle Breed: Domestic Longhair B|air, NE ' Sex: Spayed Female ~x \ Color: Black Tabby Phone: (402)426-9670 Markings: (« Birthday: 05/08/2011 � Weight: 12.00pounds on3/13/2U17 Microchip ID: 985111000282393 Tag Number: 00 Vaccination Date: 3/13/2019 Lot Number: 18308 Expiration Date: 3/13/2021 |norob Rabies Vaccine Producer: K8er)o| K/ PNLV/ R: Killed Viru's Staff Name: David E.Johnson DVM License Number: 1803 Roanoke Animal Hospital 513Byron Nelson Blvd. ' Roanoke, TX70262 (817)430-8988 ' Rabies Certificate Patient��|D� 10Q18-1 ��~ Client ID: � 10018 |e-yw0iwn^ �Lu��M�u Patient Name: � Howard ~ Client Name: '""y '"'='""" -- ` Species: Feline ' Address: 1 Breed: DonnoaMcShodhoir Sex: Neutered Male Fort Worth, TX ' Color: Orange Phone: (402)860-058 Markings: Birthday: 08/09/2012 Weight: 14.72 pounds on 8/9/2019 Tag Number: 53716 Vaccination Date: Lot Number: 17458A Expiration Date: Rabieo.Pure\ax |Producer: N1eha| | .M0/R: Recombinant Virus Staff Name: ' Joni Nne|, UVM License Number: 10038 8/0/2O1A 819/2020 [|(��—|/lA�� /0''�� ///"�- 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: Brian & Abbie Thompson Spayed/Neutered Dog or Cat: $11.00 Owner Address: 1161 Voss Cir 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) 426-5507 Drivers License #:H12337046 or Date of Birth: 8/22/1979 Subtotal licensed pets from below: ` f Replacement Tags from below: Name: 011ie DOB: 11/24/2005 Sex: Male License Fee $4 , Color: Breed: Dachshund Repl cement: Spayed/Neutered: True ❑Y IPN Mirochip # City Tag # 694 Vaccination Date: 5/23/2016 Duration: 3 year vaccine Vaccine Exp: 5/23/2019 6 Total: :'` f '31 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: Brian & Abbie Thompson Spayed/Neutered Dog or Cat: $11.00 Owner Address: 1161 Voss Cir 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) 426-5507 Drivers License #:H12337046 or Date of Birth: 8/22/1979 Subtotal licensed pets from below:(% Replacement Tags from below: Name: Gunner DOB: 11/1/2010 Sex: Male License Fee $ Color: Brown Spayed/Neutered: True Mirochip # Vaccination Date:,6119/2015 Breed: Dachshund Duration: 3 year v ccine Vaccine Exp: 5/ 2� Repl cement: ❑Y-YN City Tag # 693 511 , Total '� � Date of Rabies Vaccination: 7/1/2018 Certificate No: 0 Next Rabies Vaccination On: 7/7/2019 Previous Rabies Vaccination: VETERINARY CLINIC OWNER OF ANIMAL RO:hrig Animal Hospital -wy-att-'Matzen 225N. 3rd St. 2338 Lincoln st Arlington, NE 68002 Blair, NE 68008 402','L'478-4141 County: Washington This ` certify... ,:THAT HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW. Patient information... PAT.IENT:,.'Duke TAG NO: 022168 SPEC * lEt :,Canine WEIGHT: 55.00 SEX..'M6161o' AGE: 7M color" an4`markings: Black Signed V-' 6' - --, MATTHEW MERKWAN License: 3689 Vaccinations done... 7/7/201 MJM RABIES 1 YEAR, #022168 7/7/2018 MJM DHLPP PUPPY #3 2/28/2018 KR DHLPP PUPPY #3 2/7/2018 KR BORDETELLA ANNUAL BOOSTER 2/7/2019 2/7/2018 KR DHPP PUPPY #1 Rabies Vaccine Information... MFG BY: BI SER.NO: 4150447A LOT EXP: 4/21/19 ADM: SQ 2 x 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: Julie Thompson Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 341 S 21 st St Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008--0000 Operator Inspection Program Phone #: (402) 669-1945 Drivers License #: or Date of Birth: 11/5/1968 Subtotal licensed pets from below: 06 Replacement Tags from below: Name: Rowdy DOB: