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A02/13/2023 10:00 4024260101 HOLSTEIN DIET CLINIC PACE 01/01 2023 PET LICENB5 VERIFICATIONIAPPLICATION FOR CITY OF BLAIR IP 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. 16TR ST -- BILAIR, 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 HEAD CAREFULLY*** YOU ARE REQUIRED BY LAVA/ M LICENSEPETS TEE CITY OF BLAAIR REO,UIRE_S PROQF OF RABIES V,�CCINATION, 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 EWA4 ARE DUE BY 3/45/2Q23, The city shall reeoijnize a microchip ID number as the license number. It shill be unlawful for any clog or cat to wear any license or other city IC other than that issued by the City of Blair for such dog or cat. NEW PET LICENS(NG Must be licensed within 10 days of ownership (OR) at 6 months of ago if puppy or kitten NEW ESIDENT O BLAIR Must register pets within 10 days of residency Owner Name Adam Acker Spouse Melissa Johnson Owner Address 1391 Linden Or City/State/Zip Blair, NE 68008 phone # � 402-838.9198 Pet Name : Stryder • Age: 6Y DOB: 02-16-16 Sex: Neutered Male Color: Brown/Wht Breed: Collie Microchip # 985112007412670 Rabies Tag # 17964 PLEASE. INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE). # RABIES VACCINATION DONE ON 05-21-20 Rabies Description: 1 YEAR 3 YEAR HoIsTein Veterinary Clinic Dr. L[&a.5chrurn DVM : Dr, Krisra Holstein VVA4 718 South 19th Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteinciinic@gmall.com LICE NSE•,.F-ES Intact Dog or Cat; $16.00 Altered Dog or cat: $11.00 17eplacement Tap $5.00 Total PETS THAT ARE QtN THE ACTIVE PUYENTfALLY D�US OR DANGERaUS D4G LIST NEED TD REGISTER DIRECTLY4 CITY HALL FAXED IO2-13-23 Gil CITY OF BLAIR - 2023 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 dugs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWA�ARE DUE: March 15, 2023 Owner Name: 1� Owner Address: Il %/� �Y L Y City/state/zip: Blair,, NE 68008 Phone # LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so Is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150,00 per. pet PET LXMNSES RENEWALS ARE DUE BY 311512023. 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. We Ci" Blair reciulres Proof of rabies vaccination to The submitted with your license application. -. Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET #1 Dog ❑ Cat La Spayed/Neutered License Fee $ °G Pet Name Birthdate Sex riY10i�C Color Breed** fna Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y R-N 1 f oa MICROCHIP # (If applicable) SUBTOTAL: $ Il• RABIES VACCINATION DATE: �-15.tea (3 yr) _ (1 yr) Clty Tag # 3894 PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # ' (If applicable) RABIES VACCINATION DATE: (3 yr) _ ❑N (I yr) License Fee $ Replacement $ ** SUBTOTAL: $ City Tag # PET #3 . ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL, ** (This fee is due along wlth License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mai! TOTAL ENCLOSED $ If you have questions, please contact Blair Police bepartment at (402) 4264747 .++++++++f++++*.*......................... r.+.+t+++++++f+++++++t.t....*....... NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 151atefee date notaAakab/ef2rnewpets/newmsfdenfs) 6ewlyAgggirgd Pets: New Residents to Blair: ■ Must be liomsed mCin 10 days of ownership ■ Must register pets within 10 days of ■ <OR> at 6 months of age W puppy/Wtben residency. Thone Animal Hospital (402) 426-3630 902 S Hwy 30 131air, NE 68008 I.,d ego: I. I. cz -1771 uer CITY OF BLAIR - 2023 PET LICENSE APPLICA71ON 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, 2023 i ! �; r Owner Name: j r.'LFIC1 C{�1 Owner Address: r fills' L -I _ . Y= C- rDr City/State/Zip: Blair, NE 68008 Phone # LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to da so is a violation of City ordinances 6.10 and carries a penalty of a fine up to $150.00 per pet PET LICENSES RENEWALS ARE DUE BY V1512028. 