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WMar 04 19 08:40a Thone Animal Care 4024265808 p,1 r CITY OF GLAIR - 2019 PET LICENSE APPLICATION V 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 2-019 Owner Name: oj&4 :e--4 Owner Address: i t D city/state/zip. Blair, NE 68008 Phone #-b"l--7r A---71 1 Drivers License # or Date of Birth LICIrNSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11, oo Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $125 being collected to fund the ***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 050.00 per pet, PET LICENSES RENEWALS ARE DUE BY 311512018. The City shall recognize a microch!p 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 Cog or cat, The City of Blair requires Proof of rabies vaccination. PET #1 Dog ❑ Cat 'Q Spayed/Neutered License Fee $ c7 Pet Name g� ll A e I Sex` Color (3Ik/��— Breed* Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y l�ifN MICROCHIP # _(If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) � (1 yr) City Tag #a* rn PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Color Breed* Sex Replacement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) _ (1 yr) City Tag #f' PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Color Breed* Sex Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) T 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: _ ***SFE BACK OF FORM FOR GREED SPECIFIC LICENSE REQUIREMENTS Other 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 +++d-+....4++.++d. ++++++ *+. f + a..F +++++++++++.++ *f +-i•+++++++++ *+++++. ++++++++++ f ++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fc� date not•appflrable ibr neivpets/newti s5Vents) Newly Acquired Pets: New Residents to Blair: s Must be licensed within 10 days of ownership " ■ Must register pets within 10 days of • <OR> at6 months of age if puppy/kiUEiThpnL3 Animal Care Of Bl l Idency. (402) 426-3630 902 S. Hwy 30 Blair, NE 68008 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. 16tI1 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: )am l S.7a1�rxC� Owner Address: l9a `1 ' r1 cv [n 4rt-e city/state/zip: Blair, NE 68008 Phone # go,o2 - R!^7 - 7q6 3 Drivers License # or Date of Birth 7 `,/- 7,;? LTCENSE FEES: Dog or Cat; $16.00 Altered dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska D ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BYLAW TO LICENSE YOUR PETS, Failure to do so is a violation of City ordinances 5,103 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 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 Cityof Riair requires proof of rabies vaccination. 1l PET # 1 d Dog O Cat ❑ Spayed/Neutered License Fee $ Pet Name J t rr IC Agge 11 Sex l-e_ Color L,u.t.,- -,l~ wk •fc Breed** k a Replacement $ Declared Dangerous or Potentially Dangerous og: ❑ Y N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: $-9-/ (-, (3 yr)_ yr) city Tag a_ PET #'2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet. Name Age _ 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 Color Breed* Sex 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 CITYTAG NUMBERIF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal,) Donation to care for anunals: $1 $$ $S $1.0 Other ***SEE BACK OF FORM FOR BREED SPECIFIC LICENSE REQUIREMENTS - VISA/ MC # Signature Do Not Send Cash by Mail TOTAL ENCLOSED $ Expires: Security Code: It you have questions, please contact City Hall at (402) 426-4191 or by Fax: (41D2) 426-4195 ++++++++++++++++++++++++++++++++++++++++++++++++++++++.+•+++.t.++++++++++++.++f•+++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15fate fee date not applicable for newpe&1neivre5idents) NewlyAcauired Pets: New Residents to Blair: ■ Must be :icensed Wthn 10 days ofow ietship ilr Must register pets within 10 days or N <OR> at 6 months of age if puppy/kitten residency, l.'d 90999zvzob eaeo jewluV euoq 1 o9 :L0 6 t a l -leN 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: Jenny Wanzy Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 1640 Grant St Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008 Operator Inspection Program Phone #: (402) 278-4459 Drivers License #: or Date of Birth: 02/08/1978 Name: Pebbles Color: Sable Spayed/Neutered: False Mirochip # Vaccination Date 07/1-11269 - ! -1 " Subtotal licensed pets from below: Replacement Tags from below: DOB: 04/25/2018 Sex: Female Breed: Great Pyrenees Duration: 1 year vaccine Vaccine Exp:_07-111/2020 License Fee $, Replacement: ❑Y ON City Tag # 2464 II%MF 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: Jenny Wanzy Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 1640 Grant St Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008 Operator Inspection Program Phone #: (402) 278-4459 Drivers License #: or Date of Birth: 2/8/1978 Subtotal licensed pets from below: Replacement Tags from below: Name: Magpi DOB: Not on File Sex: Female License Fee $ Color: Black Breed: Domestic Shorthair Replacement: Spayed/Neutered: True ❑Y ON Mirochip # City Tag # 2332 ... Vaccination Date: 4/11/2017 Duration: 1 year vaccine Vaccine Exp: 4/11/2018 Total: . C� & 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: Jenny Wanzy Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 1640 Grant St Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008 Operator Inspection Program Phone #: (402) 278-4459 Drivers License #: or Date of Birth: Subtotal licensed pets from below: Replacement Tags from below: Name: Poppy DOB: Not on File Sex: Female License Fee $ Color: White/Grey Breed: Great Pyrenees Replacement: Spayed/Neutered: True OY ON Mirochip # City Tag # 2334 Vaccination Date:,,-08/1-81201'5— Duration: year vaccine I - g Vaccine Exp: 08 1-8-- 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: Jenny Wanzy Spayed/Neutered Dog or Cat: $11.00 Owner Address: 1640 Grant St Replacement Fee for Lost Tag: $5.00 Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008 Operator Inspection Program Phone #: (402) 278-4459 Drivers License Name: Cupcake Color: Black/White Spayed/Neutered: True Mirochip # Vaccination Date: 3/13/201-8 , `� ' t or Date of Birth: DOB: Not on Fil Subtotal licensed pets from below: Replacement Tags from below: Sex: Female Breed: Domestic Shorthair Duration: 1 year vaccine Vaccine Exp: Y13l't019 License Fee $ Replacement: ❑Y ON City Tag # 2333 Total: Jun 05 19 09:06a Thone Animal Care 4024266808 p.1 Thone Animal Hospital (902�S Hwy 30 Blair, NE 68008 CITY OF BLAIR - �Qi 9 PET LICENSE APPLICATION if you live in Blair City limits and own a dog(s) a/or cat(s), complete this form and return with check made payable to: City of Blair * 28 S. 16th St. • Blair, NE 68008 You may legally own a combination of or three (3) adult LICENSE RENEWALS ARE DUE: Owner Name: 71 �hy Owner Address, dot City/state/zip: Blair, NE 68008 Phone 4) a 5 (Q-_ Drivers License # or Date of Birth . & 4- lcf (4) adult pets, but no more than three (3) adult dogs per residential or dwelling unit. LICENSE FEES, Dog or Cat: $16.00 Altered Dog or Cat: $11.00 Repladement Fee for Lost Ta : $5.00 Included is a State Fee of $1.25 being collected to fund th PET #1 2r Dog ❑ Cat ❑ Spay( Pet Name__.Age 1 Color lywt--t• Breed" j Declared Danciprous or Potential) . D rigero MICROCHIP #NQPM-� C RABIES VACCINATION DATE: U-0°J 1Q PET #2 ❑ Dog ❑ -Cat ❑ SpE Pet Name Ate Color Breed "* Declared Dangerous or Potentially Dange MICROCHIP # RABIES VACCINATION DATE: PET #'3 ❑ Dog ❑ Cat q Sp< Pet Name Aq?e Color Breed * Declared Dangerous or Potentially Dange MICROCHIP # RABIES VACCINATION DATE: *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS ** (This fee is due along with License Fee if req Donation to care for animals: $1 ***SEE BACK OF FORM FOR BREED SPECIF Do Not Send VISA / MC # Signature If you have questions, please contai ++++f++++++++++++++++++f +-a-++.... NEW PET/NEW RESIDENT LICENSING REQUIRM NeINIY Acquired Pets: ® Must be licensed within 10 days of ownership N <OR> at 6 months of age if puppy/Eiffel ***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 un awful for any dog or cat to wear any license or other city Identification other than that Issued by the City'of Blair for such deg or cat. The City of Blair requires proof of rabies vaccination. Nebraska Neutered License Fee $ �v A.,, Sex YY�d,.