Not on File Sex: Male License Fee $ Color: Tri-Color Breed: Rat Terrier Replacement: Spayed/Neutered: True ❑Y 'P(N Mirochip # City Tag # 947 Vaccination Date: 10/1/2017 Duration: 3 year vaccine Vaccine Exp: 10/1/2020 Total: FROM :DSAC FAX h10. :402-533-2722 Aug. 14 2019 12:01PM P1 CITY OF FLAIR - 2019 PET LICENSE APPLICATION If you live in Blair City ►Imps and own a dog(s) and/or cat(s), complete this form and return with check made payable to; City of Blair o 218 S. 16th St, to glair, NE 68066 You may legally own a combination of four (4) adult pets, but no more thiin three (2) adult door; or three (3) adult cats per residential or dwelling unit, LICENSE RENEWALS ARE DUEm Mamh 15, 209 Owner Name- Owner Addrdtt: r` city/state/zip: Blair, NE 68008 Phone # uncl - Zt "J9 Drivers License ak or mate of Birth LICENSE FEES: Cog or Cat: $16.00 Altored Dog or Cat: $11.00 Replacement Fee for LoSt Tag: $5.00 or ***PLEASE REM CARE(-'ULLY*** YOU ARE REQUIRED BY LAW TO LIUNSE YOUR PATS. ralluro to do so Is a violation of eityt ordintances 6.103 and carries a penalty of a fln0 up to $130.00 perpet. PET LICENSES RENEWALS ARE DUE BY 34=11+1. The City shall rttb nizo 6 microchip Identification number a8 lha llwnse number. It shall be unlawful for any dog or root to wrabr any license or other city IdentlflGAlon other than that i93Uad by the City of glair for Such dop Or cat. The City of W r requires proof of cables mcination, & Cat FEET #1 14 Don 0 Cat X Spa ed Neutered License Fee $ Pet N me AR FIL Sex Color Breed * ReplrAromerit$,._., ** Declared Dangerous or Po entially Dange us Dog: I Y N MICROCHIP # � ' � f applicable) SUBTOTAL: $ RABIES VACCINATION DACE: (3 yr) (1 yr) City Tag #�* PEA' #2 U Dog U Cat U Spayed/Neutered License Fee $_. ... Pet Name_, _ _ _ An 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 �k�* PET #$ Ll Dog © Cat I) Spayed/Neutered License Fee $� Pet Name _ - . _ _.. Age Sfax . Color Breed * _ .------_--.-- Replacement $ Declared Dangerous or Potentially Dangerous Dog: u Y U 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,) DonNtion to care for animalB: $1 $3 $5 — $10 +Dtla ar ***SEE BACK OF FORM FOR BREED SPECIFIC LICENSE REQUIREMENTS Do Not Send Cash by Aral! TOTAL ENCLOSED $ VISA / MC # Expires: $ecurity Code: Signature _. If you have questions, please contact City Hall at (402) 426.4101 or by Fax: (402) 426-4195 +..++++++++t............. +++++++t++++++++++tttt+++++.............++++++tt+t.. NEWPEt/NEW RESIDENT LICENSING REQUIREMENTS (MarOr 51at�fee 0ltenot applkablefornewpels/riewresi0�yg) ■ Must kit Goetlseci t+rIHdn 10 dayts bFowrterstilp N ML16t rNl&ter PeU�Mthin M days of i �,QR;� at 6 months of age if puppy/kitten r2o@ncy, FROiV1 : BSAC FAX NO. :402-533-2722 Mar. 14 2019 02:12PM P1 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. 161h 8t. 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 dvwelling unit, LICENSE RENEWALS ARE DUE: March 15, 2019 Owner Name; Owner Address; I 0ity/state/zip: Blair, NE 68008 Phone # qDc" { Drivars Mcenvo # or Date of Birth LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat., $11.00 Replacement Fee for Lost Tap: $5.00 xnctuaeu is a ***PLEASF RUb CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violatlon of City ordinances 6,103 and carries a ponalty of a fine Up to $160,00 per pat. PET LICENSES RENEWALS ARE DUE BY =512019, The City shall rerognbe a vilcrochip itlar%fiieabm