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B2 sz 1 y CITY OF BLAIR ® 2023 PET LICENSE APPLICATION I - i 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 ACRE DUE: March 15 2023 Owner Name: ` � � i C� , ��- OwnerAddress: 4 ?'�)' S cr iiC dIt ( city/state/zip: Blair, NE 68008 Phone # L4`5,) - UL-�-u��� 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 PET # 1 '121. Dog ❑ Cat 4 Spayed Neut ed License Fee $ Pet Name Birthdate ` - Color Breed** Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y CJ� MICROCHIP # 5'- �� `t D I o (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: � (3 yr) .,C _ (1 yr) City Tag # L>9--) PET #2 ' P D o g ❑ Cat " Spayed/Neute ed = License Fee $ 1 t Pet Name�lc� (.�,r� Birthdate (1-T S �ex Color bj ( T— Breed** S Replacement $ ** Declared Dangerous or Potentiall Dangerous Dog: ❑ Y MICROCHIP # G �� '� ' `�'t✓� I I I % (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: -A-) (AP,-(3 yr) (1 yr) City Tag #-)" PET #3 g Dog ❑ . Cat Spa ed/Neutered License Fee $ Pet Name JrJ"<<` " Birthdate Sex _fo — Color Breed** - Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # 0 � rim r If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: 'T(3 yr) -X— (1 yr) City Tag # . -i *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.) TOTAL ENCLOSED $ Do Not Send Cash by Mail If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date notapplIcab/e fornewpets/newresidenis) Newly Acquired Pets: New Residents to Blair: ® Must be licensed within 10 days of ownership ■ Must register pets within 10 days of ■ <OR> at 6 months of age if puppy/kitten residency. CITY OF BLAIR ® 2023 PET LICENSE APPLICATIONw 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 15, 2023 Owner Name:f� Owner Address: 1 LI -2- 1 '\ 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 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: $S.00 Included is a State Fee of $1.2S being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET # 1 ® Dog ❑ Cat Ur Spayed/Neutered License Fee $ Pet Name -�S ! �>s 1-c- Birthdate i iiho Sex ** ° Color t_,ti, % hmL:. r, 4 Breed** a�X111ev-km`'Y Replacement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y WN MICROCHIP # (If applicable) SUBTOTAL: $ 1 v RABIES VACCINATION DATE: I i -2-0 (3 yr) o (1 yr) City Tag # Lo 1-iSr PET # 2 31 Dog ❑ Cat Q Spayed/Neutered License Fee $ i l . u o X. Pet Name -7--z-`-�c, c, Birthdate 12DI 2Sex Color jru "-A\%A--Q Breed** Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y Q N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: L( (3 yr) —X2 (1 yr) City Tag # io 3 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 $ 2-7,00 If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date notapp/icab/efornewpets/newresidents) 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/Idtten residency. Client ID: Client Name: Address: Phone: Tag Number: Vaccine: Producer: Brand: Type: -inner of Administration: 7689 Iva Baessler 1421 Lincoln St Blair, NE 68008 (402)699-0369 6098 Imrab Rabies Vaccine Merial Imrab 3 TF Killed Virus Subcutaneously Staff Name: David E. Johnson DVM License Number: 1893 Doctor Signature: Blair Small Animal Clinic PC David E. Johnson DVM 1734 Front Street Blair, Nebraska, 68008 (402) 533-2722 Rabies Certificate Patient ID: Patient Name: Species: Breed: Sex: Color: Markings: Birthday: Weight: Microchip ID: Vaccination Date: Expiration Date: Lot Number: Drug Expiration Date: 9837 Bessie Canine Shepherd Mix Spayed Female White Shepard/Heeler Mix 11/21/2010 96.00 pounds on 2/4/2023 12/18/2020 12/18/2023 18473 7/3/2021 Client ID: Client Name Address: Phone: Tag Number: Vaccine: Producer: Brand: Tvpe: inner of Administration: 7689 Iva Baessler 1421 Lincoln St Blair, NE 68008 (402)699-0369 6386 Imrab Rabies Vaccine Merial Imrab 3 TF Killed Virus Subcutaneously Staff Name: David E. Johnson DVM License Number: 1893 Doctor Signature: Blair Small Animal Clinic PC David E. Johnson DVM 1734 Front Street Blair, Nebraska, 68008 (402) 533-2722 Rabies Certificate Patient ID: Patient Name Species: Breed: Sex: Color: Markings: Birthday: Weight: Microchip ID: Vaccination Date: Expiration Date: Lot Number: Drug Expiration Date 10076 Izzabella Canine Chihuahua Spayed Female Brown/White 01 /04/2012 7.68 pounds on 10/29/2021 4/16/2021 4/16/2024 18495 11 /30/2022 02/03/2023 15:26 4024260101 HOLSTEIN VET CLINIC PAGE U1/01 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF 13WR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOO(S) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO; CITY OF BLAIR —218S. 16'THS7—BLA113, NE68DOR YOU MAY i-EGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (8) ADULT DOGS OR THREE (3) ADULT, CXfS PER RESIDENTIAL OR DWELLING UNIT. '"PLEASE REAL! CAREFULLY*** YOU ARE REQUIRED BY LAW TO IJq9RSE-"Q PETS . THE 0" or ALAIR REQUIRES PROOF OF RABRABIESVAC!DINATION, . R Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150,00 per pat, PET LICENSE RENEWALS ARE DUE RV'.I/--'---- The city shall recognize a microchip ID number as the license number. It shall be unlawful for any dog or cat to wear any license or other city ID other than that igKlecl by the City of Blair for such dog or cat. NIEWPET ILICiV �SIN Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten NEW RESIDENTS — BLAIR Must register pets within 10 clays of residency Owtior Name I Maximus Baby spouse ITAKE NAME OF.F ----- Lennie Jones Owner Address I - 602 N 15th St Cityl$tate/Zip Blaii, NE 68008 Phone # 402-237-9890 Pot Name: Thor Tag #3788 Age; 16WSex: ,.DOB: 10-13-22 Color: ., Breed: 'Rot Mix Microchip # Rabies Tag #23068 PLEASP, INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): # RABIES VACCINATION DONE ON 02.03-28 Rabies description: 1 YEAR 3 YEAR ,Holstein Veterinary Clinic Or. Lisa Schrum DVA11 : Or, Krista flolsteln DVM 718 South 191h Street Blair, NE 68008 402-426-7387 402-426-0101 Fax hoisteinclinic@gmaii.com Dog 7 ract Dog Cat: $16. Altered Dog or cat: $11.00 Replacement Tag $6.00 Total $ A u P F IS LTAI�g ON TNEA��T17ANGFROUSOp�,` LIST NEED YD REGlS7-ER PIRECTLYAT CITY HALL. 02-03-23 BY '.CIT j1 CITY OF BLAIR - 2021 PET LICENSE APPLICATION lu q If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair o 218 S 16th St • Blair, NE 68008 l 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: L /arc 5 2021 owner Name: 1 D� �-ynet T � q l r'" Owner Address: 14— me_-a P City/Stake/Zip: Blair, NE 68008 Phone # ?"0 ,�Z - 533 36'1S- LICENSE FEES: Dog or Cat: $16.00 .,e 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 3/15/2021. The City shall recognize a microchip Identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city Identification other than that Issued by the City of Blair for such dog or cat, The City of Blair requires proof of rabies vaccination. Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET # i D o T ❑ Cat � Spay�d/Neutered License Fee $ i Pet Nam � Y ' Birthdate .1 -1 � 1 Sex Wi4 � Color r&grL/w e, Breed** -t-e-r M1,5cReplacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y t4 N UP MICROCHIP # (If applicable), SUBTOTAL: $ _ RABIES VACCINATION DATE:`.?- 3/- Z.2. (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) ■M License Fee $ Replacement $ ** SUBTOTAL: $ (1 yr) T 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 $ '- 3 00 If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++.....++++++.....++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Mardi 151atefee date not applicable for newpets/new residents) NewlyAcouired 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. " of the Jeanette Hunt Animal Shelter P.O. Boa r - Blair, NB 68008 Type of I ;r2:---- Owner Surrender Other Breed: Color: Weight: Ibs Age: Thin orma Overweight Gender: M (40 F FS Unknown Dog Intake Exam Animal ID#: Intake Date: Animal Name: Spay/Neuter Scheduled Date: Scheduled Location: GAIT/MOBILITY (circle Lameness noted? NO YES (note which limb) If lameness present- weight aring? YES NO Notes: Microchip found DO YES # Date: Employee Name: ❑ Dewormer Declawed: No 2 Paw 4 Paw CONDITION Sick Injured Apparently Health Distemper 013 ITUDE riendl Fearful Fractious I BAR QAR Lethargic „ COAT & SKI Nor Abnormal Flea dirt / live fleas NO D YES (note tx below) ❑Flea/Tick Prevention ❑ Notes EYES CLrmal Abnormal EARS Normal Abnormal NOSE C!!Lm Abnormal HEART Normal Abnormal MOUTH/TEETH/GUMS NormBP7 Abnormal Painful Red gums Broken teeth Tartar UROGENITAL Normal Abnormal Tattoo Visible YES NO Females: Spay Scar YES NO Males: Testicles palpable? TWO / ONE NO Notes: ASSESSMENT: ❑ No problems, ok to be available ❑ Minor problems seen, ok to be available ❑ Problems found, hold for vet check _ ❑ Going to foster/rescue Stage: AVAILABLE NOW Petstablished: ❑ Fife Created: ❑ Pic Taken ❑ Petfinder: 0 Adopt -A -Pet: ❑ rr, 7„�- -- `I —1 , Owner's Name & Address r�norw 14A VM%A, 1UN W:H I IFICATE NASPHV Form #50 Print - use ball point pbn or a Rabies Tag Number ^� 0. PRINT -Last First M. 17 Telephone No. Street n City ` State zip p/ f(� Species: Dog Sex: Male Age: Size: Predominant Breed: 3 ❑ Colors: o Mo. to 12 mo. Under 20 lbs. ❑ Cat ❑ Female ❑ 1 12 mo, or older. 20-50 lbs.—�Ei�� Name Over 50 lbs. ❑ 11'� t Producer: NOSIVAC ®1 1 yr. Lic.Nacc. Vacc. Serial (lot) No, 9Eta'&8b922;�,; For Licensing / EXp NOCT2d�,' License No. ❑ yr. Lic.Nacc. Other DATE VACCINATED: Veterinarian's: #4 ' 3 ( S}L1 <7S) License No, Month Day Year _ Other Change ❑ Add ❑ Sign ture VACCINATION EXPIRES: I 379d Ce-, n/; r Control No. 3 a3 s + � Month Day Year s C � C V R,,# to+Ysz 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 e 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 Owner Name: Owner Address: 1.-"11VOL"v( City/State/Zip: Blair, NE 68008 Phone # -- 6- 2'e5 _. , -V 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 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 requires Proof of rabies vaccination to be submitted with your license anPlication. Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET #1 Dog ❑ Cat Spayed/Neutered License Fee sl Pet Name - A; Birthdate 3 Sex ra"rk�jlt- Color Breed**Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y .tiN MICROCHIP # "/ 6,1 / / ?50 (If applicable) SUBTOTAL: $ TRABIES VACCINATION DATE: � c c — (3 yr) C' (1 yr) City Tag # -32-;- 7 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) _ License Fee $ Replacement $ ❑N W SUBTOTAL: $ _, (1 yr) City Tag # (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.) ** * L'f- DoNotSendCashbyMail TOTAL ENCLOSED $ It ____ 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/newres/dents) 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/Idtten residency. rS CITY OF BLAIR ® 2023 PET LICENSE APPLICATION4� 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 6800 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 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.. 