-'k2_ r n(2K= Q- , K Replacement $ Dog: ❑ Y �4_ N applicable) SUBTOTAL: $ t • �'� (B yr) (1 yr) X City Tag # 2 . Sex s Dog: ❑ Y ❑ N ff applicable) — (S Yr) (I Yr) entered Sex s Dog: ❑ Y ❑ N If applicable) — (3 yr) (1 yr) License Fee $ Replacement $ ** SUBTOTAL: $ City Tag # License Fee $ Replacement $ ** SUBTOTAL: $ City Tag # A RENEWAL sting at the time of license renewal.) " I $5 $10 Other LICENSE REQUIREMENTS :ash by Mail TOTAL ENCLOSED $ Expi res; Security Code; t City Hall at (402) 426.4191 or by Fax: (402) 426-4195 ++++41 ......................................... ENTS (March IS late fee date not applicable forneiv pets/new residents) New Residents to Blair: ■ Must register pets within 10 days of residency. ILe'ej# f6d ly 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: Ronald L And Jaqueline D Warrick Spayed/Neutered Dog or Cat: $11.00 Mccracken Replacement Fee for Lost Tag: $5.00 Fee includes $1.25 for the Nebraska Dog and Cat Owner Address: 829 Meadow Dr Operator Inspection Program City/State/ZIP: BLAIR, NE 68008-0000 Phone #: (575) 650-5025 Drivers License #: or Date of Birth' Subtotal licensed pets from below: Replacement Tags from below: Name: Callie Color: Tan/Black Spayed/Neutered: True Mirochip # Vaccination Date: 1/16/2017 DOB: 8/1/2008 Sex: Female Breed: Mix Breed Duration: 3 year vaccine Vaccine Exp: 1/15/2020 License Fee $ Replacement: ❑Y ON City Tag # 1541 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: Ronald L And Jaqueline D Warrick Spayed/Neutered Dog or Cat: $11.00 Mccracken Replacement Fee for Lost Tag: $5.00 Fee includes $1.25 for the Nebraska Dog and Cat Owner Address: 829 Meadow Dr Operator Inspection Program City/State/ZIP: BLAIR, NE 68008-0000 Phone #: (575) 650-5025 Drivers License #: Name: Lil Red Color: Red Spayed/Neutered: True Mirochip # Vaccination Date: 5/7/2016 or Date of Birth: r Subtotal licensed pets from below: Replacement Tags from below: DOB: Not on File Sex: Female Breed: Mix Breed Duration: 3 year vaccine Vaccine Exp: 6/7/2019 License Fee $ Replacement: ❑Y ON City Tag # 2251 f , t J t' 6 t t t CITY OF BLAIR - 2019 PET LICENSE ADDITIONS` " 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 11 218 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: Tammy Waters Owner Address: 1629 Grant St City/State/ZIP: Blair, NE 68008 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 Phone #: (402) 960-6405 Drivers License # ja-�i 6 % ',� )or Date of Birth: 7/8/1961 Subtotal licensed pets from below: Replacement Tags from below: Total: XDog ❑ Cat ❑ Spayed/Neutered License Fee $ ky, C7Z� Pet Name V A- Pet DOB Sex �� J , Color Breed C0((4erg I ;,�$ Declared Dangerous or Potentially Dangerous Dog? ❑ YA N -- Microchip # Rabies Vaccination Date 1 �' 9ff:J01.�03 yr1 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Age Sex Color Breed Declared Dangerous or Potentially Dangerous Dog? ❑ Y ❑ N Rabies Vaccination Date ❑ Spayed/Neutered V-311179XII-1 Breed Declared Dangerous or Potentially Dangerous Dog? ❑ Y ❑ N Sex License Fee $ ❑3 yr 01 yr License Fee $ Microchip # Rabies Vaccination Date 03 yr 01 yr 2019 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF 'BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(5), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY Of BLAIR — 21.8 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_ 'PLEASEAEAD CAREFULLY*** YOU ARE REQUIRED BYLAW TO LICENSE YOUR PETS Failure to do so is a violation of City Ordinances 6.103 and carries a penalty of a flee tip to $150.00 per pet. PET LICENSE RENEWALS ARE DUE BY 3115/2019. 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 LIGIrNSING Must be licensed Within 10 days Of ownership (OR) at 6 months of age if puppy or kitten NEW LESIDENTS TO BLAIR Must register pets within 10 days of residency Owner Name Candice Watson Spouse Owner Address 929 N. 24th Ave City/State/zip Blair, NE 68008 Rhone # 402-677-5078 DL # or DOB aET # Pet Name: Earl Aye: 5Y Breed: Lab MiX sex: Male color: Black peclared Dangerous/Potentially Dangerous Dog Microchip # 98511.2008301145 Rabies Description: 1 YEAR Holstein Veterinary Clinic Dr: Lisa Schrum DVM & Dr, Krista Holstein DVM 718 South 191h Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holstei nclinic f gmalkom NO ) I YES City Tags # Rabies Tag # 15388 LICENSE FEES Intact `' or Cat: $16.0 Altered Dag or cat: $11.00 Replacement Tag $5.00 Total ,60 FAXED 03-13-19 3:03p 8Y n n TOTAL PAGES TO/TO 3DVd DINI-10 iDA NI31S-IOH T©TU9ZbZ©h ZI -SZ 6Z©Z/CZ/C© ��J-t # C�tL ol�z 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: Colt Webb Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 1862 Colfax St Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008 Operator Inspection Program Phone #: (417) 840-7542 Drivers License #: Name: Penny Color: Tri-Color Spayed/Neutered: True Mirochip # Vaccination Date: 06/16/2018 or Date of Birth: C -� L Subtotal licensed pets from below: 1 Replacement Tags from below: DOB: 06/01/2016 Sex: Female Breed: Basset Hound Duration: 1 year vaccine Vaccine Exp: 06/16/2019 License Fee $ Replacement: ❑Y ON City Tag # 2409 Total dam.. �n / $ d 8'•., CITY OF BLAIR - 2019 PET LICENSE VERIFICATION 7 4 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: WECKMULLER, CAROL, TRUSTEE Spayed/Neutered Dog or Cat: $11.00 Owner Address: 2026 NORTHRIDGE 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) 426-3188 Drivers License #: 6, or Date of Birth: 8/22/1958 Subtotal licensed pets from below: Replacement Tags from below: 4> Name: Daisy DOB: 9/20/2006 Sex: Female License Fee $ % Color: White Breed: Bichon Frise Replacement: Spayed/Neutered: True ❑Y ON Mirochip # 492EO0296E City Tag # 661 Vaccination Date: 4/4/2017 Duration: 3 year vaccine Vaccine Exp: 4/4/2020 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: WECKMULLER, CAROL, TRUSTEE Spayed/Neutered Dog or Cat: $11.00 Owner Address: 2026 NORTHRIDGE 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) 426-3188 Drivers License #: 1 `r" t or Date of Birth: 8/22/1958 Name: Charlotte Color: Blue Merle Spayed/Neutered: True Mirochip # 4C126E3A75 Vaccination Date: 1J29/2016 �-k-4 Subtotal licensed pets from below:" Replacement Tags from below:,_ DOB: 3/30/2011 Sex: Female Breed: Mix Breed Duration:year vaccine Vaccine Exp: w1126/20 9-- Y_ ". License Fee $ il Replacement: ❑YN City Tag # 889 t Total: Date of Rabies Vaccination: 04-26-19 Next Rabies Vaccination On: 04-25-20 VETERINARY CLINIC Holstein Vet Clinic 718 South 19th Street Blair, NE 68008 402-426-7387 This is to certify... Certificate No: 0 Previous Rabies Vaccination: 13506 OWNER OF ANIMAL Carol Weckmuller 2026 Northridge Drive Blair, NE 68008 County: THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW. Patient information... PATIENT: Charlotte TAG NO: 16903 SPECIES: Canine WEIGHT: 56.80 SEX: S AGE: 8 years Color and markings... Blue Merle Signed Lisa Schrum, DVM Due Date / Vaccinations 04-25-20 Hwt Dog (Heartworm Test) 04-25-20 Bronchi Shield - Oral Bordetel 04-25-20 Vangard Plus 5 04-25-20 Canine Influenza 04-25-20 Defensor 1 (1 Year Rabies) Rabies Vaccine Information... License: 2310 MFG BY: ZOETI SER.NO: 293134 LOT EXP: 11-29-19 ADM: SQ t w o Et „ CITY OF BLAIR - 2019 PET LICENSE APPLICATION =ATM iv �;t ,"4L 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 A -R x 3.,„. You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs -. E - or three (3) adult cats per residential or dwelling unit. g " LICENSE RENEWALS ARE DUE: March 15, 2019 ' 9 , .: I . Owner Name. t a.. I�w asi I' ,_�i t' � - :,.r� Owner Address: _ 1 V ." I ., City/State/Zip: Blair, NE 68008 Phone # c,a B $ F Drivers License # or Date of Birth° ` LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.130 ***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 tD fund the Nebraska Dog & Cat PET # 1 Dog ❑ Cat ❑ Spay d/Neutered License