number as the Ilconso number. It sh,)ll be unlawful for any (109 or Cat to wear any license or other city identl0cation other than that iesued by the city of ©lair for such dog or cat, Tire City of Blair requlr" proof of rubles vacdnatlnti. collected to fund the Nebraska Dtou & Cat PET � ' Dog a Cat 'Spayed/Neutered L!cense Fee $.1LO. Pet Na Aye r m Sex Color �....._.. Breed * - Replacvn?ont $_ Declared Dangerous or Potentially Dangerous Dog., ❑ Y AN MTCROCHIP # q r ILA 7fsfS4lf t3 „ _(If applicable) SUBTOTAL; $ _L RABIES VACCINATION DATE: y_,p/,/�f (3 yr) _ (I yr) _ City Tang # d ' DIET ##'2 o g a Cat J4 Spayed/Neutered License Fee $ Pet Name A?e l' Sex .i(�n i 11.Q(i}�� Color Breed * Rep a ement $� Declared Dangerous or Potentially Dangerous Dog: ❑ Y N MICROCHIP # „- __ (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE1 —NN/ C1 ,_ (J yr) X (I yr) __.. _..._ City Tap j °* PET #3 ❑ Dog 13 Cat ❑ Spayed/Neutered Licensie Fee $ Pet Name Agge Sex Color Breed** Replacement Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ _ f7ABIES VACCINATION DATE: (3 yr) T (I yr) City'I'ag # �* *PLEASE INCLUDE THE CI'i'Y TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Pee if requesting at the time of license renewal.) Donation to care for animals; _ $1 —$3 $5 $10 Other „ ***SEE BACK OF FORM FOR BREED SPECIFIC LICENSE REQUIREMENTS VISA / MC # Signature „ Do Not ,Send Cagh by Mall TOTAL ENCLOSED.$ Expires: __ Security Code: If you hevo questions, please contact City Hall at (402) 426.4191 or by Fax: (402) 426�419B +++f...a-++......+++....... a............+++++++++*+.++++++...........t.......... NEW PETINEW RESIDENT LICENSING REQUIREMENT'S (March 151ate fee dots dotappl/cable for newpe"ervrnsl(yant!) Nired NOW pts to Blair•, ■ Must be lbused within 10 days of mi4i,hip ■ Must r"istor pets within 10 days of 4 <0R> at 6 Montt of age if puppy/kit m nml&W. a 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: THOMPSON, PAULA Spayed/Neutered Dog or Cat: $11.00 Owner Address: 2362 HOLLOW RD 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) 670-0280 Drivers License #: or Date of Birth: Subtotal licensed pets from below: Replacement Tags from below: Name: Sally DOB: l4ot on Filed Sex: Female License Fee $ Color: Black Breed: Mix Breed Replacement: Spayed/Neutered: True ❑Y ❑N Mirochip # City Tag # 1570 Vaccination Date: 2/16/2018 Duration: 3 year vaccine Vaccine Exp: 2/16/2021 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: THOMPSON, PAULA Spayed/Neutered Dog or Cat: $11.00 Owner Address: 2362 HOLLOW RD 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) 670-0280 Drivers License #: or Date of Birth: Subtotal licensed pets from below: Replacement Tags from below: Name: Misty DOB: Not on F4 Sex: Female License Fee $ Color: Yellow Spayed/Neutered: True Mirochip # Vaccination Date: 2/16/2018 Breed: Labradoir Retriever Duration: 3 year vaccine Vaccine Exp: 2/16/2021 Replacement: ❑Y ❑N City Tag # 1571 Total: gL 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. 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. LICENSE RENEWALS ARE DUE: March 15, 2019 Owner Name: M'IC "Joj 1 ._-Ab rht Owner Address: 9 r' - 63 29 tb` VA e, city/state/zip: Blair, NE 68008 Phone # Li 0 Z- Ll 2 (P — 5,30 q Drivers License # or Date of Birth D21a L� LICENSE FEES: Dog or Cat: $16.00 xAltered 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. inciucleci is a state Fee of si.Z5 being collected to tunci the Nebraska Dog tip Cat PET # 1 ICI Dog ❑ Cat )q Spayed/Neutered License Fee $_ll_�'' Pet Name Aqe S � OD Color �Y Breed?