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 $ Pet Name, Birthdate Sex Color Breed** Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ ff RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # U u 6 PET #2 CI Dog ❑ Cat 0 Spayed/Neutered License Fee $ Pet Name I Birthdate ,4 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 Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ License Fee $ Replacement $ ❑N SUBTOTAL: $ � � , (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) ** Do Not Send Cash by Mail TOTAL ENCLOSED $ ._�_ D , 0 0 If you have questions, please contact Blair Police Department at (402) 426-4747 +++++++++++++++++++.+++++++++++++++++++++++++++++.++++++++++.....+++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15late fee date not applicable fornewpets/new residents) 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. 718 South 19th Street Blair, NE 68008 402-426-7387 Printed: 02-24-23 at 3:56p CLIENT INFORMATION Name Mackenzie Banas (10601) Address 675 N 24th St Blair, NE 68008 PATIENT INFORMATION Name Athena Sex Female, Spayed Birthday 12-01-21 (unknown) ID Color Yellow Reminded (none) Reminders for: Athena 03-29-23 Vanguard® Rabies 1 {1 YEAR) 03-29-23 Vanguard® DAPP/1-4 {Distemper+L Spouse Robert Rapson Species Canine Breed Lab Age 15m (unknown) Rabies 20212 Weight 54.60lbs Codes Last done 03-29-22 03-29-22 Patient Chart Holstein Vet Clinic Patient Chart 718 South 19th Street Blair, NE 68008 402-426-7387 Printed: 02-24-23 at 3:56p CLIENT INFORMATION Name Mackenzie Banas (10601) Address 675 N 24th St Spouse Robert Rapson Blair, NE 68008 PATIENT INFORMATION Name Aspen Species Canine Sex Female, Spayed Breed Lab Birthday 11-14-20 Age 2y ID Rabies 20085 Color Yellow Weight 60.00lbs Reminded (none) Codes Reminders for: Aspen Last done 02-06-25 Vanguard@ Rabies 3 {3 YEAR) 02-07-22 02-15-24 Vanguard@ DAPP/1-4 {Distemper+L 02-15-23 r Is 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 9 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: j'rj rg° Owner Address: city/state/zip: Blair, NE 6800 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 PET # 1 ❑ Dog a Cat ❑'Spayed/Neutered License Fee $ Pet Name x , ; l'; Birthdate % Sex Color i ' fi Breed** 1�, � A PA'� i Replacement $ ** Declared ` angerous or Potentially Dangerous Dog: ❑ Y Ll`N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE. -7 - (3 yr) ( y) NCity Tag# PET # 2 ❑ Dog ❑Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed" Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ 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 $ If you have questions, please contact Blair Police Department at (402) 426-4747 ++++.+++++++++++++++++++.....+++++++++++++.++++++++¢++++++++++++++.+++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15late fee date not applicable for newpets/newre5idents) 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. CERTIFICATE Date of Rabies Vaccination: 3/7/2023 Next Rabies Vaccination On: 3/6/2024 VETERINARY CLINIC Arlington Pet Hospital 225 N. 3rd St. Arlington, NE 68002 402-478-4141 Certificate No: 0 Previous Rabies Vaccination: OWNER OF ANIMAL Cherri Barnes 758 S. 16th St. Apt 332 Blair, NE 68008 County: Washington This is to certify... THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW. Patient information... PATIENT: Pretty Kitty TAG NO: 031911 SPECIES: Feline WEIGHT: 7.80 SEX: Spayed Female AGE: 5Y Color and markings: Brown Tabby Signed / / 14 �� s-� MATT TALBOT, DVM License: 3220 Vaccinations done... 3/7/2023 MT RABIES 1 YEAR, #031911 3/7/2023 MT FVRCP- C ADULT BOOSTER 3/6/2025 Rabies Vaccine Information... MFG BY: NOBIV SER.NO: 562903 LOT EXP: 10/03/23 ADM: SQ a If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair e 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 Owner Name: D —a 6 ff Owner Address: 13 i l r'( wA% er �-4 A -/ ` ll'- city/state/zip: Blair, NE 68008 Phone # 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 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 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 $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program ET #1 ❑ Dog Cat Spayed Ne tered License Fee Pet Name Birthdate l " 5 x Color Breed** " �Oii Rep/acement$ ** Declared ngerous dr Potentiall D erous Dog: ❑ Y N MICROCHIP # 5 /' l /� �� (If applicable) SUBTOTAL: $ 1� RABIES VACCINATION DATE: zi %" (3 yr) (1 yr) City Tag #-)--I? PET #2 ❑ D o g A C a t 4 Spayed Ne tered License Fee $ e Pet Na Birthdate Se Color Breed** c% U Rep/acement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable), SUBTOTAL: $ RABIES VACCINATION DATE: -(3,yr) yr) City Tag # 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 License Fee $ Replacement $ SUBTOTAL: $ . (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) ** * Do Not Send Cash by Mail TOTAL ENCLOSED $ oX�i . - If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++++++++++++++++++++++++++++++++++++++++++++++++++.....+++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Marchl5/ate fee date notapp/icab/efornewpets/newresidents) 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. 03/01/2023 15:42 4024260101 HOLSTEIN VET CLINIC PAGE 02/02 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BI-41FI IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOGIS) AND IOR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR - 218 S.16 TH ST - BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOG.S OR THREE (�) ADULT CATS PER RESIDENTIALORDWELLING UNIT. ***PLEASE READ CAREFULLY*** F CITX OF BLAIR REt1UlAES PROOF O�•RABEES VACCINATION, Failure to do so is a violation of City Ordinances 6,103 and carries a penalty of a fine up to $160.00 per pet. PET LICENSE RENEWALS ARE DLjE ByltIE2023. The city shall re000nize a microchip ID number as the license number. It shall 139 unlawful for any dog or cat to wear any license or other city ID other than that issued by the City of Clair for such dog or cat. NEW PET LICENSING Must be licensed within 10 days of ownership (DR) at 6 months of age if puppy or (iten NEW RESIDENTS TO �B Must register pets within 10 clays of residency Owner Name David Barr Spouse Owner Address 1952 Colfax Street Citylstate/zip Blair, NE 68008 Phone # 402-633-4865 Pet Nome: Pearl Tag #3653 Age, 7Y Sex: Spayed Female Color. Brindle DOB: -08.01-15 Breed: Boxer Microchip # Rabies Tag # PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): 0 RABIES' VACCINATION DONE ON 1 10-19-21 . %sA- I *2w 346AIRM Rabies- Description: w ff - IN- X"% I Holstein Veterinary Clinic Dr, /. isa Schrum D VM : Dr. Xdsra Holstein D VM 71 B South 1911 Street Blair, NE 68008 402-426-1387 402-426-0101 Pax ho Iste i nel i n ic @ g Ma i I -Com LICENSE FEES lotact Dog or Cat: $16.QQ I Alta D g or cat: $11,0 0 R&p/aaej 9a $5.00 Total $ 11 PETS T14ATARE ON TK CrIVEPOTENTIALLY DANGER -OU5OR -rjAIVGER0USDOG LIST Nf9Q TO REGISTER DIRECTLY "T1,7YHALL. FAXED 03-01-23 I BY 21 -A -T" L 03/01/2023 15:42 4024260101 HOLSTEIN VET CLINIC PAGE 01IO2 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A bOG(8) AND /OR CAT(S), COMPLETE THIS FORM AND RLTURN WITH A CHECK PAYABLE TO: CITY OF 13LAIR -m 218 S. 16TH ST - BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINK(ION 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 REQUIRE 0 BY LAW TO LICENSE YOUk PVT$, THE (CITY OF BLAIR REQUIRES PROOF OF RABIES VACCINATION, Failure to do so is a violation of City Ordinances 6.103 and carries a penalty of a fine up to $150.00 per net. PET LICENSE RENEWA�9,ARE DUE BY 3175/2023. The city shall recognize a microchip ID number as the license number. It shall be unlawful for any doff or cat to wear- any license or other city ID other than that issuers by the City of Blair for such dog or cet. NEW PET LICENgjNfLMList be licensed within 10 clays of ownership (OR) at E months of age if puppy or kitten NEW NTS TO BLAIR Must register pets within 10 days of residency Owner Name David Barr Spouse Owner Address 1952 Colfax Street City/State/Zip Blair, NE 68008 Phone # 402-533-4865 Pet Name; Sasuke Tag #3096 Age: 2Y K DOB: 11.24,20 Sex: Neutered Male Color: Tan & Wh Breed: Aussie �. Microchip # � Rabies Tag # 2017FI PLEASE INGLUnIE CITY TAG, NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): # RABIES VACCINATION DONE ON 03-17-22 Ramses Description: 'I YEAR 3 YEAR Holstein Veterinary Clinic Cyr, Lisa Schrum ©VM : Dr. hrista Holstein DVM 718 South 1916 Street Blair, NE 68008 402-426-7387 402-426-0101 Fax - tiul�toinciinlcc�gmaii.com LICENSE FEES Intact Dog or Cat: $16,00 rs7 Dog o at: $1 0 Replacement Tag $.ra.00 Total $%_ FAXED 03-01-23 BY kyoo �>. - 2023 PET LICENSE 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 Owner Name: � Owner Address: a i city/state/zip: Blair, NE 68008 Phone # 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 .�q ► Dog ❑ Cat ❑ Spayed/Neutered License Fee $ / I Pet Nae Birthdate r '� Sex' / Color�'�_a �w Bfbed**/`� �f�:� —' Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ITN MICROCHIP #' /,`)1 / (If applicable) SUBTOTAL: $ I RABIES VACCINATION DATE: / w, I -It—. 2. 2 . (3 yr) X (1 yr) City Tag # * PET #2 Dog ❑ Cat Spayed/Neutered License Fee $ Pet Name, ' �_¢ Birthda '' - � Sex Replacement Color ;'� t.._ 1 ,�g� � r .�: � �:.,,-,Breed** � . �,�_:, � � ©, p $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y 0, N MICROCHIP # `'�� i` yz (If applicable) SUBTOTAL: $ e v RABIES VACCINATION DATE i _2 , (3 yr) X (1 yr) City Tag #)4 PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate Sex — Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) (1 yr) License Fee $ Replacement $ SUBTOTAL: $ City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not send cash by Mail TOTAL ENCLOSED If you have questions, please contact Blair Police bepartment at (402) 426-4747 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Marchl5/ate fee date not applicablefornewpets/newresidents) Newly Acguired 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. 