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 Droof of rabies vaccination to be submitted with your license application. _, Re&l ement Fee for Lost Tag: $5.0 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET #1 121 Dog ❑ Cat ® Spayed/Neutered License Fee $ Pet Name Ndu Birthdate Sex ma k Color Breed** m�— ra FUT Replacement $ �* Declared Dangerous or Potentially Dangerous Dog: © Y R-N 11 00 MICROCHIP # (If applicable) SUBTOTAL: $ , I. RABIES VACCINATION DATE: �-15-Oa (3 yr) -.�(— (1 yr) City Tag # 3894 PET # 2 Cl Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (I. yr) City Tag # PET #3 , ❑ Dog :1 Cat ❑ Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) License Fee $ Replacement $ El SUBTOTAL: $ (I. yr) City Tag # *PLEASE INCLUDE THE CITYTAO NUMBER IF THIS IS A RENWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED $ `3 If you have questions, please contact Blair Police Department at (402) 426-4747 .+++++++.f.+++.+................+a-.........+.++++..... f +++++................. NEW PET/NEVI/ RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date notappllcable1brnewpetF1newres1dentF) Newly Acquired Pets: New Residents to glair: ■ Must be Ilcensed Wthin 10 days of ownership ■ Must register pets within 10 days of ■ <OR> at 6 mcrMs of age if puppy/kitten residency. Thone Animal Hospital {402) 426-3630 902 S Hwy 30 Blair, NE 68008 l'd 138£: I.6 £Z VZ Uef ICITY OF BLAIR - 2023 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 f Blair 9 218 S 16th St e Blair, NE 6008 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, 2023 Owner Name: 14�i^^-S _ Owner Address: L4 S /U ate-- S City/State/Zip: Blair,. NE 68008 Phone # q5 a - ?QC( :T c wc: - 6o-o- '10� . ' S; - a k '% 3 LICENSE FEES: Dog or Cat: $16.00 Altered Do or Cat: $11 00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/15/2023. 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 to be submitted with your license application. g Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET #1 Dog ❑ Cat ❑ Spayed/Neutered License Fee $ O Pet Name Aclu o-- Birthdate&s2La®2.\ Sex Color Breed** *l.�r Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ,� N MICROCHIP # :Aq S 141 DO q 101 (If applicable) SUBTOTAL: RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # ET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ T #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ ■M W (1 yr) License Fee $ Replacement $ SUBTOTAL: $ City Tag # Replacement SUBTOTAL: - (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER .1F THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) ** * Do Not Send Cash by Mail TOTAL ENCLOSE 6,, OC) If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++a-+++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date notappllcable fornewpets/new re5ldenls) 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. n 1, y c CITY OF BLAIR - 2023 PET LICENSE APPLICATION -6. If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair e 218 S 16th St 9 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 RENEW A S A E DUE: March 15, 2023 Owner Name: — 0 -0 � &\ Owner Address: 1�0 iV � Is1 city/state/zip: Blair, NE 68008 Phone # 46 11� 10 W LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11 00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/15/2023. 