* f li—kst-r, /acement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y 0 N MICROCHIP #G95 Q O0-937 'NO (If applicable) S BTOTAL: $ . t =� RABIES VACCINATION DATE: Q (3 yr) (1 yr) V City Tag # ` * PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name A?qe 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 Ay Sex Color Breed * Rep/acement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Donation to care for animals: $1 $3 $5 $10 Other ***SEE BACK OF FORM FOR BREED SPECIFIC LICENSE REQUIREMENTS I 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(Maroh15late fee date not applicablefor newpets/new residents) Newly Acquired Pets: New Residents to Blair: ■ Must be licensed _wi thin 10 days of ownership ■ Must register pets within 10 days of months of ag (f-puppy/Wen residency. Hl®Istein Vet Clinic 718 South 19th Street Blair, NE 68008 402-426-7387 holsteinclinic@gmail.com FOR: Michael Thornburg 805 N 24th Ave Blair, NE 68008 (402) 426-5309 Printed: 05-24-19 at 9:05a Date: 05-24-19 Account: 9694 Invoice: 99036 Date For Qty Description Net Price 05-20-19 Callie 1 Fecal Floatation/Direct Exam 23.00 05-24-19 1 Examination - Office Visit 43.50 05-24-19 66 Albon Oral Suspension PER ML #4572 25.60 05-24-19 1 HWT Dog (Heartworm Test) 41.50 05-24-19 2 HeartgardPlus < 25# (6 PACK) 87.00 05-23-19 Zoe 1 Your Receptionist is Sadie 0.00 05-23-19 1 VETSCAN® Prep Profile II 46.25 05-23-19 1 Anesthetic 20# (Or Less) 62.75 - -I Sur ical Monitoring 9.50 05-23-19 1 Canine Spay <2Yr < 74.50 - - 1 Post Surgery aser Therapy 5.75 05-23-19 1 Post Surgical Pain Injection 0.00 05-23-19 1 Post Surgical Antibiotic Injection 0.00 05-23-19 1 Nail Trim - Complimentary 0.00 05-23-19 1 Surgery Hospitalization 16.25 05- - 5 Carprofen Chew Tabs 25MG #4558 6.75 05-23-19 05-24-19 1 Soft Blue Recovery Collar (XS / SM / MD) 12.25 05-24-19 1 HWT Dog (Heartworm Test) 41.50 05-24-19 2 HeartgardPlus < 25# (6 PACK) 87.00 05-24-19 Visa payment 640.35 Merchant ID: 529000245365, Approval code: 03315C, Transaction ID: 1236139146 Ref #: 10837, Act* ************7975, Exp: XX/XX, Entry: Contacticc, Card: VISA Your card balance is not available I AGREE TO PAY ABOVE TOTAL AMOUNT ACCORDING TO CARD ISSUER AGREEMENT X Old balance Charges Payments New balance 0.00 640.35 640.35 0.00 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 - G 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, 2019f Owner Name: I'C'hGP.I (�� r` 1 1iCtfllf� ii f Owner Address: �O K) a q t6 oye City/State/Zip: Blair, NE 68008 Phone # 46 ;, 4lig1a ° 13 0 Cl' Drivers License # or Date of Birth Lj X129 & 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. I M, IfC[-1pT1.1r7?a�• -I& J1W44'," 5- r LC'��UK71171%[N 711 f49VTT-10175-' w( PET # 1 Dog ❑ Cat Spayed/Neutered License Fee $� 0 Pet Name "-C- 1 w5(') Age Sex c t-, 'k, Color _ Breed * k• .Vy "q Replacement $ ** Declared Dangerous r% Potentially Dangerous Dog: ❑ Y N MICROCHIP # 9 S O i 1 Ac)o (1 `7 1 g c11 e) (If applicable)- V SUBTOTAL: $ ja T RABIES VACCINATION DATE: i(V 2 1I9: (3 yr) (1 yr) City Tag # d . 