01/23/2023 16:32 4024260101 HOLSTEIN VET CLINIC PAGE 02/03 2023 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 — 218 S. 16T" ST — SLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS BUT NO MORE THAN THREE (3) ADULT DDGS OR THREE (3) ADULT CATS PER RESIDENTIAL- OR DWELLING UNIT. **++PLEASE READ CAREFULLY*** YOU AFtE REOl3.1 ED BY LAW TO LICENSE YOUR PETS THE CITY OF BLAIR REQUIRES PROOF OF RABIES VACCINAIM. Failure to do so is a violation of City ordinances 6,103 and carries a penalty of a fine up to $160.00 per pet. p I ENSE ENEWALS ARE ni iF AV -1/1 02�. The city shall recognize a microchip Id number as the license number. It shall be unlawful for any dog or cat to wear any license or other city ID other than that Issued by the City of Blair for such dog or cat. NEW PET LICENSING Must be licensed within 10 days of ownership (QR) at 6 months of age if puppy or kitten NEVy, EFt SIDEN?S TO BL6A Must register pets within 10 days of residency Owner Name Spouse owner Address /State/Zip Phone # Pet Name: Jd Age: 19W DOB: 09.12-22 Breed: Doodle Sex: Male Garrett Batonhorst 1102 N 20th Arse Circle Blair, NE 68008 402-278-2232 Tag #3771 Color: Microchip # 900235000372333 Rabies Tag # 23Q13 PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): # RABIES VACCINATION DONE. CAN 01-13-23 Rabies Description: /(I YEAR � 3 YEAR Holstein Veterinary Clinic Dr Llsa Schrum DVM . Dr. Krisr,? Holsteln DVM 718 South) 191h Street Blair, NE 68008 402-426-7387 402-42&0101' Fax holsteinclinlc gmalLcom LICE ISE FEES tact Dog or t: $16. Areo[dog or oat: $11.00 Replacement rap $5.00 4 Total $� — ETSTHATARE ON THE ACTT POTCNALLY DAI Gf OUS OR DAN ERDUS DO LIST NEED i EGISTER QIRECTLY T GJTY HALL, FAXED 01-23-23 BY 1 77 ,... - �.lb•:: ��'f�..in;;,';.tl!,.t.•ia'�t�;'ru:f.>ii'�h;�'I,411'f'�4��t���r•; •.t1�>�' ':.i.�i 01/23/2023 16:32 4024260101 HOLSTEIN VET CLINIC PAGE 03/03 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN FLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S). COMPLETl= THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY' OF BLwAIR - 218 S, 1WH 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 REAL] CAREFULLY' _Y„OtJ ARE REQUIRED BY LAW TC1 LICENSE YOUR PETS. TF(E CITY OF SLAIR REQUIRES PROOF 01C RABI $E VACCIN11.T10N� Failure to do so is a violation of City Ordinances 6,103 and oarrles a penalty of a fine up to $160.00 p®r pet. PET LICENSE,RENEWALS ARE DUE BY 3l 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 Blair for such dog or cat. N W PET, ICL ENSIN Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten NEW RESIDE TS TOIR Must register pets within 10 days of residency Owner Name Spouse Owner Address City/State/Zip Phone # Pet Name: Sophie Age: 4Y DOB: 10-10-18 Rroed: Great Dante Microchip # saLFASE INCLUDE CITY Sex: Spayed Female RABIES VACCINATION DONE ON Garrett Batenhorst 1102 N 20th Ave Circle Blair, NE 68008 402-278-2232 Lag #3772 Color: !Choc Rabies Tag 0 23014 IF THIS IS A RENEWAL, (IF AVAILABLE): # Rabies Descriptlon: 7 YEAR 01-13-23 Holstein Veterinary Clinic Dr. Lisa Schrum ,DVM : Dr. Krlsta Alolstain DVM 718 South 19'h Street Blair, NE 68008 402-426-7387 402-426-0101 Fax h©lsteinciinicAgmail-com LICE SE PEER. Intact Dog or Cat: $16,00 $fiWrrd---\ pog r at: $11. 0 Raplecer»ent rag $6.00 Total $ pANOEROUS DOG LIST NEED r0. REGIST€`R DIREOrLYAT CITY HAf L FAX50 01-23-23 BY �/� �,, ; .Y.''R^�4:'!';' b1/13/1f723 16:32 4024260101 HOLSTEIN VET CLINIC PAGE 01/03 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR - 218 S. 16TH ST - BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF: FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT. ***PLEASE HEAD CAREFULLY«e* ARE REQUIRED BY LAW TO LICENSE YOUR PETS THE CITY OF BLAIR REQUIM PR Or- or RABIES VACCINATION Failure to do so is a violation of City Ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PLT LICENS FtENEW LS ARE DUE BY 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 Blair for such dog or cat. (SEW PET LICENSING Must be licensed within 10 days of ownership (OR) ate months of age If puppy or kitten NEW RESIDENTS T BLAIR LAIR Must register pets within 10 days of residency Owner Name Spouse ' — Owner Address City/state/Zip Phone # Pet Name: Jack Age:. IOY DOB: 06-08.12 -Brood: 'Aussie X Microchip # PLEASE INCLUDE CITl Sex: Neutered Male RABIES VACCINATION DONE ON IF THIS IS A RENE' - [ 0'{-23.23 Rabies Description: 1 YEAR Holstein Veterinary Clinic Dr. Lisa Schrum DVM : Dr. Krlsta Holstein PVM 718 South 191h Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteinclinic@gmail -com Garrett Batenhorst 1102 N 20th Ave Circle Blair, NE 68008 402-278-2232 Tag #2406 Color; Tri Rabies Tag # 23032 (IF AVAILABLE): #t' LICENSE FEES Intact Drag or Cat: $16.00 000 no Replacement Tag $5.00 Total $_ 1 1 PO THAT AR9 ON T14E ACTIVE POTENTIALLY DANGEROUS 0R DA 1 EROUS DOG UST NE 0 TO REGISTER DIRECTLY AT C HALL, FAXED 01-23-23 BY H4L`r02-4?6-475�,':= ',�;!rj`!�I't'�+j;�:; �;:•:l. ;';�i �!.i „��;.;'"u,•I'il. •�- •'y!nr.," ,I,' �'�:, `�°l:i �;,id. ` 01/20/2023 12:35 4024260101 HOLSTEIN VET CLINIC PAGE 02/02 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CIYY LIMITS AND OWN A DOGS) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO; CITY OF BLAIR - 218 S. I 6THST - 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 I.AW TO LICENSE YOUR BETS. THE CITY or BLAIR REQUIRES PROOF OF RAW gS.A VACCINATION. Failure to do so is a violation of City Ordinances 6.103 and carries a penalty of a fine up to $150,00 per pet. PET LICENSE RENEWALS ARE DUE BY 3/1§aDD- The city shall recogniie a microchip ID number as the license number, It shall be unlawful for any dog or cat to wear any license or other city ID other than that Issued by the City of Blair for such dog or cat - NEW PET 'LICENSING Must be licensed within 10 days of'ownershlp (OR) at 6 months of age if puppy or kitten NEW B9,9112ENI.S TO -BLAIR Must register pets within 10 days of residency Owner Name Sandy Baurnberger soou!ie Owner Addr6 ss 1:379 Fieldcrest Drive City/state/zip Blair, NE 68008 Phone# 4,02-727-8107 Pet Name: Belle Tag�2677 Agei: 16Y DOS: 05-29-06 Sex: Spayed lFe ale Color: Grey. Breed: IDSH Microchip # Rabies Tog # PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): # RABIES VACCINATION DONE ON 05-31-22 Rabies Description: 1 XEAR YEAR 3 Holstein Veterinary Clinic Dr. L Isa Schrum 0 VA4 : Dr. Krista Holstein D VA4 -718 South 191h Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteincl.inle@gmail-corri LICENSE FEES 10raot Dog or Cat; $16-00 Dog rcat: $11 0 f?eplacement Toy $5.00 Total $ PETS 4_TE�QNTHEA�CTIVEPQ�TFNTI 11�YQANGER�QQSQ DANGEROUS DOG LIST NEED TO _REGISTER DIRECTLY ATCITY HALL FAXED 01-20-23 BY 24 '0' 01/20/2023 12:35 4024260101 HOLSTEIN VET CLINIC PAGE 01/02 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND 108 CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR — 218 S. 16TH ST — BLAIR, NE 68008 YOU MAY LWALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL. OR DWELLINGS UNIT. 1�**PLEASE READ CAREFULLY0** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. THE _CITY OF BLAIR REQUIRES PROOF OF RABIES VACCINATION. Failure to do so is a violation of City Ordinances 6.103 and carries a penalty of a fine up to $150.Oq ppr pet. PET LICENSE RENEWALS ARE DUE BY 3/15/2023. The city shall recognize a microchip ID number as the license number. it $hall be unlawful for any dog or oat to wear any license or other city ID other than that issued �y the City of Rlair 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 AESIIDENTS TO �LAAIR Must register pets within 10 days of residency Owner Name Sandy Balumberger Sprouse Owner Address 1379 Fieldcrest Drive City/State/Zip Blair, NE 68008 Phone # 402-727-8107 Pat Name: Cleopatra Tag 7 Age: 14Y DOB: 06-27-08 Sex; Spayed Ferrule Color: CalilWh ' Breed: Dlh Microchip # Rabies Tag # PLEASE INCLUbE CITY TAD NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): # RABIES VACCINATION DONE ON 45-31-2z Rables Description: 1 YEAR 3 YEAR Holstein Veterinary Clinic Dr. Lisa Schrum DVM , 0r. Kr/sta Holstein DVM 718 South 19th Street Blair, NE 68008 402-426-7387 402-426-01.01 Fax holsteinclinic@gmail.com Intact Dog or Cat: $16.00 A Drag o cat: $ 00 neplec t rag $5.00 Total $ PETS THATARE ON THE ACTIVE POTENTIALLY DANGEROUS OR DANGEROUS DOG LIST NEED TO REGISTER DIRECTLY AT CITY HALL. FAXED 01-20-23 BY .I.'. I�y.f '..�.:�.'4 1 I �. ICI �� ' I.. I.1 � t I. II.. III.. t ?' •, 't :I •.I:: �;I+ki?1�Y�>�t'�.Ai::�14�1�;::�,=���r!tb,�W�:��,;. ,���,::;�f:�' •'�"�:, I. :���� 1.1 , I;1, •��'•'•1� I '��I 1'I'19. L � �� ••I �••; •II ��" �, :. l . 1b 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 Owner Name: J P V V` Lt P P A S 1 -i-, Owner Address: q2� t, y r 4 h 2 city/state/zip: Blair, NE 68008 Phone # 40 -Z - 5 33 _ ,� 7 0 � 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 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 , Dog ❑ Cat 0 Spayed/Neutered License Fee $ 11 - 0 0— Pet Name Birthdate , 2 ' • Sex F Color wit,1 a�>. Breed** h r, d! Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: 0 Y 14 N MICROCHIP # q8`5 I q / 00 334, R3 iZ (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: c/ 0, 7-x (3 yr) �K (1 yr) City Tag # PET #2 ' a Dog ❑ Cat 0 Spayed/Neutered License Fee $ Vd Pet Name L6 c t Birthdate 2. Sex Color rn) h i //I rL Breed** l Replacement $ ** Declared Dangerous or Potentially Dangero s Do ❑ Y N MICROCHIP # 154 fI DG 01 S / 5 � & 6 3 (If applicable) S BTOTAL: $ RABIES VACCINATION DATE: II - 5 22. (3 yr) (1 yr) City Tag # 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) 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 $2) __. If you have questions, please contact Blair Police Department 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 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 Page 1 /2 David E. Johnson DVM 1734 Front Street Blair, Nebraska, 68008 (402) 633-2722 Client ID: 786 Janet & Jerry Beasley Invoice #: 171389 926 N. 27th Street Date: 1/3/2023 Blair, NE 68008 (402) 278-0467 Patient ID: 13983 Patient Name: Lucy Species: Canine Breed: Springer Spaniel Weight: Birthday: Sex: 32.30 pounds 07/03/2022 Spayed Female Description Staff Name guantily LOW 1/3/2023 Blood - Pre Chem 10 Young/Adult David E. Johnson DVM 1.00 $115.00 Ovariohysterectomy/Spay <40# Laser 1.00 $0.00 Gas Anesthesia-Sevoflurane <40# 1.00 $65.00 Ovariohysterectomy/Spay Canine <40# 1.00 $135.00 Hospitalized - For Surgery 1.00 $0.00 Pre -Anesthetic Injection 1.00 $0.00 Monitoring During Surgery 1.00 $0.00 Post -Op Antibiotic Injection 1.00 $0.00 Post -Op Observation 1.00 $0.00 Post -Op Follow Up Instructions 1.00 $0.00 Laser Option 2 1.00 $85.00 ECG, BPM, Pulse & Respiration 1.00 $19.50 Entroplon - Surgery 1.00 $55.00 NeoPolyDex Opthalmic Ointment 1.00 $18.70 T Douxo S3 Pyo leave on mousse (orange) 1.00 $23.80 T Ace/Atropine x cc 1.95 $2.44 Propofol x cc 5.85 $0.00 Procaine Penicillin X cc 3.90 $6.86 Patient Subtotal: $526.30 Instructions Your pet has just been surgically altered. Restrict her activity for the next two days. Keep the incision area clean and dry. If any redness appears, please call our office. ECG Monitor measures ECG, arrhythrnia, heart