Fee $ 0 Pet Name °°° I A e c Sex Color _ Breed * Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ] N s MICROCHIP # _ (If applicable) SU TOTAL: $ '-,l RABIES VACCINATION DATE: " (3 yr) (1 yr)Tag #.L,* 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 w' (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 VISA / MC # Signature _ Do Not Send Cash by Mail TOTAL ENCLOSE® $ 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 new pets/new residents) Newly Acquired Pets: New Residents to Blair: ■ Must be licensed within 10 days of ownership ■ Must register pets within 10 days of ■ <OR> at 6 months of age if puppy/kitten residency. xoqui/#Iw#4'xapui/iwtu/In/woo•xopdnAw//:sdilq Harrison Street Animal Hospital, P.C. Pti�nt Chart 73'10 Harrison Ralston, NE $6128 402-596-0355 Printed, 04-25-19 at 1:$Op CLIENT INFORMATION Name Sheila Woitaszewski (4213) Address 15859 Rosewood $t#1 Spouse 0111aha, NE 08136 Balance 100 PATIENT INFORMATION Name Ellie Sex Female Speci®s ANINE Breed Birthday 09-20-18 at Terr 11) Age m Color Tri Rabies 190032 Reminded (none) weight G .20 Ibs Codes MEDICAL HISTORY - Organ by Problem Date By Code Description —' �' Qty (Var lance) Amount 01-18-19 RPT 1020 l-epto Booster _ - -• 1030 Corona Booster 1.00 1131 Rabies Canine, 1yr, 419003 1,00 1050 DHPR Booster 1.00 No Problem -oriented Medical History found for this patient. 1.00 III i I TO/TO SJdd i -WWINd!1S NOSIddVH I 9LE3TEE60b � 6T.ZT 6TO7,/9Z/bO r(6aetul 6 60Z/5Z/b - 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: Christie Welles Spayed/Neutered Dog or Cat: $11.00 OReplacement Fee for Lost Tag: $5.00 Owner Address: 758 S 16th St #114 Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: BLAIR, NE 68008-0000 Operator Inspection Program Phone #: (402) 507-7033 .. Drivers License #: �I C-� l cry or Date of Birth: 10/10/1957 Subtotal licensed pets from below: Replacement Tags from below: Name: Bella DOB: 6/6/2013 Sex: Female License Fee $V Color: Brown/Tan Breed: Yorkshire Terrier Replacement: Spayed/Neutered: True DY qN Mirochip # City Tag # 2411 Vaccination Date: 6/27/2018 Duration: 3 year vaccine Vaccine Exp: 6/27/2021 Total: �,r r 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 a 218 S. 16th St. • Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2019 Owner Name: Owner Address: City/state/zip: Blair, NE 68008 Phone # Drivers License #t or Date of Birth- i f 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 Cityof 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 0� Cat ❑-.Spayed/Neutered License Fee $ Pet Name Age I`� Sex h Color -.� •, '� - A a- `,' Breed" A , � —Replacement Declared Dangerous or Potentially Dangerous Dog: ❑ Y L4"N MICROCHIP # (If applicable) v' d ; SUBr OTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) t ° ity Tag # ) WN' PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Aqe 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) _ ❑N (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 Licpepse 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 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 datenot 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. NEBRASKA HUMANE SOCIETY SPAY AND NEUTER CENTER 8919 FORT ST r,,IEBRASKA OMAHA, NE 68134 HUMANE (402) 905-3490 OR SOOETY (402) 444-7800 I Owner Information: FRIENDS OF JEANETTE HUNTANIMAL SHELTER 4772 TRAIL RIDGE RD BLAIR, NE 68008 (402) 533-3733 A1230529 S 2705 TORTIE DOMESTIC SH / MIX Age: 15W Weight (lbs): 3.70 Vaccination Date: 10/31/2018 Vaccination Expiration Date: 10/31/2019 1 YEAR RABIES VACCINATION: Tag # 007835 Serial#293132 Manufacturer: Zoetis Location of injection: SQ, right distal hind leg Veterinarian/License Number: Elizabeth Farrington DVM-3498 Signature 40-1.r : NEBRASKA HUMANE SOCIETY SPAY & NEUTER CENTER 8919 FORT ST OMAHA, NE 68134 PHONE: (402) 905-3490 FAX: (402) 905-3491 eo. 9maene .Soclefy WWW.nhsspayneuter.Org �` A service of the Nebraska Humane Society Receipt Number t R18-411313 Person Information: FRIENDS OF JEANETTE HUNT ANIMAL SHELTER PO BOX 233 BLAIR, NE 68008 Received From:JHAS Check No: 2007 Item: Animal ID: Name Ref( SNC RES CATALTER A1230529 _ 2705 SNC FVRCP A1230529 2705 SNC RABIES VAC A1230529 2705 _ . Clinic.Hours .: .. OPEN Monday -Thursday 7:15 AM - 5:30 PM CLOSED Friday, Weekends and Holidays Receipt Date: October 31, 2018 PID: P409923 Phone: (402) 533-3733 Clerk: ACRAIG Transaction Date: 10/31/18 Print Date: 10/31/18 Feline Certificate of Vaccination Pittman Animal Hospital 4629 Dodge Street Omaha, NE 68132-3235 (402) 556-2535 Owner Sara Wells 2W38a4Gedar-Hall--M-aii #C4 Waterloo-N-E-680B9w_ Animal Species yy Breed Age: Color Sex VACCINATIONS PERFORMED Panleukopenia 03/24/2018 Rhinotracheitis Calicivirus Feline Leukemia Rabies Date Given: Duration: Rabies Due Date: RabiesTag Number: Serial Number: Vaccine Type: Vaccine Name: TESTING PROCEDURES Tiger Feline Dsh 2 years and 3 months old. Grey Tabby MN EXPIRATION 03/24/2019? 04/27/2019 1-Year 04/26/2020 192752 Killed EXPIRATION Fecal Exam .......................................... I hereby certify that I have examined the above described animal and find same to be clinically free of infectious, contagious or communicable disease. (Last examination date: 04/27/2019) Signature: Dr. Gregory Trost Ii. f 1r1�`� l4I/)�r Jti 544!!1 Mar 06 19 07:41 a Thone Animal Care 4024266808 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), complete/verify this form and return with check made payable to: City of Blair * 218 S 16th St. * Blair, NE 63008 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: Dogar Oat: $16.00 Owner Name: WENZ, JEREMY E & JENNIFER A JOHNK Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 1095 S 16TH AVE Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: BLAIR, NE, 680084000 Operator Inspection Program Phone #: (402) 639-8351 Drivers License #: or Date of Birth: Name: Batman Color: Brown/Black Spayed/Neutered: True Mirochip # Vaccination Date: 12/23/2016 Subtotal licensed pets from below: Replacement Tags from below: DOS: Not on File Sex; Male Breed: Yorkshire Terrier Duration: 3 year vaccine Vaccine Exp: 12/23/2019 Thone Animal Care of Blair (402) 426-3630 902 S. Hwy 30 Blair, P,,IE 68008 License Fee $ Replacement: ❑Y C]N City Tag # 1800 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: Taralyn W Wernke Spayed/Neutered Dog or Cat: $11.00 Owner Address: 551 N 23rd 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 #: (308) 760-4309 _ Drivers License #: or Date of Birth: Subtotal licensed pets from below: Replacement Tags from below: i Name: Smokey Color: White/Black/Brown Spayed/Neutered: True Mirochip # 982000410222627 Vaccination Date: 11/29/2017 e I- It, -I DOB: of on File Sex: Male Breed: Mix Breed Duration: year vaccine Vaccine Exp: 1IJ29/20`1-8 I—o li License Fee $ Replacement: ❑Y ❑N City Tag # ,,2261 "� Total: Blair Small Animal Clinic PC David E. Johnson DVM 1734 Front Street Blair, Nebraska, 68008 (402) 533-2722 Client ID: 6206 Patient ID: 9697 Client Name: Tara Wernke Patient Name: Smokey Address: 551 North 23rd Street Species: Canine Blair, NE 68008 Breed: Mixed Breed Sex: Neutered Male Color: Dark Brown/Black & White Phone:308)760-4309 Markings: Birthday: 06/05/2017 Weight: 46.50 pounds on 7/16/2018 Microchip ID: 982000410222627 Tag Number: 4854 Lot Number: 18385 Imrab Rabies Vaccine Producer: Merial ! MLV / R: Killed Virus Vaccination Date Expiration Date Staff Name: David E. Johnson DVM License Number: 1893 11 /20/2018 11 /20/2021 FROM :BSAC FAX NO. :4102-533-2722 ivlar. 