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 ❑N (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: $1 $3 $5 $10 Other ***SEE BACK OF FORM FOR BREED SPECIFIC LICENSE REQUIREMENTS Do Not Send Cash by Mail TOTAL ENCLOSED $ 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 (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. Auslzy Porro 1507 Old Gaelic Bellevue, NE 68123 Cell Phone: (850) 974-9975 aiisleyineganl3@)gmail.com DP" Banfield Rabies Certificate PET HOSPITAL Certificate Date Banfield Pet Hospital 7903 Towne Center Pkwy, Tuesday, October 23, 2018 4:47 PM Papillion, NE 68046-8046 (402) 331-1108 Pet Information Rabies Tags Name: Calypso Porro Species: Canine Banfield Breed: Dachshund National Pet ID# Gender: Female (Spayed) i 2178784 ! Color: dapple �' County & Tag # 1 a Age: 1y/4m None Weight: 10.00 lbs Microchip ID: 985112009714990 Manufacturer: Home Again/Merck Microchip ID: Manufacturer: Vaccine Information Vaccine Name : Rabies (Type: Killed) Producer: Zoetis Defensor 3 Administered: 10/23/2018 Route: Subcutaneous Site: Right Rear Due Date: 10/22/2021 Lot #: 282273 Lot Expires: 8/6/2019 I hereby certify that 1 have vaccinated this pet in accordance with all state and Federal laws and regulations on this date. Administered by: 110601- b " I Licensed Veterinarian: Dr. Ryan David Hagan DVM License Number: 3891 Any rabies certificate for this pet printed prior to the date of this certificate is null and void ReportlD: RabiesCert.en.x Hospital 411514 Page 1 of 1 Time Printed: 4:47 PM Date Printed: 10/23/2018 Ansley Eidson 3307 Campbell Ct Bellevue, NE 68123 Cell Phone: (850) 974-9975 -D Banfield PET HOSPHAL Banfield Pet Hospital 7903 Towne Center Pkwy, Papillion, NE 68046-8046 (402) 331-1108 Client iD # PAP06J5 Invoice # 077618 Friday, November 10, 2017 ENTER FOR A CHANCE TO WIN $2,000! La encuesta tambi6n esta disponible en Espanol. Tell us how well we've served you and your pet today. Go to www.tellbanfield.com to complete a short survey and enter for a chance to win a quarterly $2,000 prize. (NO PURCHASE NECESSARY. See official rules at www.tellbanfield.com or at this hospital location). Use this Survey Code and share your feedback with us: 1514-1110- Quantity Regular Fee Your Fee Calypso - Puppy Early Care Plus Plan Friday, November 10, 2017 Office Visit 1.00 39.95 Physical Exam: Wellness Plan 1.00 Elizabethan Collar, lightweight, clear, 15cm (6 inch) 1.00 10.99 9.89 OWP Ovariohysterectomy Package Canine Level 1 1.00 309.95 Acepromazine Injectable (per ml), Anesthesia Canine Ovariohysterectomy, Blood Pressure Monitoring, Anesthesia, Butorphanol 10mg/ml Injectable (per ml), Electrocardiogram Monitoring, Fluid Administration-Normosol, Hospitalization-Doctor's Supervision, Hospitalization -Hospital Team Care, Hospitalization -Ward Fee, IV Catheter Insertion, iV Extension Set (Each), IV Fluid Administration Set (Each), IV Fluids Pump, l,idocaine 2% Injectable (per ml), Operating Room and Setup, Ovariohysterectomy Surgical Fee, Pain Block Injectable, Post -Op Pain Control injectable (Canine), Pre -Anesthetic Examination, Propofol injectable (per ml), Pulse Oximeter, Recovery Care After Anesthesia, Rimadyl 50mg/ml Injectable (per m1), SecuroCryl Suture w/ Needle, Sterile Instrument Pack (Major), Sterile Surgical Drape, Sterile Surgical Gloves, Sterile Surgical Gown, Surgical Assistant, Surgical Prep, 'tracheal Intubation OWP Pre -Anesthetic Labwork Package 1.00 133.00 Complete Blood Cell Count (CBC/5 part machine differential), Electrolytes (K, Na, CI), internal Organ Function Screen, Machine Differential