rate, blood oxygen saturation, respiration, body temperature and blood pressure. This valuable information was used to help monitor your pet during this surgery or emergency situation. We are proud to be able to provide you with the latest in technology to ensure your pet's health and safety. BECAUSE YOU CARE .... WE CARE. Reminder J_ . S IV�ti12/05/2023 Distemper/Parvo DAPP-Annual y X 14",' Oral Bordetella/Parainfluenza -7/1 V Rabies Vaccination - Canine Syr Leptosporosis Vaccination annual Order your pets supplies online now through our website www.blairsmallanimalelinic.vetsfirstchoice.com For questions contact us at 402-533-2722. Blair Small Animal Clinic PC David E. Johnson DVM 1734 Front Street Blair, Nebraska, 68008 (402) 633-2722 Janet & Jerry Beasley 926 N. 27th Street Blair, NE 68008 Page 1 / 1 Client ID: 786 Invoice M 169876 Date: 9/8/2022 (402) 278-0467 Patient ID: 12957 Weight: 34.10 pounds Patient Name: Bella Birthday: 06/28/2021 Species: Canine Sex: Spayed Female Breed: Brittany Spaniel Description 9/8/2022 Heartworm Test - Snap RT Examination General Distemper Hep Lep Parvo-Annual Rabies Vaccination - Canine 3yr Intranasal Bordetella/Parainfluenza Apoquel Tabs 16mg x tablet Reminder 09/08/2023 Heartworm Test - Snap RT Distemper Hep Lep Parvo-Annual Intranasal Bordetella/Pa rainfluenza 05,08/2025 Rabies Vaccination - Canine 3yr Staff Name guantity 'Total David E. Johnson DVM 1.00 $38.00 1.00 $30.00 1.00 $40.00 1.00 $30.00 1.00 $35.00 21.00 $47.04 T Patient Subtotal: $220.04 Invoice Total: $220.04 default Tax Rate: $3.29 Total: $223.33 Balance Due: $223.33 Previous Balance: $0.00 Balance Due: $223.33 VISA Card Number: ... XXXX4369: (,2203.33) Less Payment: ((!,,223.33) Balance Due: $0.00 Order your pets supplies online now through our website www.blairsmallanimalclinle.votsfirstchoice.com For questions contact us at 402-533-2722. Blair Small Animal Clinic PC David E. Johnson DVM 1734 Front Street Blair, Nebraska, 68008 (402) 533-2722 Janet & Jerry Beasley 926 N. 27th Street Blair, NE 68008 Client ID: 786 Invoice #: 171060 Date: 12/5/2022 (402) 278-0467 Patient ID: 13983 Species: Canine Weight: 32.30 pounds Patient Name: Lucy Breed: Springer Spaniel Birthday: 07/03/2022 Sex; Female Description 12/5/2022 Examination -Wellness Distemper/ Parvo DAPP (3rd) Leptosporosis Vaccination annual Rabies Vaccination -Canine lyr Oral Bordetella/Parainfluenza Staff Name QuantU Total David E. Johnson DVM 1.00 $30.00 1.00 $35.00 1,00 $30.00 1.00 $30.00 1.00 $35.00 Patient Subtotal: $160.00 Instructions Your puppy has received the last in the series of vaccinations for Distemper, Parvo, Hepatitis, Leptospirosis, and Flu and is now fully protected. Annual boosters are required to maintain this protection. Some pain at the injection site, lethargy, and loss of appetite for 24-36 hours is normal. Call this office if reactions becorne severe. Reminder 5/2023 Distemper/Parvo DAPP-Annual Oral Bordetella/Parainfluenza Rabies Vaccination - Canine Syr Leptosporosis Vaccination annual Invoice Total: $160.00 Total: $160.00 Balance Due: $160.00 Previous Balance: $0.00 Balance Due: $160.00 VISA Card Number: ... XXXX1362: �; I c' 0. 0 0) Less Payment: ('IC)0.00) Talance Due: $0.01 Order your pets supplies online now through our website www.blairsmallanimalclinic.votsfirstchoice.com For questions contact us at 402-633-2722. 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, 2023 Owner Name: Cat C-- �;6-A Owner Address: lib � L 1 roq Cw i2 le. city/state/zip: Blair, NE 68008 Phone # q6z- Z %- 9 s0 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 reuuires proof of rabies vaccination to be submitted with your license application. Replacement Fee for Lost i ag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET #1 ,6 Dog ❑ Cat A Spayed/Neutered License Fee $ a Pet Name to gK r A Birthdate '7hiq iz Sex Color SpAcK H f -rAtj Breed** u5ky ry ix Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: 4 Y ❑ N MICROCHIP # (If applicable) P SUBTOTAL: $ RABIES VACCINATION DATE: t 1 Z. 1 � (3 yr) X (1 yr) City Tag # 3a 3 i 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 M (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.) Do Not Send Cash by Mail TOTAL ENCLOSE® $ 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/newres/dents) 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/Idtben residency. 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 Owner Name: �PV_ v k Owner Address: city/state/zip: Blair, NE 68008 Phone# 1102-low-M1F) 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 PET #1 2( Dog ❑ Cat W Spa ed/Neutered License Fee $ I " Pet Nam 1 X) Bidate Sex Color Breed** , Replacement $* Declared D ngerous or Potentially Dangerous Dog: ❑ Y '5d N MICROCHIP # 04 7 (If applicable) SUBTOTAL: $ torso-- RABIES VACCINATION DATE. I -� - (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 ❑ N 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) _ 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.) Do Not Send Cash by Mail TOTAL ENCLOSED $ Q9, C0 If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date notapp/icab/e fornewpets/newresidenis) 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/kdtben residency. CITY OF BLAIR 2023 PET LICENSE APPLICATION ® I fO , 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' City of Blair e 218 S 16th St 9 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: Nftwldum ky&m k Owner Address: A City/State/Zip: BlaINE 68008 Phone # _ ��'-7-- LICENSE FEES: Dog or Cat: $16.00 Alt red 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. e g . Replacement wee for Lust Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET # YPA Cat SpayedM tered License Fee $ , �Pet Na i60 B' hdate Sex 0Ate Color Breed** Do Replacement $ ** Declared Dan Brous or Potentially Dangerous Dog: ❑ Y 4 N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: a (3 yr) (1 yr) City Tag # `b 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) _ ME (1 yr) License Fee $ Replacement $ SUBTOTAL: $ City Tag # ET #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.) .p. Do Not send Cash by Mail TOTAL ENCLOSE® $ If you have questions, please contact Blair Police Lepartment at (402) 426-4747 ++++++++++++++++++++++++.....r++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date notapplicable for newpets/newresldents) 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. Feb 172309;14a p,1 CITY OF SLAIR - 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 Owner Name: Owner Address: \ it9 - City/State/Zip: Blair, NE 68008 Phone # �L�- 0 &aD LICENSE FEES: Dog or Cat: $16.00 Alt ed Mn or Cat: tl:L 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 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 identifleation other than that Issued by the City of Blair for such dog or cat. The otv of Blair requires proof of rabies vaccination ibu be submitted with your license application. er 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 A Spayed/Neutered License Fee $ ti! Pet Name Birthdate 0"-I 5 0 Sex T)** Color � ac.2 K. _ _ Breed** �Mti� ,w i ' �� Rep/acement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y 8 N06 MICROCHIP #(If applicable) SUBTOTAL; $t RABIES VACCINATION DATE:AI-'�- (3 yr) ,_,,.1Y_ (1 yr) City Tag # 3190 PET #2 ❑ Dog CI 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 D 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 # *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.) DoNot Send Cash by Mail TOTAL ENCLOSED $ If you have questions, please contact Blair Police Department at (402) 426-4747 ............. +................................................................ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Mardi 151alefee (4afenatapp/rcablef01'neWPFW'newresidenls) N,ewlyAcouired pets. New Residents to Blair: ■ Must be llowsed wbin 10 days of w re ship ■ Must register pets within 10 .days of ■ <OR> at 6 months of age if puppy/Wen residency. 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 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. LICENSE RENEWALS ARE Dr:March 15, 2023 Owner Name: _CS��.; _., ..., Owner Address: 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 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 ET #1 Dog ❑ Cat Spayed/Neutered License Fee $ I Pet Name Birth ate Sex Color. Breed** Ln k Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y 0 N MICROCHIP # /000,-Tt�6,33(If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: .3 7 01 (3 yr) 2L (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: Ll Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ m ■® (1 yr) License Fee $ Replacement $ SUBTOTAL: $ City Tag # * License Fee $ Replacement $ SUBTOTAL: $ (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSE $ If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date notapplIcab/e fornewpets/new residents) Newly AMuired 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/khen residency. 02/23/2023 09:01 4024260101 HOLSTEIN VET CLINIC PAGE 01/01 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO; CITY OF BLAIR -- 218 S. 16TH ST - BLAIR, NE 68005 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOC3$ OR THREE (2) ADULT CATS PER RESDENTiAL OR DWELLING UNIT. ***PLEASE At RAV CAREFULLY"* YOU VACC�T10N. 