07 2019 02:50PM P1 CITY OF 13LAIR - 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 Sig. * Blair, NE 68008 You may legally own a combination of four (4) adult pietas, but no more than three (3) adult daps or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: Mauch 15 2019 } Owner Name: Owner Address. City/state/Zip: Blair, ttNE 68008 Phone # UT , al J H MU . Drivers Liconse # or iyate of Birth LICENSE FEES: ling or Cats $16,00 Altered Dog or Cat: $11.00 Replacement Pea for Lost Tag: $5.00 Included is a ;date Fee of $1.25 being collected to fund tli ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS, Failure to do to is a violation of City ordinances 6.103 and earrlds a penalty of a fine up to 4 50.00 per pat. PET LICENSES RENEWALS ARE DUE BY a Li sy_ L2M, The City shall retognize a microchip Identification number as the license number. YI' shall be unlawful for any dog or cat t9 wear any license �r othor City identification other than that Issued by the city of 01air for such dog or Cat, The City of Blair requires proof of rrtrids vaeC+natinn. Nebraska PET #1 o A Cat ',6Spaye /Neutered Pet Name Aqe m gSe� Color Breed * Declared Dangerous or Potentially Dangerous Dog: Ll Y MICROCHIP (If applicable° RABIES VACCINATION CRATE: (3 yr) — Cat Operator Inapectlon Progwam License Fee — Replacement $_ SUBTOTAL; $ City Tag #�* PET #2 0 Dog © Cat ❑ Spayed/Neutered License Fee $ Pet Name Aae Sex Color Breed * .Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: U Y 0 N MICROCHIP # (If applicable) SUBTOTAL: $ _._. RABMs VACCINATION DATE: (S yr) — (I yr) City Tag fk�* PET #3 ❑ Dog ❑ Cat 0 Spayed/Neutered License Fete $r Pet Name Age _— _ Sex ** Color reed * REpldcelYtent $ Declared Dangerous or Potentially Dangerous Dog: Cl Y 0 N MICROCHIP * (If applicable) SUBTOTAL: $ _ RABIES VACCINATION DATE: (3 yr) (1 yr) _ City Tagk *PLEASE INCLUDE THE CLTY 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 , $10 Other ***SEE BACK OF FORM FOR BREED SPECIFIC LICENSE REQUIREMENTS Do Not Sent! Cash by Mall 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 ++ttt....... *+.+++t++tt... fifii^'t"W++"M............................................ NEW PAT/MEIN RESIDENT LICENSING R15gtJIAWENTS (Match 15late The date notappllcalrle fernew pa%1now residents) Iwl�tly Af,�llili ed Pam: New ResidCM xo 010ir; W Y ■ Must be lk��d wthin io days or ownesllip ■ Must register pets within 10 days of 0 �OR� nt 6 moms of age W PuPPY/Ww residency, 03/07/2019 17:30 4024260101 HOLSTEIN VET CLIHIG PAGE 04/07 201.9'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 — GLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THRr:r= (3) ADULT CATS PR RESIDENTIAL OR DWELLING UNIT. 'PLEASE READ CAREFULLY' YOU ARE REOUIgEp BY LAW TO LICEf�5E 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 LICENSE RENEWALS ARE DUE BY 3/I5 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 81�!r 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 Jamie Whitelock Spouse Becky Owner Address 1404 Colfax Street City/State/Zip Blair,, NE 68008 --Phone # 402-533-8254 DL * or DOB T # Pet Name; Kane Age: --gy Sex.�Neutered Male Color: Brindle/Wt Breed: OU11 X Declared dangerous/Potentially Dangeroui--600 0 Microchip # 985112005978803 City Tag * mow Rabies Tag # 16492 Rabies Description: I YEAR YEA� Holstein Veterinary Clinic Dr. V-5a Schrum DVM & Dr. Krista Holstein 718 South 19,h Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteindinic@grrail,com LICENSE FEES Intact Dog or Cat: $16,00 Dog or cat: $11.00 ' Replacement $5.00 Total $ b (' FAXED 03-07-19 4:2 BY TOTAL PAGES 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; + ilry OF Bl-AIR - 2iS S.:L6T" ST ECLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FQI,IR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL DR DWELLING UNIT. ***PLEASE DEAD CAREFULLY*** YOW ARE REQU RED BY LAW T LICENSE Y UR 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 LICENSE RENEWALS ARE Q Q E BY 3 15 2019. The city shall recognize a microchip 1D 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 ferlsuch dog or cat. NEW PET LICENSING be licensed within 10 days of Qwnership (OR) at 6 months of age if puppy or NEW fiES1DENT5 TO BLAIR Must register pets within 10 days of residency _ Owner Name Spouse Owner Address City/State/Zip Phone # DL # or DOB PET # Pet Name: Skipper Age: 13Y Sex: Neutered Male Laurie Wink Todd 2811 Westridge Drive Blair, NE 68008 402-533-0536 Color: Breed: Beagle Declared Dangerous/potentially Dangerous Dag NO 'YES Microchip # +C(ty Tag # Rabies Vaccination Date: � 10- 17 Ftables Description', 1 YEAR Holstein Veterinary Clinic Di� Lisa Schrum PVM & Dr. Krista Holstein DVM 718 South 19th Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteinclinic@gmall.com Rabies Tag # FAXED EZE TOTAL PAGES LICENSE FEES Intact Dag or Cat: $16.00 Dog pr cat: $11.00 Replacement Tag $5.00 Total 4 4 of-2s-19 8:39a cl 0� --- Z0/Z0 39vd OINI-10 13A NI3IS-I01-1 T0T09ZbZ0b ZT:60 6T0Z/9Z/T0 2019 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /QR CAT(S), COMPLETE THIS FORM AWE) RETURN WITH A CHECK PAYABLE TO: CITY OF 13LAIR - 210 5, 16TH 5T - BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING, UNIT. ***PLEASE READ CAREFULLY*** YOU ARE REQUIREd BY LAW TO LI�NSE YOUR PETS. Failure to do so is a violation of City Ordinances 6.103 and Carries a penalty of a fine up to 5150-00 per pet. PET LICENSE iRENEWA ARE DUE BY 3 �S N19. The city shall recognize a microchip IQ number as the license number. It shall be unlawful for any dog or cat to wear any license or other city 1D 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 PET # Pet Name: Finley Age, 23M ;max: Spayed Female color: Breed: Beagle Declared Dangerous/Potentially Dangerous Dog NO YES Micrachip # 985112005077862 City Tag # €4 - Rabies Vaccination Gate: I k' ` 0- lb Rabies Tag # 16483 Rabies Description: 1 YEAR YEA Holstein Veterinary Clinic Dr. Lisa 5chri± m DVM & Dr, Kristc,1401steili DVM 718 South 19th Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteindinic@gmaiLcom LICENSE FEES intact Dog or Cat: $16.00 ltered D or cat; $11.00 Replacement Tag $5.0c) Total $ 1 �+_00 FAXED 01-25-19 8:38a BY TOTAL PAQES 36/TU 39VcI OINI-ID iDA NI3iS-IOH TOT093b33b ZT:63 6T6Z/5Z/T0 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: Beverly Wielgus Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 820 SouthFork RD Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008 Operator Inspection Program Phone #: (402) 533-1107 Drivers License #:G01219319 or Date of Birth: 1/6/1936 Name: Herbie Color: Black/White Spayed/Neutered: True Mirochip # Vaccination Date: 11117264t Subtotal licensed pets from below: Replacement Tags from below: : Not on File Sex: Male Breed: Mix Breed Duration: 3 year vaccine Vaccine Exp: 1/11/2019 License Fee $ Replacement: ❑Y EON City Tag # 1636 Total: //� CERTIFICATE OF VACCINATION Date of Rabies Vaccination: 01-08-19 Next Rabies Vaccination On: 01-07-22 VETERINARY CLINIC Countryside Small Animal 1306 Stevenson Fort Calhoun, NE 68023 402-468-4060 Certificate No: 0 Previous Rabies Vaccination: 16-0036 OWNER OF ANIMAL Carol/Bev Schany/Wielgus 713 Southfork Rd. Carol Blair, NE 68008 County: This is to certify... THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW. Patient information... PATIENT: Herbie TAG NO: 19-0029 SPECIES: Canine WEIGHT: 17.80 SEX: N AGE: 13 years BREED: Schnauzer, Miniature Color and markings... Salt and Pepper Signed Kaycee Points License: Vaccinations done... 01-08-19 KNP Canine Rabies Vaccn, 3 yr, #19-0029 01-07-22 08-16-18 KNP Canine DA2PPL 08-16-19 Rabies Vaccine Information... MFG BY: ZOET SER.NO: 288181 ' LOT EXP: 24SEP19 ADM: Sq CITY OF BLAIR - 2019 PET LICENSE APPLICATION ("Vi'x. s j 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 RENEWALSARIE Owner Name: DUE: Mitrch C4 15, 2019 L/ `QC� Owner Address: -` /t 1 City/State/Zip: Blair, NE 68008 22 Phone # �(9) 2 /g�- Z J Drivers License # or Date of Birth 6"' ®/ Z I(%V6 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 # i 1 D�g ❑ Cat Spaye k-eutered License Fee $ Pet Name �' ` Aq * SexReplacement $Color Y� - Breed ��r Declared Dangerous or Potentially Dangerous Dog: ❑ Y N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) _,� (I yr) City Tag # PET #2 Dog ' Cat Spaye I eutered License Fee $ � � s Pet Name_'�C��h, Aqe Sex114 Color Ou e'J -4, G f' reed * , Replacement $ ** Declared Dangerous us or Potentially Dangerous Dog: ❑ Y N MICROCHIP # (If ap licable SUBTOTAL. $ RABIES VACCINATION DATE: -i - _1 yr) (1 yr) City Tag # PET #3 Dog ❑ Cat Spaye /Neutered `� License Fee $ Pet Nam 1— Cet� A Sex , 4 4 ,- h Color IV eed * Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y N MICROCHIP # If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: 1 T (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 DoNot 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 lioensed within 10 days of ownership ■ Must register pets within 10 days of ■ <OR> at 6 months of age if puppy/ldtten residency. 