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 Citv of Blair requires proof of rabies vaccination to be submitted with your license application. :Replacem,crit Fcc for Lost Tag: $5.000 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET # 1 o g ❑ Cat payed/ eutered License Fee $ a _ Pet Name Bi hdate Sex Color Breed** 04 it Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) BTOTAL: $ RABIES VACCINATION DATE: I o a' (3 yr) (1 yr) City Tag # PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ M (1 yr) (1 yr) License Fee $ Replacement $ SUBTOTAL: $ City Tag # License Fee $ Replacement $ SUBTOTAL: $ City Tag # *PLEASE INCLUDE THE CTTYTAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL E CLOSE® $ (IU 1 inn vS, IC Do �. QK_ Y)o Wtnr tr P If you have questions, please contact Blair Police Department at (402) 426-4747atn� ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Matoh15/ate fee date notapp/icablefornewpets/newre5idents) Newly Acquired Pets: New Residents to Blair: ■ Must be licensed within 10 days of ownership ■ Must register pets within 10 days of ■ <OR> at 6 months of age if puppy/kitten residency. Blair Small Animal Clinic PC David E. Johnson DVM 1734 Front Street Blair, Nebraska, 68008 (402) 533-2722 Rabies Certificate Client ID: 9273 Patient ID: Client Name: Brandy Adler Patient Name: Address: 163 N. 25th Street Species: Breed: Blair, NE 68008 Sex: Color: Phone: (402)677-1120 Markings: Birthday: Weight: Microchip ID: Tag Number: 7321 Vaccination Date: Vaccine: Imrab Rabies Vaccine Expiration Date: Producer: Merial Lot Number: Brand: Imrab 3 TF Drug Expiration Date: Type: Killed Virus anner of Subcutaneously Administration: Staff Name: David E. Johnson DVM License Number: 1893 Doctor Signature: 14026 Libby Canine German Shorthair Pnt Female Black/White 08/31 /2022 17.00 pounds on 12/15/2022 12/15/2022 12/15/2023 18535 11 /17/2023 02/14/2023 17:02 4024260101 HOLSTEIN VET CLINIC PAGE 01/01 2023 PET LICENSE VERIFICATION/APPLICATION FOR. CITY OF BLAIR. IF YOU LIVE IN BLAIR CITY LIMES AND OWN A DOG(5) AND /On CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: C{"I'Y OF BLAIR -- 218 S. 1ST" ST - BLAIR, NE 68008 YOU MAY LLC,ALLY 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 YOU14 PETS. THE CITY QF BLAIR REQUIRES PROOF OF RABIES VACCINATION Failure to do so is a violation of City Ordinances 6_103 and carries a penalty of a line up to $150,00 per pet, PET LICENSE RENEWALS ARE DUE 13Y 3/15/2023. 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 Elair for such dog or cat. NEW PET LICENSING Must be licensed within 10 days of ownership (OR) at 6 months of aye if puppy or kitten NEW RMDiTNTS TO RL IIRR Must register pets within 10 days of residency Owner Name Stephanie Aguilar Spouse Owner. Address 1080 N 25th Ave city/State/zip Blair, NE 68008 Phone # 575-693-2684 Pet Name: Hank �Tag #2508, Age: 4Y DOS: 06-02-18 Sex: Neutered Made Color, Cold Breed: Golden Retriever _ Microchip # ~ Rabies Tag # 20628 PLEASE INCLUDE CITY sAO NUMBER IF THIS IS A RENEWAL (1F AVAILABLE): # RABIES VACCINATION DONS ON 09-07.22 Rabies Description: 1 YEAR YEAR Holstein Veterinary Clinic Dr, Lisa Schrum 0VA4 Dr, 16ista Holstein DVM 718 South 19t' Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteimlinic@gmail.com LLMNSE FEES intact Dog or Cat: $16.00 AltereW --, Dog or cat: $11,00 Replacemenr Tay $6.00 Total $ PETSTN TAREONTNEACTI xPpOTENTIALLY AAN� t (JIJSOR DANGEROUS'RO!�LfSTNEEDTC1R 687-ERDIRECTLYAT LrYMALL, FAXFD 02--14-23 BY ;�.,::;�.,.,iGIT1C:�i��pl►l�;4•:;;,��;0����6,�:4'i:;9'�.,� 7) If you live in Blair City limits and own a clog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair @ 218 S i ttt 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, 2023 Owner Name: A ` Owner Address: Phone # LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/15/2023. 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 to be submitted with your license application. Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PETD o ❑Cat a ed utere License Fee $ ) C' Pet Name�Uiou-) Birthdate Dr z Sex Color` I�� Breed** -.vn�'A- -e-uL, Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # W (If applicable) SUBTOTAL: RABIES VACCINATION DATE: 3-b -e50 (3 yr) -Y-- (1 yr) City Tag # I l' og ❑Cat xl Spaye /Neutere License Fee $ . Pet Name KD r Birthdate Sex /ill Color Breed**Replacement Declared Dann gerous or Po"telftially Dangerous Dog: ❑ Y ❑ N MICROCHIP # IV f\1 (If applicable) SUBTOTAL: RABIES VACCINATION DATE: /d -C9 (,- (3 yr) �4— (1 yr) City Tag # GO!; - PET #3 *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.) ����� t)'C ) Do Not Send Cash by Mail TOTAL r2LY . If you have questions, please contact Blair Police Department at (402) 426-4747 .+++++.....a.....+++++++++++++++++++++++.+++++++++++++++++++a-+++++++++......++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Mar015/ate fee date notapp/icab/efornewpets/newresidents) 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/kitten residency. CITY OF BLAIR ® 2023 PET LICENSE APPLICATION 1. 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 f Blair e 218 S 16th 8t e Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 1S, 2023 Owner Name: �� . 'j 1;'V, - A i . Owner Address: , -' T �J,,n ✓i� r ��✓�' city/state/zip: Blair, NE 68008 Phone # Al n' r d 2-6• - 2 9 LICENSE FEES: Dog or Cat: $16.00 Altered Do or Cat: $11 00 ***PLEASE FULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/15/2023. 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 to be submitted with your license application. g Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska & Cat Operator Inspection Program PET #1 W Dog ❑ Cat )21 Spayed/Neutered License Fee $ ' l - Pet Name a Birthdate _ Sex A 'n1' Color �/ / �,� � � i Breed** iL /I 7 r-.en n,`x 4z Replacement $ * * Declared Dangerous or Potentially Dangerous Dog: ❑ Y W N MICROCHIP # 419 � x 4z- l , � (If applicable) SUBTOTAL: RABIES VACCINATION DATE: L) - / .- z- 41 (3 yr) LjZ(I yr) City Tag # 00-2/-12 ET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ i` #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ W m (1 yr) (1 yr) License Fee $ Replacement $ SUBTOTAL: $ City Tag # * License Fee $ Replacement *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not send Cash by Mail TOTAL // _ If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++..........++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++.+ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March15/ate fee date notapplicablefor newpets/newresldents) Newly Acquired Pets: New Residents to Blair: • Must be licensed within 10 days of Umiership m Must register pets within 10 days of • <OR> at 6 months of age if puppy/Idtten residency. CITY OF BLAIR ® 2023 PET LICENSE APPLICATION si — - 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 9 218 S 16th St e Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. Owner Name: ytc'cr�// ��i fWIS ��✓_ Owner Address: 3 9 9 1�o yc b' city/state/zip: Blair, NE 680 Phone # 7 �70� 4-17 - Si7_Z LICENSE FEES: Dog or Cat: $16.00 Alt d Do or. Cat- $11 00 ***PLEASE FULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3115/2023. 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 renuires Proof of rabies vaccination to be submitted with your license application. ere g . Replacement Fee ear Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program Dog ❑ Cat Spayed Neutered License Fee $ �/- �' Pet Name , cal.s,�er:.,-r Birt date °�s i� Sex 40 ** Color � c.�. Breed" L- 01,-Ie-,-- �L- Replacement$ Declared Dangerous or Potentially Dangerous Dog: ❑ Y 29 N MICROCHIP # 1M& ,,? r v iV 3 W70 (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: 11 X14- Ido k) (3 yr) A_ (1 yr) Ci Tag # T T #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ P t Name Birthdate Sex Co o Breed** aC-ement $ ** Declared Da us or Potentially Dangerous Dog: ❑ Y ❑ MICROCHIP # (If appli bl SUBTOTAL: $ RABIES VACCINATION DAT : _ r'� 3 yr) (1 yr) City Tag ET #3 ❑ Dog LIQa-t' ❑ Spayed/Neuter License Fee $ ' Pet Name .