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 N5E RENEWALS QRE dUE BY 3115/2423. The city shall recognize a microchip ID number as the license number. it .shall be unlawful for any dog or Gat to wear any license or other city ID other than that issued by the City of Blair for such clog or cat. NEW t'ET LICENZING 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 dame Barb Billeter Spouse Owner Address 1255 N. 10TH APT # 201 city/State/Zip Blair, NE 68008 Phone # 402-253-5193 Pet Name: Dif,6y Tad #3453 Age: 7Y DOB: 0347-15 Sex: Spayed Female Color: Black and Tan Breed: Terrier X � Microchip # 981020041837981 Rabies Tag # 20123 " 'AVAILAILA)M-E); # PLEASE INCLUDE CITY TAG NUMREIi IF THIS IS A RENEWAL (IF RABIES VACCINATION DONE ON 02-22-22 Rabies Description; 1 YEAR C YEAR Holstein Veterinary Clinic Dr. Lisa Sahvurtr DVM Dr, lXrista Holstein DVM 718 South 1911 Street Blair, W 68008 402-426-7387 402-426-0101 Fax hoisteinclinic@grnail.com LICENSE F Intact Dog or Cat; $16.00 A11tered — og or11.00 flep.p aGemerrt Tags $16.00 Total PETS TNATARE ON )-HE ACTIVE PDTENTlAL{y�J4N�iER4US Oft DANGER&JS DQG LIST NEED TO REGISTER 1]1fiRCTLYAT CITY NJ�LL. FAXED 02-23-23 BY 02/09/2023 17:27 4024260101 HOLSTEIN VET CLINIC PAGE 02/04 2023 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 & 16TH ST -- BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS. BUT NO MORE THAN THREE (3) ,ADULT DOGS ON THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT. '"**PLEASE READ CAREFULLY"* —QU ARE REQUIR p BYLAW TO LICFUSE YOUR PETS.,THE CITY OF BLAIR 19 IRES PRQ(�F OF RABIES VACCINATION.. Failure to do so is a violation of City Ordinances 6.103 and rgrries a penalty Qf a fine up to $150.00 per pet. PET LICENS> RENEWALS A t) E BY 3/15/ The city shall recognize a microchip ID numlaer as the license number. It shall be unlawful for any dog or cat t4 wear any Iloense or other city Ile other than that issued by the City of Blair for Such dog or cat. N# W PET LIGEN! I Must he licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten NEW RESIDENTS T QjajAl-fi Must register pets within 10 days of residency Owner Name Spouse Owner Address City/State/Zip Phone # Pet Name: Chip Age: 2Y DOB: -09-01-20 Breed: Mix Microchip # Jim Birrell 2449 Clark Street Blair, NE 68008 402-426-8930 Tag #3796 Sex: Neutered Male Color: Black and Tan Rabies Tag # PLEASE INCLUDE CITY TAU NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): #i RABIES VACCINATION DONE ON 07-05-22 Rabies Description: 1 YEAR 3 YEAR Holstein Veterinary Clinic Dr. Lisa Schrum DVM Dr. ICrista Holstein DVM 718 South 191h Street Blair, NE 68008, 402-426-7387, 402-426-0101 Fax holsteinclinic@gmail,com LICENSE FEES Intact Dog or Cat: $16-00 Dog cat: $11-69 Reply ap $b,QO Total $., PETSTNATARI= THEACTlVEPOTENT! LLVDANGEROUS R DANGEROUS DOG 11ST NEED TO REGI$T! k DlRECTLYAT C1TY HALL. FAXED 02-09-23 BY 02/09/2023 17:27 4024260101 HOLSTEIN VET CLINIC PAGE 04/04 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A 000(S) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO; CITY OF BLAIR - 218 S. 16TH ST - BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT, "O*P'LEASE READ CAREFULLY*** YdU ARE REQUIRED BY LAW TO LICENSE;.Y�1tlI� LETS THE CITY OF BLAIR REQUJI tES PI1CfdF OF RABIES VA��I�IAIL�� Failure to do so is a violation of City (Ordinances 6,103 and carries a penalty of a find up to $150.00 per pet, PET LICENSE RENEWALS ARE DUE E1Y 3115/2023. The city shall recognize a microchip ID number as the license number. It shall be unlawful for any clog or cat to wear any Iiconse 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 aye if puppy or kitten NEW RESIDENTS TO BLAIR Must register pets within 10 days of residency Owner Name I Jir>t^I Birrell Spouse Owner Address 1 2449 Clark Street City/Statelzip I Blair, NE 68008 Phone # I ' 402-426-8930 Pet Name: Levey Dovey Tag#3798 w Age: 15M Sax.: Spayed Female Color: Black 008: �10-22-21 Breed: DSH Microchip # 985141004487202 Rabies Tag # PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE). # RABIES VACCINATION DONE ON 06-20-22 Rabies Description: 1 YEAR 3 YEAR Holstein Veterinary Clinic Dr. Lisa Schrunn DVM : or. Krista Holstein DVM 718 South 19th Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteinclirlic@cgmail.com LICENSE FEES Intact Dog or Cat: $16.00 AADKwd Do or cat: $11. 0 1i'cp eiit Tfir $5.00 Total $-r PETS THAT ARE ON THEAMVE P TE TIALLY DANGEROUS lift DANGEROUS DOG LIST NEED TOR STER DIRECTLY AT CITY HALL, FAM 02-09-23 BY 02/09/2023 17:27 4024260101 HOLSTEIN VET CLINIC PAGE 03/04 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG($) AND MR CAT(S), COMPLETE, THIS FORM AND RETURN WITH A CHECK PAYABLE TO; CITY OF BLAIR — 218 S. 16T" ST — BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT QQQ$ OR THREE (2) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT_ *"PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW_) LICENE Yt]UI� PETS THE CITY OF BLAIR REQUIRES P�QF QF RABIES VACCINATION. Failure to do so is a violation of City Ordinances 6.103 and carries a penalty of a fine up to $150.00 pQl' pat• PET LICENSE RENEWALS ARE DUE BY 3/15/2Q23- The city shall recognize a microchip ID number as the Ilcenss number. It shall be unlawful for any dog or cat to wear any license or other city ID other than that issued by the City of Blair for such dog or cat. NEW PET LICENSING Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten NEW RESIDENTS TO BLAIR Must register pets within 10 days of residency Owner Name Spouse Owner Address CitylState/Zip Phone # Pet Name, Sweety Age: 1QM DOB: 04-04-22 Breed: Domestic Sex: Spayed Female Microchip # 985141004975332 CITY TAG NUMBER IF THIS IS A Jim Birreil 2448 dark Street Blair, NE 68008 402-426-8930 Tag 797 [Collor; Brn/Blk/'Wt RABIES VACCINATION DONE ON 09-20-22 Rabies Description; 1 YEAR Rabies Tag # 3 YEAR Holstein Veterinary Clinic Dr. Lisa Schrum DVM Dr. Krfsta Holstein DVM 718 South 191h Street Blair, NE 68008. 402-426-7387 402-426-0101 Fax holsteinclinic@0mail.com ;# LICENSE FEES Intact Dog or Gat: $16.00 Alters po r (:,gt: $19. 0 Replacemant rags $5.00 Total $�.L— PETS THAT ARE Qiy KY AKTIVE POTENTIALLY DANGEROUS OR DANGERQL15 Q0G LIST NElr t- TO REGISTER DIREGTLYAT C(TY 1 fA LL, FAXED 02-09-23 BY Leavt 1di 60 CITY OF BLAIR - 2023 PET LICENSE APPLICATIONi -jj2) ) 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 Owner Name: 4 Owner Address: city/state/zip: Blair, NE 68008 Phone # 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 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 requires proof of rabies vaccination to be submitted with your license application. g Raplacerfivant Fee for Lost Tag: $5.U0 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET # 1 ❑Dog ❑ C a t L3--S�6yed/Neutered License Fee $ Pet Name ri Birthdate Sex Color,:. ti Breed** .. ; . y ,.-° Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # s t ' �.°J 4_,�_(If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: ,(3 yr) " (1 yr) City Tag # PET #2 Lill Dog ❑ Cat 21-Sppayed/Neutered License Fee $ Pet NameBirthdate Sex Color Breed**,,-;-,, ,, i i : ? J Replacement $ ** Declared/Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # iJ ; ` (If applicable) r` SUBTOTAL: $ RABIES VACCINATION DATE: " 7" (3 yr) ', (1 yr) City Tag # � 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) _ ❑N (1 yr) License Fee $ Replacement $ SUBTOTAL: $ City Tag # 4 *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED $ If you have questions, please contact Blair Police Department at (402) 426-4747 +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++¢++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March ISlate fee date notapplicable fornewpets/newresidents) Newly Acquired Pets: New Residents to Blair: ■ Must be Iiornsed within 10 days of ownership ■ Must register pets within 10 days of ■ <OR> at 6 months of age if puppy/Idtten residency. Blair Small Animal Clinic PC David EJohnson DVM 1734 Front Street Blair, Nebraska, 68008 Client ID: 2887 Patient ID: Client Name: RamdvBjmrk Patient Name Address: ' 1O8Riverview Drive Species: Broad: Blair, NE88OOB Sex: Phone: i217>521-0009 Markings: Microchip ID: Tag Number: OOOOO Vaccination Date: Vaccine: |nnnob Rabies Vaccine Expiration Date: Producer: K8ehg| Lot Number: Brand: |nlnsb3TF Drug Expiration Date: Type: Killed Virus innarof Subcutaneously Staff Name: David E.Johnson DVM License Number: 1883 Doctor Signature: 10709 Waffles Feline Oomestio8horthair Neutered Male 8ianu|t80hiba O1/18/2U18 12.62 pounds on 10/25/2022 1/18/2O28 1/18/2026 18535 11/17/2U23 CITY OF BLAIR ® 2023 PET LICENSE APPLICATION r CJ 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. LICENSE RENEWALS ARE DUE: March 15, 2023 Owner Name: t `'i 1 `i lz� , Owner Address: i a i ti city/state/zip: Blair, NE 68008 Phone #J 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 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 Citv of Blair requires Droof 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 Dog ❑ Cat ❑ Spayed/Neutered License Fee $ l -� Pet Name f J' c'" Birthdate `- ' ,2_ Sex F Color `4..)�-N c Breed** Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ 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 # 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) _ W License Fee $ Replacement $ SUBTOTAL:$ . (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSE® $ ** * If you have questions, please contact Blair Police Department at (402) 426-4747 +++++++++++++.++++++++++++++++++++++++++++++++++++++++++¢+++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15late fee date not applicable fornewpets/new residents) Newly Acquired Pets: New Residents to Blair: • Must be licensed within 10 days of ownership 0 Must register pets within 10 days of • <OR> at 6 months of age if puppy/kitten residency. Blair Small Animal Clinic PC David E. Johnson DVM 1734 Front Street Blair, Nebraska, 68008 (402) 533-2722 Client ID: 9248 Patient ID: Client Name: Donna Bjork Patient Name: Address: 106 Riverview Drive Species: Breed: Blair, NE 68008 Sex: Color: Phone: (402)490-1460 Markings: Birthday: Weight: Microchip ID: Tag Number: 7310 Vaccination Date: Vaccine: Imrab Rabies Vaccine Expiration Date: Producer: Merial Lot Number: Brand: Imrab 3 TF Drug Expiration Date Type: Killed Virus inner of Subcutaneously I ,administration: Staff Name: David E. Johnson DVM License Number: 1893 Doctor Signature: 13981 Sadee Canine x Walker Coonhound Brown and White 08/28/2022 29.30 pounds on 12/5/2022 12/5/2022 12/512023 18542 3/10/2024 I - 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 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 15, 2023 Owner Name: Owner Address: I �YY�I'1� S,- city/state/zip: Blair, NE 68008 Phone # 102 2�1 —I l32 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 Droof of rabies vaccination to be submitted with your license aDDlication. 