2019 PET LICENSE VERIriCATION,/AP PLICATION FOR, CITY OF RLAIR 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 GLAIR — 210 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 CAREKULLY*** YOU ARE RE UIRED BYLAW TO LICENSE YO R 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 LICENSE RENEWALS ARE PUE eY3/15/2U�4- `1"he city shall recognize a microchip ID number as the license number. It shall be unlawful for ony dog or cat t4 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 RESIQENTS 7O BLAIR Must register pets within 10 days of residency Owner Name Brenda Wilkins spouse owner Address 3080 Westridge Dr Blair, NE 68008 City/state/Zip Phone # 402-290-1811 DL # or DOB DET # 1 Pet Name: M011Y Age: ( DOB: . Sex., spayed Female Color: Brown Breed: Yorkie X Oeclared dangerous/Potentially Dangerous Dog NO YES Microchip # City Tag # I WV."td r' 6,`� d1,_ra o' .,i Rabies Tag # IRables Description: 1 YEAR Holstein Veterinary Clinic Dr. Lisa Schrurn DVM & Dr. ICr,isi:a Holstein DVM 718 South 19th Street Blair, NE E8008 402-476-7387 402-426-0101 Fax holsteindinic@tmail-COM FAKED 04-19-19 BY 971 TOTAL PAGES LICENSE 'FEES Intact [dog or Cat: $16.00 Altered og or cat: $11 0 Replacement Tag $ 5.00 Total S u . o o ZO/ZO 39Vd OINI-10 13A NI3IS�OH ZOZ09'V30t, 90:9Z 6To71/6Z/b0 2019 PET LICENSE VERIFICATION/,APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN 13LAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PA'YA81,E TO, CITY op BLAIR — 218 S. 16-r" 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 RESIVENTIAL OR DWELLING UNIT. ***PLEASF- READ CAREFULLY*** YOU ARE REQUIRED E'}(,IAW 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 $-.50.00 per pet. PET LICENSE RENEWALS ARE DUE BY 3 15 ZQ19. The city shall retognize•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 al k �� lch dog or cat. NEW PET LICENSING Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy NEW RESIDENTS TO BLAIR Must register pets within 10 days of residency Owner Name Brenda, Wilkins spraWs+a Owner AddressEE 3080 Westridge Dr city/State/Zip Blair, NE 68008 Phone # 402-290-1811 DL # or DQR PET # 21 Pet Na rne: Archie Ages SM IUDs: 11-05-18 Sex: Male Color: Black and White Breed: Goldendoodle Mix [declared Dangerous/Potntially Dangerous Dag NO YES Mlcrochlp # City Tag # f Rahies Tag # 10EI9a :.;�. ,.,i vN\n :_�ti�.��;� . ' s�ti_ •• ..�ti� , � ,.' ,c.XU`a'P' fa .�V.1111L° ;}'„�+�o }�!n'�Ir�ol�ifl . !�Ya '' ., tl �:� I M\ r r:.4JAV" ll"�i. n f .�: �'t li��..r '.'. i.. `..,,• . ... ... i...•.. - Rabies Des-Cr\iptiont YEA 3 YEAR Holstein Veterinary Clinic FAXED Dr. Lisa Schrum DVM & Dr. Krista Holstein DVM BY 718 South 19th Street Blair, ICE 68008 402-426-7387 402-426-0101 Fax TOTAL PAGES holsteinciinicIpgmail.com 04-1D-19 LICENSE FEES Intact D or Cut: $1 Altered Dog or cat: $11.00 Replacenient Tag $ 5.00 Total J Z0/T0 39Vd DINI-10 i3A NI3iS-101-1 TOT09ZbZ0b 90:9T 6T0Z/6T/b0 02/27/2019 13:10 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(5) AND /OR GAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR — 210 S. 16TH ST R BLAIR, NE 168008 YOU- MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT. 'PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PE7S, Failure to do so Is a`vlolation of City Ordinances 6,103 and carries a penalty of a fine up to $150,00 per pet, PET LICENSE RENEWALS ARE DUE BY/1S/2019. The city shall recognize e 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 glair 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 Narne Frank Wilkins spouse Jacque Owner ,Address 1350 S 16th St City/;state/Zip► Blair, NE 68008 Phone # 402-426-5078 DL # or DOB 1 Pet Name: Bob Age: 11Y sex: Neutered Made CQ➢ur: Black Breed: Domestic Shorrthair Declared Dangerous/Potentially Dangerous Dog NO YES Microchip # City Tag # n BC 6 V r"! 4° N L a r w LwLnr. , cyr�o 3f �v y�ri;rau tY2iug1 E^ r'' 61. If:rftn n gy atr t r :. o it l + A !fl_ �' Ra ➢�➢e tsi Tag# o +:'-t+L'• SM!ti tr u� 4 r .Ir5, r�r?;o'E Pr•rv.1,, rr a a . � rCjt ��aratj,�,ir;�.aaA;l�i!x'll �!P��' �rd31 ,�J3, . m 6 ' � t �'' � LL'.N: !,. r1'q`:i it �f n@Purr i.u�8�a �r nricn,rKr -;tx. r�• Rabies description: ►. 3 YEAR Holstein Veterinary Clinic Dr, Lisa Schrurn DVNI & Dr, Krzsto Holstein DVM 18 South 19th Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteinclinic@gmail.com LICENSE FEES Intact [dog or Cat: $16.00 AILP-re D g or at: $11. 0 Replacement T'a(y $5,00 Total $ �V'70- -FAX E -02-27-19 1:03p BY TOTAL PAGES r, 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: Willard L And Nancy D Tierney Spayed/Neutered Dog or Cat: $11.00 Owner Address: 2804 Sunrise 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 #: <NO PRIMARY PHONE> Drivers License #: or Date of Birth: 8/26/1953 Subtotal licensed pets from below:__ Replacement Tags from below: Name: Binx DOB: 12/9/2011 Sex: Male License Fee $ Color: Black Breed: Domestic Shorthair Replacement: Spayed/Neutered: True ❑Y ❑N Mirochip # City Tag # 2150 Vaccination Date: 809/20't4 Duration: 3 year vaccine c Vaccine Exp: 8/19/2017 << Total: y r`ti� FROM :BSAC FAX NO. :402-533-2722 Feb. 26 2019 03:55PM P2 CITE' OF BLA,IR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), oomplete/verify this form and return with check mado payable to: City of Blair * 218 S 1 Oth St, * Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than threo (3) adult dogs or throo (3) adult Cate per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2019 LICENSE FEES: Dog or Cat: $16.00 Owner. Name: Cathy Williamsen Spayed/Neutered Dog or Cat: $11.00 Owner Acitlte� : 1433 Perk 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 W Phone #: (402) 426-9744 Drivers License #: or Date of Birth: 1/28/1949 _„ ... Subtotal licensed. pets feom boloW.' Replacement Tags from below: Name: Bubba Color: ©range SpayedlNeutered; True Mirochip # Vaccination pate: 3/19/2016 13013: Not on File Sex: Male Breed: Domestla Shorthair Duration: 3 year vaccine Vaccine Exp: 311912019 License Fee $ Repl ement: 0'? N City Tag # 18 Total-, FROM :BSAC FAX NO. :402-533-2722 Feb. 26 2019 03:55PM P1 CITY OF SLAIR W 2019 PET LICENSE VERIFICATION If you live, in Blair City limits and own a dog(a) and/or Gat(s), complete/verity this form and return with check made payable to: City of Blair * 218 S 18th St. * Blair, NE 68008 You may legally own a combination of four (4) adult pats, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit, LICENSE RENEWALS AIDE DUE: March 15, 2019 1.101;NSE FITS: p+Mg or Get: $16.00 Owner Name Cathy Willlam!3en Spayed/Neutered Clog or teat: $11.00 Owner Address: 1433 Park St Replacement Fee for Lost Tag: $5.00 Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIPBlair, NE 68008--0000 Operator Inspection Program Phone #: (402) 426 0744 Drivers License #: or Date of Birth: 1/28/1949 _... „ . .. Subto.tal.11censed pets from ,below: Replacement Tags from below: Name, Mo Color: Tabby Spayed/Neutered: True Miroehip # Vaccination Date: 10120/2017 DOB Not on File Sex. Female Breed: Domestic Shorthair Duration: 3 year vaccine Vaccine Exp: 10/20/2019 License Fee I,j NPment: City Tag # 1833 Countryside Small Animal 1306 Stevenson PO Box 119 Fort Calhoun, NE 68023 402-468-4060 Printed: 06-11-19 at 10:02a CLIENT INFORMATION Name Terri Willmott (1349) Address 679 N. 15th Blair, NE 68008 Phone 402 426-4059 PATIENT INFORMATION Name Kate (6330) Sex Female, Spayed Birthday 11-30-16 ID 985112008044357 Color Tri Color Reminded 03-05-18 Reminders for: Kate 10-05-21 Canine Rabies, 3 y 10-06-19 Canine DA2PP-L MEDICAL HISTORY Date By Code Description ap-�- y Patient Chart Species Canine Breed Australian Shepherd (mini) Age 2y Rabies 18-1135 Weight 22.25lbs Codes