- Birthdate Sex Color Breed** ep/acement$ ** Declared Dan ous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHI . # (If applicable) SUBTOTA A. RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTALENCLOSED$11,06) If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++++++++.....+++++++++++++++++++++++++++++++++¢++++++.+....+++++++++++.+¢+ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS(Match l5latefee date not applicablefor newpets/newresldents) Newly Acquired Pets: New Residents to Blair: ■ Must be licensed within 10 days of ownership m Must register pets within 10 days of ® <OR> at 6 months of age if puppy/kitten residency. CITY OF BLAIR - 2023 PET LICENSE APPLICATION/i � J ­)-0 If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair 9 218 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 IS, 2023 Owner Name: Ct --) A c-r, ('1 d ,0 r Owner Address: ) l3 3 S— 7 City/State/Zip: Phone # Blair, NE 68008 y6o - C9 . ? LICENSE FEES: Dog or Cat: $16.00 Altered Do or Cat: $11 00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 31 5/2023. 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 renuires Proof of rabies vaccination to be submitted with your license application. g Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program ET #1 Id Dog ❑ Cat W Spayed/Neutered License Fee $ _ f_ Pet Name C,`' C-- Birthdate , k � Sex f Color iScowN Breed** I fllc� Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ ® N MICROCHIP #q% to P -10 (Ifapplicable) SUBTOTAL: $ it sU RABIES VACCINATION DATE: to, 14 - 7� \ (3 yr) �/ (1 yr) City Tag # 'P PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ (1 yr) License Fee $ Replacement $ SUBTOTAL: $ City Tag # PET #3 , ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED $ o6 f r If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date notapplicable fornewpets/newresldenl ) 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/Idtten residency. Date of Rabies Vaccination: 10-14-21 Next Rabies Vaccination On: 10-13-24 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: 16343 OWNER OF ANIMAL Sandra Andersen 1035 N 27th Blair, NE 68008 County: THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW. Patient information... PATIENT: Gracie SPECIES: Canine SEX: S Color and markings... Tan Signed Krista Holstein, DVM Rabies Vaccine Information... TAG NO: 19547 WEIGHT: 34.40 AGE: 11 years License: 3612 MFG BY: ZOETI SER.NO: 500084 LOT EXP: 08/09/22 ADM: SQ 02/07/2023 11:52 4624260101 HOLSTEIN VET CLINIC PAGE 01/02 2= 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 THI$ 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 DEAD CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS T'NE CITY OF BLAIR PROOF OF RABIES 1/AGCINATION. 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 RENEW Ly $ IaRE DUE �Y 3/75/2023. 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 thg City of Blair for such dog or cat. NEW EEj i-ICEN5 - Must be licensed within 10 days of ownership (OR) at B months of age if puppy or kitten NEVI( RESIDENTS T[7 B) AIR Must register pets within 10 days of residency Owner Name Roger Anderson Spouse Penny (Johnson) Owner Address 1233 Kristin Circle City/State/Zip Blair, NE 68008 'hone # 402-278.1613 ' Pet Name: Jenny Blue Tag #1697 Age: 9Y DOB: 06-14-1a Sex: Spayed Female Color: Tri Breed: Aussie Microchip # Rabies Tag # 19243 PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): # RABIES VACCINATION DONE ON 06-12-21 Rabies Description: 1 YEAR .3 YEAR Holstein Veterinary Clinic Dr. kisa Sohrum ,0014 : Dr, Krista 1 /olstoin D IAM 718 South 181h Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteinclinic@gmail.com LICENRE FEES Intact Dog or Cat; $16.00 A/ ad og or cat; $11.0 Replacement tog $5.00 Total $ ` I