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 $ 1 LD— Pet Name e Birthdate 20 Sex F Color s:\jcr Breed** rek'Aoy Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y A N 2I MICROCHIP # g5U0000l345- '3 3l7 (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: 4 - S- 2 Z (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) _ W ■® License Fee $ Replacement $ SUBTOTAL: $ (1 yr) City Tag # License Fee $ Replacement $ SUBTOTAL: $ (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED $ 20 If you have questions, please contact Blair Police Department 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 ■ Must register pets within 10 days of ■ <OR> at 6 months of age if puppy/kitten residency. pr I I I � Vj-6 CITY F SE 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 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 15, 2023 Owner Name: Owner Address: city/state/zip: Blair, NE 68008 Phone # 40 LICENSE FEES: Dog or Cat: $16.00 Alt red 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 Droof of rabies vaccination to_ be submitted with your license anDlication. e 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 $ C-J Pet Namey\." Birthdate 114 181 I Sex ** Color & Breed** 'u'I L Rep/acement $ Declared Dangerous or Potentially Dangerous Dog: LJ Y N MICROCHIP # (If applicable) . SUBTOTAL: $ RABIES VACCINATION DATE: L.1 _ l i (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) _ 71W (1 yr) License Fee $ Replacement $ SUBTOTAL: $ City Tag # PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Rep/acement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED $ If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/ NEW RESIDENT LICENSING REQUIREMENTS (Marchl5/ate fee date not applicablefornewpets/new residents) Newly Acquired Pets: New Residents to Blair: ■ Must be liaensed within 10 days of ownership ■ Must register pets within 10 days of ■ <OR> at 6 months of age if puppy/kitten residency. v57 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 CJ Owner Name: S ff '" Ah np- #80211L Owner Address: 516 X. 2-3 ra/ A city/state/zip: Blair, NE 68008 Phone# (SI-2)Gg6 3-Y217 - r� LICENSE FEES: Dog or Cat: $16.00 Altered noor 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 ET #1 CiD o g ❑ Cat R'Spayed/Neutered License Fee $ H. 00 Pet Name � cave ici Birthdate ad it Sex Color �l Breed** ,/ikx-le— /!e Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y Cl'N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: ;L0z2 � (3 yr) wL.. (1 yr) City Tag # b6956 B 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) _ License Fee $ Replacement $ ❑N SUBTOTAL: $ (1 yr) City Tag # (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 ENCLOSE® $ //. ov If you have questions, please contact Blair Police Department 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 Iloensed within 10 days of ownership ■ Must register pets within 10 days of ■ <OR> at 6 months of age if puppy/Idtten residency. 03/17/2023 12:42 4024260101 HOLSTEIN VET CLINIC PAGE 03/03 2023 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 I HIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR — 218 S, 16TH ST — BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT. ***PLEASE READ CAREFULLY` EFS PROOF OF RABIES VACWNAT-1-0—N., YOU ARE UIRED LAW T LICENSE YOUR PETS. T"r= Cl UP tQ $150.00 per Pet. Failure to do so is a violation of City Ordinances 6.103 and carries a penalty of a fine PET LICENSE FIIF-NgWAILSARE -�3/95/2d2$, The city shall 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 Issuer] by the City of Blair for suoh dog or cat, NEW FET_UCENSINCj-Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten _ NEW RESID LN!aj —019A.ABI Must register pets within jo doym of residency Owner Name John Borchardt $pouse, Barb 0miner Address 2357 Clark Street citylstate/zip Blair, NE 68008 Phone # 402-426-8279 Pet Name: Max Age: BY DOB: 07-16-14 Breed: Lab Mix Sex: Neutered Male Microchip # 985112005501095 ouiennim, Color-, Brown/Wt Rabies Tag # 20633 PLEASE INCLU DE Cl-ry TAG NUMBER IF T"IS IS A RENEWAL (IF AVAILA LE). # RABIES VACCINATION DONE ON 09r08-22 Rabies Description' 1 YEAR 3 YEAR Holstein Veterinary Clinic Dr. Lisa Schrum D VM , Dt. Kris ta Ho Is te In D VM 718 South 190, Street Blair, Nrz 68008 402-426-7387 402-426-0101 Fax liolstei neli nic @g mail Com LICENSE FEW Intact Dog or Cat: $16-00 A re Dog or 0 Replacement Tag $5.00 Total PETS 7 HAT ARE RN THE A9C-nug ALLY DANGEROUS OR DA NG E R, 0 US -DOG LIST NEED TO R ASTER DIRE 9TL Y A -TO TY HALL. FAXED 03-17-23' I 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, 2023 Owner Name: Owner Address: ***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. city/state/zip: Blair NE 68008 1 Phone # �i ��� 1r��`�, PET LICENSES RENEWALS ARE DUE BY r as the lice 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 LICENSE FEES: Dog or Cat: $16.00 be submitted with your license anPlication. 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 Ca perator I ,on -Program Pet Nam Color Declared Dange Cat S� License Fee Bireed** to Replacement $ ** Qa ji$� ngerous Dog: ❑ Y I�'IV ACCINATION DATE: (3 PET #2 ❑ Dog Cat W-s'payed Neutered License Fee $ Pet Name Birthdate - Sex eke Color Itwr k i AMA— Breed** Y Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y �&N MICROCHIP # (If applicable) SUBTOTAL: $_ RABIES VACCINATION DATE: -lr) (1 yr) City Tag # 3* PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Rep/acement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED $ If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March mate fee date notapplicable 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. Date of Rabies Vaccination: 03-07-23 Next Rabies Vaccination On: 03-06-24 VETERINARY CLINIC Countryside Small Animal 1306 Stevenson Fort Calhoun, NE 68023 402-468-4060 Certificate No: 0 Previous Rabies Vaccination: 21-0664 OWNER OF ANIMAL Sharon Boudreau 758 So. 16th Apt. 282 Blair, NE 68008 County: This is to certify... THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW. Patient information... PATIENT: Butchy SPECIES: Feline SEX: N BREED: Domestic Shorthair Color and markings... Orange and White TAG NO: 23-0146 WEIGHT: 11.28 AGE: 15 years Microchip Number: 496C2D3314 Signed _ C`o1- i Kaycee Points License: 3770 Vaccinations done... 03-07-23 KNP Feline Rabies Vaccn, 1 Yr, #23-0146 03-06-24 Rabies Vaccine Information... MFG BY: ZOETI SER.NO: 569634 LOT EXP: 15AUG23 ADM: Sq 0 -n (D M M n C: n n Q F3' 3 =3 :3 (D _0 _0 (D =3 3 m =5 m m 0- o- (D (D m (D m rD (D U Ln o- Ln (n [A (D m rl) rD (D (D rD > CL (D 3 m z 0 r+ 0 0- CL Ln xv, 1 rD CL rD Ln (D z z 0 =3 0 rl) 3 z r+ cu Ln V) . . w 3 w 11 Z CD (D 1+ 3 3 C: 0 _0 3 3 (D 0- Nr+ a- (D (D 0 (D r+ r) c Ull 0 U.) w w (D 00 r+ (D z NJ 0 "I CL 0) w 00 0 r+ > 0 00 Ln (D ;u (D r) <❑ 0 0 0 n 0 0 0 0 0 0 0 0 0 0 0 0 0 3 — m m = m = m = m m 3 w Et ED 0 Ln 70 > vi- (D 0 (D < < w r) (D = (D (D n n (D 0 x (D nzi Ln r+ w (D n n (D 0 3 w (D CL Z -< _0 w (D (D 0 (D n =3 7Q C: H. o (D (D (D CL CL LU (D El KI r) 00 -n M 3 ri w CD C N > Cc fD C NO > =3 r) r) r) n r) r) r) r) w w w w w w cu w r+ cu r+ -t It L/) Ln Ln 0 Ln (A (n EA (D _0 < < Do r) U) > z =3 n w cu w 0 (D m 3 (D n (D (D (D n r) (D (D O CD 3 r+ m V) rD CL n (D 0 Ln x _0 rt (D (D (D 0 =3 c r+ (D =3 (D LU cup (D (D (D r+ F1 F] -n 0 3 Date of Vaccination: 02-07-23 Next Vaccination on:.'02-06-26 Certificate No. 31896 Previous Vaccination: OWNER OF ANIMAL Pet Vaccination Clinic Ida Bower 2911 S. 120th St. 758 S 16th St #452 Omaha, NE 68144 Blair, NE 68008 402-480-3393 (402) 237-5239 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Kisses TAG NO: 231339 SPECIES: Canine BREED: Chihuahua SEX: Spayed Female AGE: 3 years WEIGHT: 0.00 Ibs COLOR: Tri Color MICROCHIP: MFG BY: ZOETi, SERIAL: 584384, EXPIRES: 09/05/23, ADMIN: SQ Signed: vin Do sh, DVM Other Vaccination ... Vaccinated By 04-04-22 JR Vaccination Next due Canine DA2PP + Lepto Vaccination 1 04-04-23 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: I-4 DNA Owner Address: I � 11 P/ S ,-s--+ �ae city/state/zip: Blair, NE 68008 Phone # -31!S -'7 i('--5 1-I I 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 Repiacement 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 Dog ❑ Cat Spayed Neutered License Fee $ 1 I , 0-0 Pet Name _A_nr4,),, Birthdate z-� Sex fyl Color 7---, Breed** k; - Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y N MICROCHIP # I (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: 1 (3 yr) (1 yr) City Tag # _-----...... PET #2 Dog ❑ Cat 1w' Spayed/Neutered License Fee $ Pet Name CN l o Birthdate -zorq Sex Color ill c k Breed** Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y N MICROCHIP # (If applicable) SUBTOTAL: $ )1, RABIES VACCINATION DATE: 10 .z z-c, (3 yr) (1 yr) City Tag # Z'Z-z6 ET #3 14 Dog ❑ Cat Spayed/Neutered License Fee $ 1 � . Pet Name h - Birth ate 'Lo r5 Sex Color Breed** Replacement $ 00 ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y XIN MICROCHIP # (If applicable) SUBTOTAL: $ 16,0 RABIES VACCINATION DATE: z. (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 39- 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/newresidents) 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. Mar 06 23 04:02p p.1 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 161th 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: city/state zip: Blair, NE 68008 Phone # V\k - WAG LICENSE FEES: Dog or Cat: $16,00 Altered Dog or Cat: $I.1.00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 8.103 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_vroaf of rabies vaccination to be submitted with your license application. Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $L25 being cdlected to fund the Nebraska Dog & Cat Operator Inspection Program PET # 1 ❑. p o g C a t �Spay / + utered License Fee $ 11 Gam` Pet Na e n� \ Birt�ldate r L t._Sex Color'��`�' ,C?,' Breed** Replacement $ ** Declared Dangerous or Piotentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable SUBTOTAL- $ RABIES VACCINATION DATE: '~ (3 yr) _ (1 yr) City Tag #�* PET #2 ❑ Dog `12l Cat I SSpayed/Neutered License Fee $. k\_ ice'0 Pet Na e \;K �_�� Birthd`ate 1 1 i 1 �i Sex � 1�� Color � t^r'? Breed** Replacement$ � ** Declared Danger us or Potentially Dangerous Dog: ❑ Y ❑ N j �i� MICROCHIP # "�"" (If applicable) SUBTOTAL: $ 5 _ RABIES VACCINATION DATE: ") ? (3 yr) (I yr) City Tag # 2358 PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Sirthdate _ 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 # *PLEASE INCLUDE THE CITYTAG 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 $ 1. LM If you have questions, please contact Blair Police Department at (402) 426-4747 t..............+++*+f..........++*.......... .... +++4......................... NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Mani 15147te fee datenotapplirahko for newpet4/newresidents) Newly Acquired Pets,• New Residents to Blair. ■ Mu5t be kaised wthh 10 days of ownership ■ Must register pets within 10 days of ■ [OR> at6 rnno`�Vhss offaI Tl 969W 1l10n residency. Thone (402) 426-3630 902 S NwY 3Q Blair, NE 68008 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 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 15, 2023 Owner Name: e Owner Address: City/state/zip: Blair, NE 68008 Phone # f 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 PET # 1 ► '`Dog ❑ Cat ❑ Spayed/Neutered License Fee $ �I U-1 Pet Name -�� Birthdate 1-10= `i Sex Color E r� K., Breed** Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) , SUBTOTAL-.$ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # 6`'° 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 # 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) _ (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 ENCLOSED If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++++++++++++++++++++++++++++++++.........