Last done 10-06-18 10-06-18 Qty (Variance) Photo 12-28-18 KNP NGL1 Nexgard 24.1-601b Single Dose 2 10-06-18 KNP RV3 Canine Rabies Vaccn, 3 yr, #18-1135 DA2PL Canine DA2PP-L 07-03-18 JJS OVI+ Ovitrol Plus Flea Spray 16 oz 05-05-17 KNP PREV57 Previcox 57mg chew tab 3 Give 1 tablet by mouth once daily (every 24 hours) for inflammation and pain. START FRIDAY EVENING. CHIPR Registration, Lifetime, HomeAgain HOME Microchip, Home Again SPAY25A Ovariohysterectomy, Canine <25 Ibs <6mos P presented for OHE and microchip implantation this morning. Weight: 22.25lb/10.1 kg The p was induced with 1ml Ketamine + 1ml Diazepam IV and intubated with an ETT. Anesthesia was maintained with Isoflurane and oxygen. The p was clipped and prepped for surgery. The hair extending from the caudal abdomen to the sternum was clipped and the skin was scrubbed with chlorhexidine and betadine. ❑:® Patient Chart for Kate Date: 06-11-19, Time: 10:02a Client: Terri Willmott Page: 3 Date . By Code Description Qty (Variance) Photo No evidence of inflammation or debris a.u. No evidence of nasal or ocular discharge. Adult incisors are erupting. No abnormalities on cardiopulmonary auscultation. Skin and hair coat were clean and well-groomed, No evidence of fleas or flea dirt. No abnormalities on abdominal palpation. No evidence of umbilical hernia. Intact female. ASSESSMENT: - Dx: Apparently healthy puppy PLAN: 1) Administered 0.33ml Diphenhydramine 15 minutes prior to vaccines - AO that she could administer another oral dose (17.5mg) this evening. 2) Administered vaccinations - DA2PP-L: Left shoulder SQ - Rabies: Right hind limb SQ 3) Trimmed p's nails 03-09-17 JJS HGS Heartgard Plus 0-25 Ibs 03-01-17 JJS DA2P Canine DA2PP SUBJECTIVE: P presented for wellness exam and vaccines today. 0 reports that p is doing great at home. E/D/U/D normally. No V/D observed. OBJECTIVE: Weight: 131b BCS: 5/9 --- growing puppy BAR. Very friendly. T: 101.7 No evidence of inflammation or debris a.u. No evidence of nasal or ocular discharge. Deciduous dentition present. No abnormalities on cardiopulmonary auscultation. Skin and hair coat were clean and well-groomed. No evidence of fleas or flea dirt. No abnormalities on abdominal palpation. No evidence of umbilical hernia. Intact female. ASSESSMENT: - Dx: Apparently healthy puppy PLAN: 1) Administered DA2PP vx: Right shoulder SQ 2) Trimmed p's nails 02-02-17 JJS CPV Canine Parvovirus Vaccination (CPV) Countryside Small Animal 1306 Stevenson PO Box 119 Fort Calhoun, NE 68023 402-468-4060 Printed: 06-11-19 at 10:03a CLIENT INFORMATION Name Alex Willmott (3006) Address 679 N 15th Street Blair, NE 68008 Phone 402 237-9457 PATIENT INFORMATION Name Case (8021) Sex Birthday Male, Neutered 10-27-18 ID 985112010982880 Color Blue Reminded (none) Reminders for: Case 02-07-20 Canine Rabies, 3 y 01-08-20 Canine DA2PP-L 04-02-19 25.40 02-07-19 16.25 01-08-19 10.00 Patient Chart Species Breed Queensland Blue Healer Age 7m Rabies 19-0144 Weight 25.40lbs Codes Last done 01-08-19 MEDICAL HISTORY Date By Code Description Qty (Variance) Photo 04-02-19 KNP PREV57 Previcox 57mg chew tab 4 Give 1 tablet every 24 hrs for pain and discomfort. NT Nail Trim CHIPR Registration, Lifetime, HomeAgain HOME Microchip, Home Again CAST25A Castration, Canine <25 Ibs <6mos P presented for neuter today. The p was intubated with an ETT and anesthesia was maintained with Isoflurane and oxygen, The p was placed in dorsal recumbency and clipped and prepped for surgery. The hair covering the pre -scrotal skin, caudal abdomen, and medial thighs was clipped and the skin was scrubbed with chlorhexidine and betadine. NEUTER: The left testicle was advanced into the prescrotal skin and an incision was made into the skin and SQ tissues overlying the testicle and the left testicle was exteriorized. The left testicle was clamped and ligated using a walking clamp technique with a mosquito hemostat. The spermatic cord was ligated with two ligatures (1 encircling followed by 1 transfixation) using 0 Gut. The cord was transected and the testicle and hemostat were removed from the body. Hemostasis was confirmed Countryside Small Animal 1306 Stevenson PO Box 119 Fort Calhoun, NE 68023 402-468-4060 Printed: 06-11-19 at 10:03a CLIENT INFORMATION Name Terri Willmott (1349) Address 679 N. 15th Blair, NE 68008 Phone 402 426-4059 PATIENT INFORMATION Name T.J. (2488) Sex Male, Neutered Birthday 09-26-11 ID Color Tri Color Reminded 07-14-17 Reminders for: T.J. Species Canine Breed Papillon Mix Age 7y Rabies 16-0883 Weight 22.60lbs Codes Last done 03-27-20 Heartworm Test, Antigen 03-28-19 10-06-19 Canine DA2PP-L 10-06-18 08-01-19 Canine Rabies, 3 y 08-01-16 01-18-13 Canine Bordetella Vaccination MEDICAL HISTORY Patient Chart Date By Code Description Qty (Variance) Photo 04-11-19 KNP 7017S Canine w/d Can 3 04-09-19 JJS PREV57 Previcox 57mg chew tab 0 o has meds at home. Rx 57mg sid x 4 CLIN75 Clindamycin 75mg 15 Give 1 capsule morning and evening until gone. PEN Penicillin, Proc/Benzathine G EXT2 Extractions, premolar/molar/canine EXT1 Extractions, minor 5 DEN1 Dental Prophylaxis, Canine 0-40# Routine cleaning, flushed with CLS and polished. Teeth and gums in very good condition with mild/mod tartar. See dental chart for extractions. KRJ LACT Lactated Ringers 1 L IVCATH Catheterization, Intravenous Placed 22GA IV cath in RIGHT foreleg. 125cc administered during procedure. Flushed and capped IV post procedure. Pulled cath prior to discharge. KRJ 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 1 LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 st T a tr.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. Replacement Fee for Lo ag. xiuded is a State Fee of $125 being collected tlD fund the Nebraska Dog & Cat Operator' Inspection Program PET # 1 W, Dog ❑ Cat CJ. Spayed/Neutered V License Fee $ Replacement �e Pet Named �� f Age Sex °� ** Color\ �' ;\� %�� Breed * " <� t r r f \ (a -- r$ Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N I^� MICROCHIP # (If applicable) ` SUBTOTAL: $--=----- RABIES VACCINATION DATE: "`�'�• '`' �_ (3 yr) (1 yr) City Tag #� PET #2 Dog ❑ Cat ,Ij�Spayed/Neutered License Fee $ Pet Name �u A e �c�,: Sex ** Color U Breed*— "\ Rep/acement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ —Li-- RABIES VACCINATION DATE: g- (3 yr) (1 yr) ____ City Tag #�;* PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Ave Sex Replacement$ ** Color Breed Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N SUBTOTAL: $ MICROCHIP # (If applicable) 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 - March 15/ate fee�dateaot#pplf R'/a %rnewpets,/newresrdentsJ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS ( Newly Acquired Peas' hew ..ems ■ Must be licensed within 10 days of wrierdhip ■ Must register pets within 10 days of ■ <OR> at 6 months of age if puppy/ldtben residency. SPAY/NEUTER CERTIFICATE VETERINARY CLINIC Countryside Small Animal 1306 Stevenson Fort Calhoun, NE 68023 402-468-4060 This is to certify... OWNER OF ANIMAL Laurie Wilson, 906 N. 24th St. Blair, NE 68008 County: THAT I SPAYED OR NEUTERED THE ANIMAL DESCRIBED BELOW ON 11-19-18. Patient information... PATIENT: Bella AGE: 18W SPECIES: Canine WEIGHT: 8.25 SEX: Spayed Female BREED: Terrier, Jack Russell Color and markings: Black and White Signed Kaycee Points Vaccinations done... License: 11-05-18 KNP Canine Rabies Vaccn, 1 yr, #18-1224 11-05-18 KNP Canine DA2PPL 11-05-19 09-24-18 KNP Canine DA2PP CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a clog(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: Bobi Eriksen-Witherspoon Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 834 N 13th St. Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008 Operator Inspection Program Phone #: (402) 426-4297 Drivers License #: `-' Vy Lr Date of Birth: Subtotal licensed pets from below: Replacement Tags from below: e Name:.DofMe P, wr DOg t o -on ile-Se�x: Male License Fee $/� Color: Black/Brown Breed. Mix Breed- ` opkp � 'Deplacement: True �N Spayed/Neutered: Tag # 1837 Mirochip # (i&ni(fl6tlo Vaccination Date s19/20 �uration: 3 year vaccine 3 4Vaccine Exp:�-206 e Total: FAX t10- :402-533-2722 Mar. aS 2019 03:04PM P1 FROM :BSAC 2�1 T m and return LICENSE APPLICATION CITY OF BLAIR made payable to: �mptete this for Xf you live in Blair City lime end of Blair• (� �18 S. 16th St. • shirr NE 68008 4 adult per. but n0 More than three (3) adult dogs You may legally oWNt a combination of four () or three (3) Adµlt cats per rwlderitial or dwelling unit. LICENSE RENEWALS ARE DUE: i'Mar�'--1 Owner Name+: Owner Address: c: 0�$ir, NE 66000 ity/State/z±p -I () a - L, Q. Phone # Drivem LiCen$e # or Date Birth LICENSE FEES: bag or Cat: $16'00 AltarOd Dog or Cat: $11•0o Replacement Fee for l ow �� 5-00 d th 03SASE READCARI~FUMY*** tift PETS. you ARE REQU iR aD of By LAW TO of City P dS anon 6.103 and cnrrieri Failure to do so k i5D.Go par pat. a penalty of a fine uN to PET LIMSES RENrgWALS ARV, DUO ByVj5LZM. rno city shall it Or C8t t0 Weal' any nSe 6r Othdr Clty micro fecognize b ',lip Identification number as UGk3 the Ucense number, shall be unlaWfl11 for any dbg (Ldt Tfh clinic of ey thanir proofProotun Tablale s Yrscclndatlan'��tn doy or lqu aeu I a .w ..� /Neutered Liaerlse Fee PpT #1 ❑ Dog l,� cat A e ex ** Replacement $ Pet Name reed Color '.--- �- - Declared Dangerous or Potentially DangerocifD09'."able SUBTOTAL; $ MICROCHIP # (3 yr) T1�(1 yr) -- City Tag RABIES VACCINATION DATE: ""�� _..-. --.:.__.........•.._.._..-- 0 0 Cat ❑ Spayed/Neutered -- License Fee $____----- PET #2 ❑ D 9 -- ** Pet Name,,,.,...., Age �...-..rt--- Sex _Replacement $ Color Breed * N Declared Dangerous or Plotenklally Dangerous applicable) ❑ Y ❑ (If appilcable) MICROCHIP # (3 yr) I ,ASIFS VACCINATION DATE: SUI&TOTAL: $ -- _ (i yr) . City"tag ...,. _._.... to ___.....---- .�--T-- p Cat ❑ SpayedJNeutered License Fee $_�— P E`�` # 3 ❑ Dog Age . Sex—_-�.�..--�---T l cement $ * � Pet Name _ Rep a Color .---.------ Breed* ❑ y 0 N Declared pangeraus or Potentially DangerQu(� f applicable) SUBTOTAL. $ _-------- MICRpCHIP # (3 yr) ---- (1 yr) — till/ Tag # _ --- RABIE(S VACCINATION DATE: -- *PLEASE INCLUDE THE CITY TAG NUIvIBEpee if ra ISM RENEWAL- �� -- Xl7 r ** (This fee is due along with License fee i� roil s1 Ing at the time of lice0 newel.) IREMENTS Donation to, Care for animals: _ _. $1 ***SEE. SACK 00 FORM FOR GREED by SPECIFIC d' IF LI Reel TOTAL ENCLOSED $ ____---- po NotCPO Security Code: VISA / MC # „,..M.- .. Signature �- Fax: (402) 426-4195 If you have 00stions, plefitse fyontact City Mall at (402) ................... g1 or by /cablernPwpets/newaosidents) t+.+.+++tt+++t+t+t+++++t+t+++++++++�� t5late f&a date not qpp) blrnewPe+++++dents) + ......................... rt+ UIREMENTS ( i NIl1'UW FE.I.INEW RESxi�I�W MENSINCa REQ # Must register pets within 10 days of ■ Must be ilea used ,v in 10 days of mvneashlp residency. R 4M at 6 monthe of age f Rut]PYl WW s V1, CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verifythis 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: Angela Wick Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 442 S 11 th St Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008 Operator Inspection Program Phone #: (402) 533-1087 Drivers License #: or Date of Birth: Subtotal licensed pets from below: Replacement Tags from below: Name: Jeremy Color: Black/White Spayed/Neutered: True Mirochip # Vaccination Date: 10191.201-6 DOB: Not on File Sex: Male Breed: Havanese Duration: 3 year vaccine Vaccine Exp�_1D/9f2018 License Fee $ Replacement: ❑Y ON City Tag # 1634 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: WIDTFELDT, RICHARD A & Spayed/Neutered Dog or Cat: $11.00 Owner Address: 277 E BARONAGE DR, ELIZABETH E 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) 426-4745 Drivers License #:G29003623 or Date of Birth: 8/7/1950 Subtotal licensed pets from below: Replacement Tags from below: Name: Rusty DOB: Not on File Sex: Male License Fee $ i/. o c) Color: Tri-Color Breed: Australian Cattle Dog Replacement: Spayed/Neutered: True ❑Y ON Mirochip # 985112004197750 City Tag # 1668 Vaccination Date: 6/30/2016 Duration: 3 year vaccine Vaccine Exp: 6/30/2019 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 ocombination r three (3) adult cats per residential o three (3) adult dogs or dwelling unit. LICENSE FEES: Dog or Cat: $16.00 LICENSE RENEWALS ARE DUE: March 15, 2019 Spayed/Neutered Dog or Cat: $11.00 Owner Name: Brian & Sue Woebbecke Replacement Fee for Lost Tag: $5.00 Owner Address: 1943 Lincoln St Fee includes $1.25 for the Nebraska Dog and Cat Operator Inspection Program City/State/ZIP: Blair, NE 68008--0000 Phone #: (402) 658-1230 Drivers License #: or Date of Birth: 1/2/1979 Subtotal licensed pets from below:_______ Replacement Tags from below: Name: Sulley Color: Blue Merle Spayed/Neutered: True Mirochip # - Vaccination Date1612015 f - I - � DOB: 1/1/2014 Sex: Male Breed: Australian Shepherd Duration: 3 year vaccine Vaccine Exp: ,41.612018 LIGt:1MW I �` v+ - Replacement: ❑Y ON City Tag # 11710 10 Total: — Date of Rabies Vaccination: 06-02-18 Certificate No: 0 Previous Rabies Vaccination: 15-0411 Next Rabies Vaccination On: 06-01-21 VETERINARY CLINIC OWNER OF ANIMAL Countryside Small Animal Sue Woebbecke 1306 Stevenson 1943 Lincoln Blair, NE 68008 Fort Calhoun, NE 68023 402-468-4060 County: This is to certify... I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW. THAT Patient information... PATIENT: Sulley TAG NO: 18-0657 SPECIES: Canine WEIGHT: 80.00 SEX: N AGE: 5 years BREED: Shepherd, Australian Mix Color and markings... Blue Merle Signed Kaycee Points License: Vaccinations done... 06-02-18 KNP Canine Rabies Vaccn, 3 yr, #18-0657 06-01-21 06-02-18 KNP Canine DA2PPL 06-02-19 02-22-14 JJS Canine Rabies Vaccn, 1 yr, #14-0147 01-21-14 JJS Canine Parvovirus Vaccination (CPV) 12-17-13 JJS Canine DA2PP Rabies Vaccine Information... MFG BY: ZOET SER.NO: 236501C LOT EXP: 11 Dec18 ADM: Sq t 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: Brian & Sue Woebbecke Owner Address: 1943 Lincoln St City/State/ZIP: Blair, NE 68008--0000 Phone #: (402) 658-1230 Drivers License #: Name: Buddy Color: White/Tan Spayed/Neutered: True Mirochip # Vaccination Date: 6/13/2016 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: 1/2/1979 Subtotal licensed pets from below: Replacement Tags from below: DOB: 1/1/2015 Sex: Male Breed: Labrador Retriever Duration: 3 year vaccine Vaccine Exp: 6/13/2019 License I-ee ZO Replacement: ❑Y ON City Tag #" Total: CE'RTiIFICATE OF VACCINATION Date of Rabies Vaccination: 06-13-16 Next Rabies Vaccination On: 06-13-19 VETERINARY CLINIC Countryside Small Animal 1306 Stevenson Fort Calhoun, NE 68023 402-468-4060 This is to certify... Certificate No: 0 Previous Rabies Vaccination: OWNER OF ANIMAL Sue Woebbecke 1943 Lincoln Blair, NE 68008 County: THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW. Patient information... PATIENT: Buddy TAG NO: 16-0717 SPECIES: Canine WEIGHT: 69.40 SEX: N AGE: 4 years BREED: Retriever, Labrador Mix Color and markings... Tan and White Signed Jeri Sill Vaccinations done... License: 1986 07-09-18 KNP Canine DA2PPL 07-09-19 06-13-16 JJS Canine Rabies Vaccn, 3 yr, #16-0717 06-13-19 04-06-15 JJS Canine Rabies Vaccn, 1 yr, #15-0412 Rabies Vaccine Information... MFG BY: PFIZ LOT EXP: 12Apr16 SER.NO: S411411 B ADM: Sq �• FAX NO. :402-533-2722 Feb. 02 2019 10:49AM P1 CITY OF BLAIR - 2019 PET LICENSE APPLICATION If you live in Blair City limits and own a doo(s) and/or cat(s), complete this form and return with check made payable to: City of Blair * 218 S.161h St. a BIal r, 'NE 66008 You may legally own a combination of tour (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: M it h 15 Owner Name.` l �� Owner Address: U&i city/state/zip., Bla� 08 Phone # Drivers License #k or Date of Firth LICENSE FEES: Dog or Oat: $16.00 Altered Dog or Cat: $11.00 ReplaltA►rlent Fora far Lost Tag• $5 nn ***PLEASE REAb CA1V :1JLLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PRTS, Fallure to do so 19 a violation of City ordinances 6.103 and carries a penalty of a tine up to $ISO.00 par pat. PET LICENSES RENEWALS ARE DUE BY ;I!