Invoice Documentation, OWP Blood Sample Collect / Prep Pedicure with Dremel 1.00 19.99 17.99 Pyrantel Pamoate 50mg/ml (per ml) 0.50 14.02 Rimadyl 25mg Chewable Tablet 2.00 7.67 6.90 Medical Waste Disposal Fee 1.00 3.20 Subtotal: $538.77 $34.78 Sales Tax at 7.50% Because your pet is on an Optimum Wellness Plan®, you saved $503.47 today. This savings calculation does not reflect any Optimum Wellness Plan enrollment fees or monthly payments you have paid, other than those made at this visit reflected by this invoice. * Indicates Taxable Service/Product 0.52 Regular Fee Your Fee Total: $538.77 $35.30 Report ID: Invoice.enx Time Printed: 4:04 PM Hospital 111514 All sales on medication and services are final Page 1 of 2 Date Printed: 11/10/2017 Ansley Eidson 3307 Campbell Ct Bellevue, NE 68123 Phone: (850) 974-9975 Pet Information Name: Species: Breed: Sex: Color: Age: Weight: Calypso Canine Dachshund Female dapple 16 weeks 4.60 Lbs/2.09 Kgs Microchip Information Manufacturer: Route: Subcutaneous Microchip ID #: Banfield PET HOSPITAL Banfield Pet Hospital 7903 Towne Center Pltwy, Papillion, NE 68046-8046 (402) 331-1108 Home Again/Merck Site: Intrascapular 985112009714990 Microchip Information Report ID: MCihipCert,en.x Hospital 111514 Page 1 of 1 Time Printed: 4:17 PM Date Printed: 10/12/2017 v 3- 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: Earlene Thornton Spayed/Neutered Dog or Cat: $11.00 Owner Address: 1048 S 13th Ave, Unit 202 Replacement Fee for Lost ag: $5.00 Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008 Operator Inspection Program Phone #: <NO PRIMARY PHONE> Drivers License #: i 3 -7 or Date of Birth: Subtotal licensed pets from below:_ %J.P_d Replacement Tags from below: Name: Jango DOB: Not on File Sex: Male License Fee $ ,0 0 Color: Black Breed: Mix Breed Replacement: Spayed/Neutered: True ❑Y ON Mirochip # City Tag # 2369 Vaccination Date: 11/30/2017 Duration: 3 year vaccine Vaccine Exp: 11/30/2020 Total: d/', 1�' `) 02/05/2019 11:42 4024260101 HOLSTEIN VET CLINIC PAGE 01/01 20t9 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR Ir YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR - 218 S. 16TH ST,- BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT, 'PLEASE READ CAREFULLY*" YOU ARE REQUIRED BYLAW TO LICENSE YOUR PETS, Failure to do go Ig a vioMlon of City Ordlnmces 6103 and carries a penalty of a fine up to 5150.00 per pet. PET LICENSE RENEWALS ARE PPE 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 I icense 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 Don.-Trevarthen Spouse Dixie Owner Address 1152 South Street City/state/Zip Blair, NE 68008 Phone # 402-960-4338 DL # or DOB 4 o o- — :A to o - 40 o tA --t-- Pet Name: Dory Age., 6MSpayed Female T� Color: Merle Breed: HEELER/AUSSIE Declared DangeroUS/Potentially Dangerous Dog NO YES Microchip # 985112010834102 City Tag # Rabies Tag # 1668-7 Rabies Description: EA 3 YEAR Holstein Veterinary Clinic Dr. Lisa Schrum DVM & Dr. Krista Holstein DVM -18 South 19th Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteinclinic@gmall.com LICENSE FEES Intact Dog or Cat- $16.00 �Altere Do Replacement Tag $5.00 Total $ FAXED 02-05-19 8:52a BY TOTAL PAGES 2019 PET LICENSE VERIFICATION /APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(5) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CM OF BLAIR — 218 S. 16TH ST — BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, ,13U-r