++++++++++++++++++++++++.....++++ 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 m Must register pets within 10 days of ® <OR> at 6 months of age if puppy/ldlten residency. u1/'2b/2b23 14:13 4024260101 HOLSTEIN VET CLINIC PAGE 01/01 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN SLAM CITY LIMITS AND OWN A DOG(5) AND /08 OAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR -- 218 S. 16T" ST - BLAIR, NE 68005 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (a) ADULT 13DGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLiN(3 UNIT. ***PLEASE READ CAREFULLY"* YOU ARE atJIREi] BY I AW TO r2NSE VQ1 IR PETS THE C1— OF _ LAB IR REQ�11RE8 lP bOF DiP RABIES VACC NI ATIt1N. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150,00 per pet. PET LICENSE RE WALS RF1 E DUB 1#y 3/ i�12y2�. The city shall recognize a ricrochip ID number as the license number. It shall be unlawful for any clog or cat to wear any license or other city ICI other than that issued by the City of Blair for sLICh clog or cat. NEW PST LICEM NG MuSt Ijs licensee) within 10 days of oimership (OR) at 6 months of age. if puppy or kitten NEW RIR<SICtENT� TO BLA),$ Must register pets Within 10 clays cif residency Owner Name Spouse Owner Address City/Sitatelzip Phone # Maureen Brag Seth 1116 N 28th St, Flair, NE 68008 402-650-1662 Pet Name: MOOse Agra: 2Y Sex: Neutered Male DOB: 03-30-20 Tag ,#35 - Color; Yellow k Breed: Schnaodle Microchip # 9851411002127908 Rabies Tag # 19357 QLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): # RABIES VACCINATION DONE ON Q8.06-21 Rabies Description: 1 YEAR YEAR :Holstein Veterinary Clinic ,Dr: Lisa, $DImirn DVM ; Dr. Krista Holstein AVM 718 South 1S11 Street Blair, Nr 68008 402-426-7387 402-426-0101 Fax holsteinelinic @ gmail .com, LICE S_E FEES frttact Dog or Cat: $16.QO Do r cat: $1 .OQ Replacement rag $5.00 Total $ PETS ATARE ON THEACTfVF. POTENTIALLY DANGER4�U5OR DANGEROtA DOG LIST NEED TOR Cal57ER DIRECTLYA7' lTY HALL. FAXED 01-26-23 BY C'IT'Y,4i, .ALL :c : 4 �4426­195� 01/23/2023 16:34 4024260101 HOLSTEIN VET CLINIC PAGE 01/01 2023 PEA' LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR iF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S), COMPLETE THiS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAiR — 218 S. 16TH ST — BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT, ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS THE CiTY OF BLAIR REQUIRES PROOF OF RABIES VACCINATION. 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. PET LICENSE RENEWALS ARE DUE BY 3/15/2023 The city shall recognize a microchip ID number 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 LICENSING Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten NEW ksiown TO BLAIR Must register pets within 10 days of residency Owner Name Kathy Brechbill Spouse Terry Owner Address P 0 Box 604 Clty/State/Zlp Blair, NE +68008 Phone # 402-657-8364 Pet Name: TeddyTag 3 154 Age: 4Y DOB. 08-23-18 Sex: Neutered Male Color: White/Brin Breed. Shih Tzu MicroghiP # Rabies Tag # 23031 PLEASE INCLUDE CITY TAG NUMBER IF THiS IS A RENEWA4 (iF AVAILABLE): # RABIES VACCINAT16N DONE ON 01-23.23 Rabies Description: PEAR 3 YEAR Holstein Veterinary Clinic Dr. t1ss Schrum DVM : Dr, Kr/sts Holsteln DVM 718 South 1911, Street Blair, NE 68008 402-426-7387 402-426-0101 Fax hoistainclinic@gmaii.com LICENSE FEES intact Dog or Cat: $16.00 eyed D or cat: $11.0 Replacement iao $5.00 Total $ PETS THAT ARE ON THEACTIVE POTENTIALLY DANGEROUS OR DANGEROW DOG LIST NEED TO REGISTER DiRECTLYAT CITY HALL FAXED 01-23-23 BY 6fdl' ii t r. i.'� "'4:1y��(J��, .�f� i� /� r•:4. �i i�i.' "IS,. :'„�, �,, i't}!�I�v;�'.rn•'•,ii•�i:��'°itif�,,;,,,;,,,,,, ;',.;•. ;i..ut,•i.':.,,•.:t:..l : �..,•!: 14/y 6 CITY OF BLAIR ® 2023 PET LICENSE APPLICATION- 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 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 15 2023 Owner Name: ,r, - l Owner Address: A— city/state/zip: Blair, NE 68008 �p Phone # a✓6C6- Z H 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 Replacemen! 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 $ r Pet Named��,�(` Bi date Sex N Color tS► e Breed**_Replacement ** Declared Dangerous or Potentially Dangerous Dog. ❑ Y (�Y N MICROCHIP # ` 5 1 O'i.^k'� -- If applicable) SUBTOTAL: $ � RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Rep/acement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate Sex — Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) License Fee $ Replacement $ SUBTOTAL: $ (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED $ 1101 If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March I5/ate fee date notapplicable fornewpets/newres/dents) 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. Blair Small Animal Clinic PC David E. Johnson DVM 1734 Front Street Blair, Nebraska, 68008 (402) 533-2722 Rabies Certificate Client ID: 7818 Patient ID: Client Name: Aaron Brensel Patient Name: Address: 1313 Maple Dr. Species: Breed: Blair, NE 68008 Sex: Color: Phone: (402)595-8784 Markings: Birthday: Weight: Microchip ID: Tag Number: 7581 Vaccine: Imrab Rabies Vaccine Producer: Merial Brand: Imrab 3 TF Type: Killed Virus inner of Subcutaneously administration: Staff Name: David E. Johnson DVM License Number: 1893 Doctor Signature: 10352 Lucy Canine Labrador Mix Spayed Female Black/White 01 /23/2015 38.00 pounds on 3/10/2023 Vaccination Date: 3/10/2023 Expiration Date: 3/10/2026 Lot Number: 18535 Drug Expiration Date: 11/17/2023 02/17/2023 14:45 4024260101 HOLSTEIN VET CLINIC PAGE 01/01 "�i d'# C4{r/ t P1f t,{r Y. �.:r ITT., ,� h Ili 13 i� {'� , er^y� ! f� I�{i' i4 , 1{� , ��if ' >i J ! Date of Rabies Vaccination, 02-17-23 -Certificate No: 0 Next Rabies Vaccination On: 02-16-26 Previous Rabies Vaccination: 16009 VETERINARY CLINIC 1,OWNER OF ANIMAL Holstein Vet Clinic !Al1i Brewer 718 South 19th Street 1:812 S 16th St Blair, NE 68008 :Blair, NE 68008 402-426-7387 :County: I This is to certify:.. THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW. Patient information._ PATIENT: Penny TAG NO: 23097, SPECIES- Canine Tag #3282 :WEIGHT: 64.80 SEX, 8 AGE: 8 years Color and markings... Signed .... ... Krista Holstein, DVM License:, 3612- Rabies Vaccine Information... MFG BY: ZOETI SER.NO, 584:384 LOT EXP: 9/05/23 ADM: SQ o 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 Owner Name: NWV- `1 IN)JU 13k2E-V�)CY' Owner Address: t) l 2 i3 I \D"T-tk City/State/Zip: Phone # Blair, NE 68008 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 Dog ❑ Cat WSpayed/Neutered License Fee $ 1 �O . _� Pet Name tvc Birthdate , 2� 19 Sex IF Color ' Leo ejL..dual,� Breed** o %Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y XN MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: 9 (3 yr) (1 yr) City Tag #-2��-- SEE �c Ei� I tJkl tk 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) _ ■W W License Fee $ Replacement $ SUBTOTAL: $ (1 yr) City Tag # (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.) 00 Do Not Send Cash by Mail TOTAL ENCLOSED $ If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March Mate fee date not applicable fornewpety/newresidents) 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. 1 -��/ I __ '4 - � V 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 15, 2023 Owner Name: s Vl Un S' (Ow tr_' 5(0'tA) (' Owner Address: fl- St' city/state/zip: Blair, NE 68008 Phone# (`10zi g53��0&2- 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 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 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 T # 1 ❑ Dog ] Cat Spaye /Neutered License Fee $ 0 a Pet Name tM-er �_ Birt date Sex Color - Breed** ome L Shor r Replacement $ ** Declared bang rous or Potentially Dangerous Dog: ❑ Y 4 N MICROCHIP # (If applicable) SUBTOTAL: $ '9' RABIES VACCINATION DATE: q /1Y/ zaz( (3 yr) (1 yr) City Tag # 33 7!1 PET #2 �J Dog ❑ Cat CX Spayed/Neutered License Fee $i ao Pet Name Birthdate 2 0-ol S x F_ Color cL + w Breed** AITRep/acement$ ** Declared Dangerous or Potentially Dangerous Dog: Lj Y 4 N MICROCHIP # (If applicable) SUBTOTAL: $ o 0 RABIES VACCINATION DATE: og - 2 ( (3 yr) K J1 yr) City Tag # 13 9-1 PET #3 , � Dog ❑ Cat 0 Spayed/Neutered License Fee $ I w Pet Name CTSG o Birthdate 10 2- Sex 'AA Color J31 Cd c� cyv\ c Breed** r ( M;1' i Replacement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y 0 N MICROCHIP # (If applicable) SUBTOTAL: $ , 00 RABIES VACCINATION DATE: o zz 2 (3 yr) (1 yr) City Tag # 2L(L( *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 $ LN1 c aU If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March Mate fee date notapplicable fornewpets/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/Idtten 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 • 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: ikCy1Yt0/-\ V ST waif '5✓ e(- Owner Address: S S Z /\/161 t L-f' city/state/zip: Blair, NE 68008 Phone # ) s 3 Z -(qQ I LICENSE FEES: Dog or Cat: $16.00 Altered Do or Cat• 4M 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. 9 - 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 0 Cat $d Spayed/Neutered License Fee $ 0 D Pet Name Li lvefRr Birthdate 3Z 2013 Sex Color C Breed** � S Replacement $ ** Declared Dang rous or Potentially Dangerous Dog: ❑ Y Cd N MICROCHIP # (If applicable) SUBTOTAL: $ 1 ob RABIES VACCINATION DATE: 2dY (3 yr) 7� (1 yr) City Tag # 217 q—* 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) _ License Fee $ Replacement $ SUBTOTAL: $ (1 yr) City Tag # ** PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Rep/acement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED $ If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++++++++++++++++++++++++++++++++..........