PETS THATAMt ON THEACT1V✓wPOTENTIALLY DANGEROUSOR DANGEROUS DOG LIST NEED TO /iPGISTER O1REC7i Y AT GTY NAB FAXED 02-07-23 BY CITY HALL Q 402-426-4195 02/07/2023 11:52 4024260101 HOLSTEIN VET CLINIC 2023 PET LICENSE PAGE 02/02 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 CHF,CK 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 REtIUIRED BY LAW TO LICENSE YOUR PI TS. THE CITY GLAIR REQUIRES PROOF OF RABES VACCINATIQN Failure to do so is a violation of City Ordinances 6.103 and carries s penalty of a fine up to $150.00 per pet. PET LlIEINSEREKMALS ARE DUE BY 3 15/2023. The city shall recognize a microchip ID number as tho license number. It shall be unlawful for any doff or cat to weer any license or other city ID other then that issued by the City of Blair for such dog or cat. NEW PI=T LICENSING Must be licensed within 10 days at 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 Roger Anderson Spouse Penny (Johnson) Owner Address 1233 Kristin Circle City/State/Zip Blair, NE 68008 Phone # 402-218-1613 Pet blame: Bale Tag #1990 Age: 6Y DOE: 06-12-16 Sex: Neutered Male Color: Blk Ball Breed: Pomeranian microchip # 985112008167188 Rabies Tag # 18867 PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): # RABIES VACCINATION DONE ON 10-21-26 Rabies Description: 1 YEAR 3 YEAR, Holstein Veterinary Clinic Dr. Lisa .'Schrum D14714 Dr. Krista Holstein DVM 718 South 191h Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteirlclirlic@gmail.com LICENSE FEES /ntact Dog or Cat: $16,00 og or cat: $11.00 Replacement Tag $5.00 Total $^1 . PETS THATARE ON THEAQVE POTENTIALLY DANCvE'WyS OR DANGEROUS DOG LIST NEED TO REGISTER DI RECTLY AT CITYHALL; FAXED 02-07-23 BY CITY HALL @ 402-426-41J5 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 f Blair @ 218 S 1th St e Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15 2023 Owner Name: �,/�, Owner Address: �J�4 �� city/state/zip: Blair, NE 6808 Phone # //ye— 6 33 LICENSE FEES: Dog or Cat: $16.00 Altered Do or Cat: $11 00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/15/2023. 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 renuires proof of rabies vaccination to be submitted with your license application. g . Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET #1 'A Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Z_ Pet Name �� �-� Birthdate Oj Sex Color j aN 5 % Breed** &-tlken Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: RABIES VACCINATION DATE: Z--3 - ZZ. (3 yr) ✓° (1 yr) City Tag PET #2 Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Zr Z - Sex Color [ 4},4(r r� Breed** ,� 1 Replacement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N /I MICROCHIP # (If applicable) SUBTOTAL: RABIES VACCINATION DATE: ,� �Z Lrl (3 yr) ✓ (1 yr) City Tag # LL ET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ W (1 yr) License Fee $ Replacement $ SUBTOTAL: City Tag *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED $ ZL If you have questions, please contact Blair Police bepartment at (402) 426-4747 ++++++++.+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++.....+ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date not applicable fornewpets/new residents) Newly Acquired Pets: New Residents to Blair: ■ Must be lioensed within 10 days of ownership m Must register pets within 10 days of m <OR> at 6 months of age if puppy/kitten residency. If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City Of Blair e 218 S 16th St e Blair,, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE, March 15 2023, Owner Name: � C .Il !//� f�.a5 " 1 -M R Owner Address:. Q�. 7 - city/state/zip: Blair,, NE '11 Phone , LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat. $11 00 ***PLEASE READ FULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/15/2023. 