NO MORE THAN THREE (3) ADULT 0065 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 6.103 and Carries a penalty of a fine up to $150.00 par pet, PET LICENSE RENEWALS ARE DUE BY 3/1512019. The city shall recognize a microchip ID number as the keriso 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 11cen5ed within 10 days of ownership (OR) at 6 months of age if puppy or kitten NEW RESIDEN15 TO BLAIR, Must regl5ter pets within 10 days of residency Owner Name Todd Trimpe Spouse Sarah Owner Address 521 N 10th Street City/State/Zip Blair, NE 68008 Phone# 402-426-1360 DL # or DOB DET # Pet Name: Stella Age: 2V sex: Spayed Female Color: Blue Breed: German Shepherd Declared Dangerous/Potentially Dangerous Dog M1�croch�fp # 985112008180641 City Tag # 'Irro R i, • 5977�g ,�j Rabies Description., I YEAR YEAR Holstein Veterinary Clinic Dr. Lisa Schrum DVM & DnKrista Holstein DVM 718 South 19th Street Blair, NE 68008 402-426-7387 402-426-0101 Fax hoisteinciinic@gmaiI.com LICENSE FEES Intact Dog or Cat: $16.00 Dag Qr cat: $11 Replacement Tag $5.00 Total $ (t-L-0- FAXED 03-12-19 4:39p BY �A TOTALPAGES TO/To 39vi DINI-10 iDA 1,11�1S-101-1 T9T09ZVZOP 6i?:9T GTOZ/ZT/CO FRDM :BSAC FAX N0. :402-533-2722 Feb. 23 2019 11:33AM P1 CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), completelverify this form and return with oheck mad@ payable to: City of )glair * 218 S 16th St. * Flair, ICE 68008 You play legally own a combinaWn of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dowelling unit, LICENSE RENEWALS ARE DUE, March 15, 2019 LICENSE FEES; Dog or Cat: $16.60 Owner Name: Steven Triplett Spayed/Neutered Dog or Cat; $M00 Replacement Fee for Lost Tag: $5.00 (Owner Address: 1709 South St Fey includes $1.25 for the Nebraska Dog and Cat City/State/71P: Blair, NE 68008--0000 Operator ln5pcctionProgram _••,• Phone #: (402) 426-5746 Drivers l_iconse #:VO0243776 or Date of Birth: 5/14/1975 Name: Atticus Color: Black/White Spayed/Neutered: True Mirochip # 985121013106187 Vaccination Date: 9/13/2016 Subtotal licensed pets -from below: 1 Replacement Tags from below: DOB: 3/10/2012 Sex: Male Breed: Border Collie Duration: 3 year vaccine Vaccine Exp-. 911312019 License Fee $ i _ 00 Replacement: ❑YIK City Tag t 1118 Total: 1 - 0 0 FROM :BSAC FAX NO. :402-533-2722 Feb. 23 2019 11:33AM P2 CITY OF BLAIR - 2019 PET LICENSE 'VERIFICATION If you live in Blair City limitc and own a dogs) and/or ont(s), complete/verify this form and return with check made payable to: City of I81air * 218 S I8th St. * Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs ,or throe (3) adult cats per residential or dwalling unit. LICENSE RENEWALS ARE [SUE: March 15, 2019 LICENSE FEES: Dog or cat: $16,00 Owner Nnme: Steven Triplett Spayed/Neutered peg or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 1709 South St Fee includes $1.25 for thL5 Nebraska Dog and Cat CitylState/71P: Blair, NE 68008-0000 operator inspection Program �m Rhone #: (402) 426-5746 Drivers License 4:VO0246775 or pate of Birth: 5/14/1975 Name: Dexter Color: Golden SpayedlNeutered: False Mirachip # 986121011296763 Vaccination Date, 6/23/2016 3t,btotal licensed -pets-from below: J',i- 00 Replacement Tags from below: DOB: 11/28/2011 Sex: Male Breed: Golden Retriever Duration: 3 year vaccine Vaccine Exp: 6/23/2019 License Fee $ f ro Replacement: nY IPN City Tag # 1097 Total : & . () G