_1512010, The City shall recognize a microchip idadtifitdtiod dumber a9 the Iirenso number. It shall be unlawful for any (log or tat to wear any license or other city Identification other than that issued by the City of Elair for such dog or cat. The City of Blair requires proof of rabies vaecinatlon, ItOuded i$ a State Fee of 1�25 behN collected to fund the Nebroslca Dog & Cat OpelryWr Inspection Program PET # 1 orb �$, Cat Spaye /Neutered License Fee $ Pet Name . Ace j Sex Color Breed '* Replacement $ ** Declared Danger a Q Potentially Dangerous Dog: ❑ Y'14 N 103 MICROCHIP # _ (If applicable) , SUBTOTAL: $ RABIES VACCINATION DATE: .mm (3 yr) _�L (i yr) _ City Tag # , PET #2 ❑ Dog CI Cat 0 Spayed/Neutered Pet Name A e Sex Licensie Fare $ Color'— _ Breed * Declared (dangerous or Potentially Dangerous Dog: 0 Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RASIM VACCINATION DATE: (3 yr) (i yr) _ City Tag # * PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License free $� Pet Name, A?e . Sex 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 CM 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 N.11 TOTAL ENCLOSED $ Expires: S®curity Code: If you have gtlestlons, pleaae contact City Hall at (402) 426-4191 or by FIX: (402) 426-4195 .........+t.....tt......4....+h..........i•.......-F.+.a-................. F-Ft.4- ... NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Mangy`)i5latelt(Yatenot applloblefor newpeWnewresidents) Newly Air ui_ red Peb; mew Residoni +IR gldiri a Must be i erer Wthin ib day$ of ownership Ili Must register pis Wthil-1-16 days of ■ <1714at 6 montl is of age iF puppy/khm residency. 10/03/2019 18:13 4024260101 HOLSTEIN VET CLINIC PAGE 01/01 2019 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF SLAIR IF YOU LIVE IN BL.AIR CITY LIMITS AND OWN A DOG(5) AND /OR CAT(S), COMPLETE THIS FORM ANI) RETURN WITH A OME,CK PAYABLE TO! CITY' OF BLAIR — 218 S. 16T" ST — GLAIR, 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 0Y W TO LlCEN5�Y0UR PETS, Failure to do so is a violation of City Ordinances 6.103 and carries a penalty of a fin@ up to $150,00 per pet. PEf LICFNSE RENEWALS ARE DUE 6Y 3 15 2019. The city shell recognize a microchip ID dumber as the license number. It shall he 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 LICEN5ING 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 Pet Name: KOda Wood Age: 3Y 1 oB� 10-03-16 sex: Spayed Female color: Brindle Breed: Mastiff X Declared Dangierous/Potentially Dangerous Dog NO YES Microchip # City Tag # Ip�ty�,� ,: •, ,�, `i";.It,'rT;:aC^y, i?f•ui, ` � .i p d ,.. t Rables Tag # . n Si ,l1tf!'; a'iZgi t. c �`afe•:p, ;�i f 7 .*lag•;n;.� ,uri;.:Ind.t=�`.♦;:��{r��'irtvuf':,F:.a�.�{fir}� Babies Description: I YEAR YEAR Holstein Veterinary Clinic Dr. ,Lisa Schrum DVM & Dr, •lei ista Holstein DVM ,18 South l9th Street Glair, NE 68008 402-420-7387 402-426-0101 FaX hofsteindinic- gmaiLcom LICENSE FEES Intact Dog or Cat: $16.00 r' Altered Dog or cat:• $11.00 Replacement Tag $5.00 ff �� Total 1 FAXED 10-03-1.9 BY VITAL PAGES h 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: WOODARD, DEBRA K Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 1355 LINCOLN ST Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: BLAIR, NE, 68008--0000 Operator Inspection Program Phone #: (402) 427-5712 Drivers License #: or Date of Birth: � 1`i(% %T q-(;q Subtotal licensed pets from below:$ Replacement Tags from below: Name: Jax Color: Tabby Spayed/Neutered: True Mirochip # 985112005500810 Vaccination Date: 10/16/2016 DOB: Not on File Sex: Male Breed: Maine Coon Duration: 3 year vaccine Vaccine Exp: 10/1612019 License Fee $ \\ ,-Qu Replacement: ❑Y ON City Tag # 528 Total:- o Holstein Vet Clinic 718 South 19th Street Blair, NE 68008 402-426-7387 Check out our new website! WWW.HOLSTEINVET.COM Printed: 10-25-19 at 2:31 p FOR: Don Woodhull Date: 10-25-19 Q 6Uler-,S I " ` Account: 8942 Blair, NE 68008 Invoice: 103288 (402) 278-1427 Date For Qty Description Net Price 10-25-19 Gizzy 1 Vaccinate & Mini Exam 18.00 10-25-19 1 Vangard Plus 5 26.25 10-25-19 Mastercard payment -44.25 Merchant ID: 529000245365, Approval code: 01497Z, Transaction ID: 742135933 Ref #: 13972, Act #: ************0532, Exp: XX/XX, Entry: Contacticc, Card: MASTERCARD 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 44.25 44.25 0.00 Reminders for: Gizzy (Weight: 11.8 Ibs -) Last done 10-24-20 Vangard Plus 5 10-25-19 08-31-20 Denfensor 3 (3 Year Rabies) 09-01-17 05-31-20 Bronchi Shield - Oral Bordetel 06-01-19 09-05-18 Hwt Dog (Heartworm Test) 09-05-17 Thanks for choosing us to take care of your pet's health care needs! 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 * 2,18 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: Curtis & Elizabeth Worsfold Spayed/Neutered Dog or Cat:;$11r00 Owner Address: 123 S 23rd 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) 426-9719 Drivers License #: or Date of Birth: 11/27/1958 Subtotal licensed pets from below- Replacement Tags from below: Name: Tia DOB: Not on File Sex: Female License Fee $ Color: White Breed: Jack Russell Terrier Replac ment: Spayed/Neutered: True OY Mirochip # 4849626D19 City Tag # 186 Vaccination Date: 2/14/2017 Duration: 3 year vaccine Vaccine Exp: 2/14/2020 Total ',, '4,G4,-� g ykrzt 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: Curtis & Elizabeth Worsfold Spayed/Neutered Dog or Cat. $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 123 S 23rd St Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008--0000 Operator Inspection Program Phone #: (402) 426-9719 Drivers License #: or Date of Birth: 11/27/1958 Name: Lexi Color: Black/Tan Spayed/Neutered: True Mirochip # 985112009207209 Vaccination Date: 05/09/2018 Subtotal licensed pets from below: Replacement Tags from below: DOB: 09/04/2017 Sex: Female Breed: Cavalier King Charles Spaniel Duration: 1 year vaccine Vaccine Exp: 05/09/2019 License Fee $ Repl�caement: ❑Y City Tag # 2434 Total: , L --I " CITY OF BLAIR - 2019 PET LICENSE VERIFICATION t t 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: 11 tT ' 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: Barbara Wright Spayed/Neutered Dog or Cat: $11.00 Owner Address: P O Box 112, 457 S 21st 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 1 Operator Inspection Program Phone #: (402) 533-2510 Drivers License #:H12233417 or Date of Birth: Name: Toby Color: White/Black/Brown Spayed/Neutered: True Mirochip # 981020016720101 Vaccination Date: 6/26/2016 Subtotal licensed pets from below: Replacement Tags from below: DOB: 1/1/2014 Sex: Male Breed: St. Bernard Duration: 3 year vaccine Vaccine Exp: 6/25/2019 License Fee $ Replacement: ❑Y ON City Tag # 1920 00 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: WULF, CORY J & JESSICA R Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 1461 SOUTH ST Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008--0000 operator inspection Program Phone #: (402) 306-5760 Drivers License #: or Date of Birth: 12/07/1986 Subtotal licensed pets from below: Replacement Tags from below: iI F t- i e (.; Name: Deke DOB:--0fi/-1S'/2ff6 Sex: Male License Fee $ Color: Brown Breed: Labrador Retriever Replacement: Spayed/Neutered: False ❑Y ON Mirochip # City Tag # 2460 Vaccination Date: 03/16/2018 Duration: 3 year vaccine Vaccine Exp: 03/16/2021 Total: 12/06/2018 10.22 4024260101 HOLSTEIN VET CLINIC Holstein Vet Clinic 71El South 19th Street Blair, NE 66D08 40,2-428-7387 Printed: 12-06-18 at 10:17u CLIENT INFORMATION Name Kenny Wulf (7768) Address 1572 Colfax Blair, NE 68ow Phone 402 306-,5756 PATIENT INF�7RMATION Name Addy Sex (unknown) specia$ Canine Birthday 09-12-12 Breed Lab Age 6y ID Color Whitp Rabies 16462 Weight 76.00lbs Reminded (none) Codes Reminders for; Addy Last clone 11-19-19 Defensor 1 (1 Year Rabies) 11-19-18 11-10-19 Vangard Ploy 5 L4 11-19-18 08-21-16 Bronchi Shield - Oral Bordetel 08-22-15 M05-15 Canine Influenza Booster PAGE 01101 r` + I l't Patient Chart _ <k" _, { .:. d r{