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 to be submitted with your license application. Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Ins 'on Program vex Dog ❑ Cat R'Spa4-7 / eutere License Fee $ Pet Name Birthdate- Sex Al .aj.&,_ Color Breed** Replacement$ ** Declared ngerous o Potentially Dangerous D . ❑ Y li]-'N MICROCHIP # -( applicable) SUBT TAL: $ RABIES VACCINATION DATE: 3 yr (1 yr) City Tag # 3 PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ W (1 yr) License Fee $ Replacement $ * * SUBTOTAL:$ *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL L If you have questions, please contact Blair Police bepartment at (402) 426-4747 ++++++.....+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++.+ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date notapplicable fornewpets/newre5ldents) Newly Acquired Pets: New Residents to Blair: Must be licensed within 10 days of ownership N Must register pets within 10 days of <OR> at 6 months of age if puppy/kitten residency. 01/05/2023 16:05 4024260101 HOLSTEIN VET CLINIC PAGE 03/06 2023 PET LICENSE * VERIFICATION/APPLIGATION FOR'CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CATJS), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR — 218 S, 16TH ST — GLAIR, NE 08008 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 REQQjRElD BY LAWjD LICENSE YOUR PErs. THE CITY OF 13LAIR REQUIAES P1100F OF 11 BIES VAC—CINATION. Fbilure to do so is a violation of City Ordinances 6.103 and oarries a penalty of i fine up to $150.00 per pet, PET UCgNS.E RENEWAL$ ARE DMA BY 3/15/9023. The city shall reoognize a microchip ID number as the license number, It shell be unlawful forany 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 RESIN[ gNM TO BLAIB Must register pets within 10 days of residepoy -Owner Name Pam Ashley ppouse Barry Owner Address 1113 S I Sth Ave city/state/zip Blair, NE 68009 Phone # 402-677-4660 Pot Nime: Max Taa #2884 Age, SY QOB: ­67-07-117 Sex: Neutered Male Color. Black and Ton Breed,' '..Rott/X Microchip # ,h Rabies Tag # IMG PLEASE. NCLUDE CITY TAG NUMBER IF THIS IS RENEWAL (IF AVAILABLE):# RABIES VACCINATION DONE ON 12-11-20 Rabies Description: 1 YEAR EAR `.,.;:H,o1stein Veterinary C1,inic Dr Liss Schram DVA4 Dr. Krista Holstein DVM 7 ' 18 South 1911 Street Blair, NE 68008 402-426-7387 402-426-0101 Fax ho I stej ncl i*n ic @ 9 ma 11 co m LICENSE FEES Intact Dog or Cat: $16,00 Doi cat: $1 I.PO Replacement Toy $5.00 Total it r\.(M PEAS T DAt(QERQUS DOG usr NEED TO REGISTER DIRECTLY AT CITY Y&L rAX -E-05--d-1-05-23 BY 01/05/2023 16:05 4024260101 HOLSTEIN VET CLINIC PAGE 02/06 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR iP YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(8) 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 ACOM13INATION OF rOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL ON DWELLING UNIT. YOU ARE REQUIREQ BY LAW LICEN ***PLEASE READ FULLY*** CAREUIRES P_Roc)r--o—F—BA,3-1—E—s—VACC—IN—AIQN-- 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 LIO—N—S—E—R—gDW—W—A—LS—A&E—DUE —gy-3/-15—!9M- The city shell recognize a microchip ID number as the license number. It shall' be unlawful for any dog or cat to weer any license or other city ID other than that issued by the City of Blair for Suchd09 or cat, NEW PET L)CENSIIySzMust be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten NjV_Bgi�TIJ BLAIR Must register pets within 10 days of residency Owner Name Spouse Owner Address city/state/Zip Phone # Pet Name: Marley —4Y DOB: 06-01-18 Breed: Lab Mix Sex: Spayed Female Microchip # 985112011396389 PLEASE INCLUDE CITY TAG NtJMI RABIES VACCINATION DONE ON Rabies Description: I YEAR Pam Ashley Barry 1113 S 16th Ave Blair, NE 68008 402-677-4660 Tag #2664 --T—CoiorBrin—dle I Rabies Tag# 18017 IS A RENEWAL (IF LIAVA ABLE): # 3 YEAR Holstein Veterinary Clinic Dr. Llsg Schrum D VIL4 : Dr. Kri-sts Holsteln D VA4 718 South 1 91hStreet Blair, NE 68008 .402-426-7387 402-426-0101 rax hoisteinclinic@gmaii.corn L&ENSE FW Intact Dog or Cat: $16.00 Re'Placement 1'-79 $5.00 Totals—A--n PgN THATAg QN THEACrIVE P0TENMLLK2AN9962yi0 DAN -R ,%RQUS 00(3 LIST NEED TO -EGISTER PIRECTLYAZ QnL14—ALL 01/05/2023 16:05 4024260101 HOLSTEIN VET CLINIC PAGE 01/06 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YUU LIVC 11V BLAIN CITY LIMITS AND OWN A 000(0) ANP /On C n.T(9), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO! CITY OF BLAIR — 218 S. 161H ST — BLAIR, NI_ IJttvuts YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CAT5 PER RESIDENTIAL OR DWELLING UNIT. ***PLEASE READ CAREFULLY*** V- YOU P)riC rtQUI,RFb OV LAW TO Ll--Q E�/O1JR Pr-T!S_ THE ciTy OF. GLAIR B�OUIRES I:i00F O R BIi: COIN N. Failure to do so is a Violation of City Ordinances 6,103 and carries a penalty of a fins up to $150.00 per pet. ! T LICENSE RENEWALS ARI_ D) 1,1 BY 3/16/2023. TIIe pity •rliall I'000gni=c; a miprobhip Ili numhor acz thA lincinrum number. It shall be unlawful fpr any dog or cat to wear any license or rather city Id other than that issued by the City of Blair for such dog or cat. NEW T LI CENSINGMust be licensed within 10 days of ownership (011) at 6 months of age if puppy or kitten NEW RESi6EN S BLAIR Must register pets within 10 days of residency owner Name Spouse owner Address City/State/Zip Phones # Pat Name: 'Yuri Age: 7Y Sex: Neutered Male DOM .06-14-115 Breed: Mix Microchip # Sierra Ashley 1118 S 16th Ave Blair, ICE 68008 402-Z78-1004 Rabies Tag # 20507 PLEAS I- INCLUDE CITY TAG NUMBER, IF THIS IS A RENEWAL (IF AVAILABLE): # RABIES VACCINATION DONE ON 07.15-22 Rabies Description: "I YEAR �% 3 YEAR Holstein Veterinary Clinic Or. Lisa Schrum DVM : Dr Krista Holsteln DVM 718 South 191h Street Blair, NE 68008 402-426-7387 402-420-0101 Fax hoisteinclinic@gmail.com LICE N ES FEES Intact Dog or Cat: $16.00 Itered Dog r cat; $11.00 R#p/acement Tag $6.00 Total $ IPETSM, TAREONTH ACTIV POTENTIALLYPANGERCIUSQ DANGEZ S DOG L16 HALL, t CITY OF BLAIR - 2023 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, 2023 LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/15/2023. 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 Citv of Blair renuires proof of rabies vaccination to be submitted with your license application. Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET # 1 D o g ❑ Cat Spay t ed License Fee $ Pet Na Birthdate Sex Color nInACf, Breed** Replacement$ ** Declare Dangerous or Potentially Dangerous Dog: ❑ Y N MICROCHIP # __(Jf applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # 1 PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED $ j i� If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March I5late fee date not applicable fornewpeLs/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. ,� Download / Full screen Print ® Hide email GA Date of Rabies Vaccination: 08-13-21 Certificate No: 2459 Next Rabies Vaccination On: 08-12-24 Previous Rabies Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Thone Animal Hospital Scott Lucht 902 S Hwy 30 1529 South St Blair, NE 68008 Blair, NE 68008 402-426-3630 County: This Is to certify... THAT i HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW. Patient information... PATIENT: Toby TAG NO: 007020 SPECIES: Canine WEIGHT: 0.00 SEX: N AGE: 3 years Color and markings... Black Signed Dr.Kamala Freeman License: 3894 Vaccinations done... 07-05-22 KF DA2PPV 1yr 07-05-23 07-05-22 KF Bordetella Oral 08-13-21 KF Rabies Vaccination (3 Year), #007020 08-12-24 0842-20 KF Rabies Vaccination (1 Year), #006023 Rabies Vaccine Information... MFG BY: ZOETI SER.NO: 470342 LOT EXP: 5-10-22 ADM: SQ X Dog TA