+++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date not applkable I&newpels/newresidenLs) Newly Apguired Pets: New Residents to Blair: m Must be licensed within 10 days of ownership ■ Must register pets within 10 days of 0 <OR> at 6 months of age if puppy/Men residency. Client ID: 4069 Client Name: Shannon & Stewert Brewer Address: 552 North 19th Street Blair, NE 68008 Phone: (402)953-6082 Tag Number: 0000 Lot Number: 18508 Imrab Rabies Vaccine Producer: Merial K / MLV / R: Killed Virus Blair Small Animal Clinic PC David E. Johnson DVM 1734 Front Street Blair, Nebraska, 68008 (402) 533-2722 Rabies Certificate Patient ID: Patient Name Species: Breed: Sex: Color: Markings: Birthday: Weight: Microchip ID: Vaccination Date: Expiration Date: Staff Name: David E. Johnson DVM License Number: 1893 11054 Merlin Feline Domestic Shorthair Neutered Male Gray/White 07/02/2018 15.62 pounds on 9/14/2021 9/14/2021 9/14/2023 CERTIFICATE OF VACCINATION Date of Vaccination: 06-09-21 Next Vaccination on: 06-08-24 VETERINARY CLINIC Pet Vaccination Clinic 2911 S. 120th St. Omaha, NE 68144 402-480-3393 Certificate No. 21242 Previous Vaccination: OWNER OF ANIMAL Stewart Brewer 552 N 19th St Blair, NE 68008 (402) 800-7245 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Miley TAG NO: 215183 SPECIES: Canine BREED: Terrier, Yorkshire Mix SEX: Spayed Female AGE: 7 years WEIGHT: 0.00 Ibs COLOR: Black and White MICROCHIP: MFG BY: ZOETI,,, SERIAL: 419390, EXPIRES: 09/14/21, ADMIN: SQ Signed ule Roraback, DVM License: 3094 Other; Vaccinations... Vaccinated By Vaccination Next due 06-09-21 JR Canine DA2PP + Lepto Vaccination 1 06-09-22 06-09-21 JR Canine Lyme Disease Vaccination, 1Y06-09-22 06-09-21 JR Canine Bordetella Vaccination, 1Y 06-09-22 Blair Small Animal Clinic PC David E. Johnson DVM 1734 Front Street Blair, Nebraska, 68008 (402) 533-2722 Rabies Certificate Client ID: 4069 Client Name: Shannon & Stewert Brewer Address: 552 North 19th Street Blair, NE 68008 Phone: (402)953-6082 Patient ID: 10395 Patient Name: Cisco Species: Canine Breed: Labrador Mix Sex: Neutered Male Color: Black Markings: Birthday: 10/03/2014 Weight: 36.10 pounds on 10/22/2021 Microchip ID: Tag Number: 6782 Vaccination Date: 10/22/2021 Lot Number: 18513 Expiration Date: 10/22/2024 Imrab Rabies Vaccine Producer: Merial K ! MLV / R: Killed Virus Staff Name: David E. Johnson DVM License Number: 1893 Blair Small -Animal Clinic PC David E. Johnson DVM 1734 Front Street Blair, Nebraska, 68008 (402) 533-2722 Rabies Certificate Client ID: 4069 Patient ID: 7842 Client Name: Shannon & Stewert Brewer Patient Name: Sylvester Address: 552 North 19th Street Species: Feline Breed: Domestic Shorthair Blair, NE 68008 Sex: Neutered Male Color: Gray Phone: (402)953-6082 Markings: Birthday: 03/21/2013 Weight: 15.00 pounds on 8/5/2021 Microchip ID: Tag Number: 0000 Vaccination Date: 8/5/2021 Vaccine: Imrab Rabies Vaccine Expiration Date: 8/5/2023 Producer: Meriai Lot Number: 18507 Brand: Imrab 3 TF Drug Expiration Date: 1/20/2023 T"ne: Killed Virus . iner of Subcutaneously Administration: Staff Name: David E. Johnson DVM License Number: 1893 Doctor Signature: 12/01/2022 17:49 4024260101 HOLSTEIN VET CLINIC PAGE 03/04 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN GLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CKNS), COMPLETE THIS FORM AND RETURN WITH n 0KCK 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 PR RESIDENTIAL OR DWELLING UNIT, ***PLEASE REAM CAREFULLY*** YOU ARE. REQUIRED BY LAW TO LICkNSE YOUR PETS. THE C-TY OF BLAIR REQUIRE$. P900F CF RABIES VACCINATION. Failure to do so is a violation of City Ordinances 6.103 and carries a penalty of a title tali to $150.00 per pet. • PET I E RENEWALS AR B 3/�5/�02�. The city shall recognize a microchip ID number as the license number. It shall be unlawful for any dog or cat to wear any license or other city ID other than that issued by the City of Blair for such dog or cat, NEW PET LICENSING Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten Ng)A RESIL?ENTS TO BLAIR Must register pets within 10 days of residency Owner Name Spouse Owner Address City/State/zip Phone # Elizabeth Brice 1457 Butler Blair, NE 68008 402-533-2351 Pet Name: Tiny " U" Age; '15Y Sex: Neutered Male Color: Apricot � DOB: 10-07-07 Breed: Poodlejoy Microchip # Rabies lag # IB058 PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): # RABIES VACCINATION DONE ON 04.08.21 Babies description: 1 YEAR 3 YEAR Holstein Veterinary Clinic Dr Lisa Schrum VVM : Di-. Krista Holstein DVM 718 South 1901 Street glair, NE 68008 402-425-7387 402-426-0101 Fax hQlstoincl1nic mail -corn ' LICEN5KJ-EE- Intact Dog or Gat: $16,00 =ro 0 g10 Replacement Tag $6.00 Total PETS THAT ARE ON THE ACTIVE POTENTIALLY DAN�aE OR tJS OR DANCJ RODS DOG LIST NECU i �] REGISTER DIREGTLYAT CITY HALL. FAXED 12-01-22 • BY r 12/01/2022 17:49 4024260101 HOLSTEIN VET CLINIC PAGE 02/04 2023 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 -J 218 S. 16 TH 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 t3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT. .***PI -EASE READ CAREFULLY9'0* CLUIRE, ARE 8 5 or OF ARIES VACCINATION YOU Y.I-AW 0 LICIENSE--Y-O—UKEE!a,—Ir—H—E-Cyy--OF—B—L—AfLf�-Ea Failure to do go is a violation of City Ordinances 6.103 and carries a Penalty of a fine up to $160- 00 per pet. PET N_SE RENEWALS ARE q - �EIIY Ma 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. WV PET LICENSING Must be licensed within 10 days of ownership (051) at 6 months of age if puppy or kitten NEW I ENTS T 13LAIR Must register pets within 10 days of residency Owner Name Spouse Owner Address City/State/Zip Phone # Elizabeth Brice 1457 Butler Flair, NE 68008 402-523-2351 Pet Name: Sweetheart it Age: 8y Sex: Spayed Female Color: Black and Tan DOB: -,;10-05-14 Breed; dachshund lli/licro6hip # Rabies Tag# PLEASE INCLUDE CITY TAG NUMBER IF -tHIS IAFEWAL (IF AVAILABLE): # RABIES VACCINATION DONE. ON 08-11-22 Rabies Description: 1 AR) 3 YEAR Holstein Veterinary Clinic Dr, Lisa Sc&un) D VM : Dr,'Krlsta Holstell? D VM 718 South 19th Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteindinic@CII-nail.C6M LICENSE U-M Intact Dog or Cat, $16.00 D(g or cat: $11 )0 noplacement rag $5m Total$ —]A----:— PETS THAT A ARE ON THE RANG ROUS DOG L67NEED TO REIilSrER -DIRECTIIA'l CITY HAIL. ,f- FAXED 12-01-22 BY 1777, 7 7 CITY OF BLAIR - 2023 PET LICENSE APPLICATION f 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, 2023 Owner Name: &r�i 4,� f/S5; col rDyvii Owner Address: ��FJ V bScJ �r I IA - 61900 city/state/zip: Blair, NE 68008 Phone # 4D?---17D - '600 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 renuires Proof of rabies vaccination to be submitted with your license application. Replacement Fee or Last Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program P T# 1 Dog Ll Cat ayed/Neutered License Fee Pet Name Birthda a '12s 21 Sex Color Breed** Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # 619 "i'-i L 001+1 ,1 1 l ? (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) _&-_ (1 yr) City Tag # Q3 * 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) _ W M (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.) Do Not Send Cash by Mail TOTAL ENCLOSED $ If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March I5/ate fee date notapplicable fornewpets/newresidenty) 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/Idtten residency. Blair Small Animal Clinic PC David E. Johnson DVM 1734 Front Street Blair, Nebraska, 68008 (402) 533-2722 Rabies Certificate Client ID: 8847 Patient ID: 1298 Client Name: Jessica Brown Patient Name: Dais Address: 1405 Voss Drive Species: Cani a Breed: Gold n Retriever Blair, NE 68008 Sex: Spayed Female Color: Gold Phone: (402)770-3003 Markings: Birthday: 07120 2 Weight: 66.00 ounds on 11/28/2022 p Microchip ID: 1021 9851 004277190 Tag Number: 7300 Vaccination Date: 11/28/I2022 Vaccine: Imrab Rabies Vaccine Expiration Date: 11/2812025 Producer: Merial Lot Number: 1854� Brand: Imrab 3 TF Drug Expiration Date: 3/10/ 024 Type: Killed Virus finer of Subcutaneously __ministration: Staff Name: David E. Johnson DVM License Number: 1893 Doctor Signature: c 10 c m 0 D 3 v Ln S m r+ m m x 'O O 0! I � c 0 A z ' m � {� m m m -n O 3 z O O 0 Q 3 a- m m m ! o �, o c o_ m c 3 c Ln O. c m m n rD O ram+ (WD Q) n O Ul 0- w W W 1p O in (D (D n < n O o v Q m o j c rt c d < � v m n �O CL D r+ n� n 3 m 30 m c rF iv m m rr -n O 3 O O O O 0 r z r r E- (D rn m Q c n Q Q m m m -p _0 m m m m ro (D rn n m Q Q m 3 m w z r�r < Q-Ln—I (D x �O c V) z z ~' cm � -�' o m 3 3 3 c rn p m v �• m co (D ❑ \ \ W OW �LF1 ul O z w O m 7- 7z t� O W N � 7p 4 O m O 0 3 p p p p o°u 0*0 Ooo Ooa V V1_ QL < < m m < n n N n� m n n m c n Q z v m c O r* c m m p Q C N W ❑ © \ N 01 N O v r N pnj p N vi vi v m < < c n w w n) n m '< n n m (D n N m x m \ v 6 L2 Z .O c m O rr (D � � O p C W r+ p m (rtD ❑ ❑ p 0 p 0 0 o o Oo_ Oo Oo '_ cm m L (a_ N Lq vi n L z v� O rD mv x (° m o 3 O_ (D O m rr ((DD x v v v w lu rr rr rt rh rt W N D z O (D Oq v (D m o fD 3 n m 21, T z 0 O O O O O O ® -n x �o r n Z r E; n E; r n N m m = c 3 M ;;a C- 0- m m m m m m m v dl N CT ut ut ut = m � m N n n m m m m m v► o o c A r z 0) ,+ �, -s -I o s —• o o -o rD _ rD m m 3 c� -a r N m � m N f+ a- O h r� rD "0 ram+ v rD O �— rD rn (D' m O m o ❑ W W W :3O a rOy N J O I ~' w to V1 l0 \ 1 Lo (� o o m d N N Ul Cl) rNr 00 {�-� W N O 'O w W p m O e--h � m O OCY CD I n (D p 0 O 0 O 0 O O 0 O 3 _< ° _< ° an Dora con_ coo coo ooa_ con cm crQ O QrQ Q r�r O r�r O Q Q p Ln v v v v vi W v, O vi v, Z rD ram+ m n m n n m — (D x 0� G 'ter n m CL rz 't m '% 3 o m m CL z w m m 0 On O O m Q w r (A o coo ❑ © w N G1 <c Cl) m n� m Lri (D m m NO Z 70 (DD (D N v1 S 'o V) O O O O S (DD 70 m -o m rr ::o a m O O D rD D v v v v v v N r+ r+ rr w rr oni rM rr r+ rr nni rr p�j r+ n Ln vi < vi < vi vi n ul (/) vi D vi z m m v m n o rn 3 O �' O rt m x (D m r* j (D v Z m o' o a I O O �' rr C rr N O r+ 3r+ rD m 0 O rr, O w Ln O w rD O N (D G�1 rD ❑ ❑ r - 0 3 m X ' t rf rD LA L"d Ln Client ID: Client Name: Address: Phone: Tag Number: Vaccine: Producer: Brand: Type: inner of Administration: Staff Name: License Number: Doctor Signature: 7842 Myranda Brown 2347 Washington Street Blair, NE 68008 (402)210-0690 00000 Imrab Rabies Vaccine Merial Imrab 3 TF Killed Virus Subcutaneously Anna M. Camden Blair Small Animal Clinic PC David E. Johnson DVM 1734 Front Street Blair, Nebraska, 68008 (402) 533-2722 Rabies Certificate Patient ID: Patient Name: Species: Breed: Sex: Color: Markings: Birthday: Weight: Microchip ID: Vaccination Date: Expiration Date: Lot Number: Drug Expiration Date: R t 13343 Buttercup Feline Domestic Shorthair Spayed Female white/tabby 06/25/2021 8.93 pounds on 6/17/2022 3/3/2023 3/3/2026 18535 11 /17/2023 Client ID: Client Name Address: Phone: Tag Number: Vaccine: Producer: Brand: Type: inner of Hdministration: Staff Name: License Number: Doctor Signature: 7842 Myranda Brown 2347 Washington Street Blair, NE 68008 (402)210-0690 00000 imrab Rabies Vaccine Merial Imrab 3 TF Killed Virus Subcutaneously Anna M. Camden Blair Small Animal Clinic PC David E. Johnson DVM 1734 Front Street Blair, Nebraska, 68008 (402) 533-2722 Rabies Certificate Patient ID: Patient Name: Species: Breed: Sex: Color: Markings: Birthday: Weight: Microchip ID: Vaccination Date: Expiration Date: Lot Number: Drug Expiration Date 12183 Nala Feline Domestic Longhair Spayed Female Gray 10/23/2018 6.37 pounds on 3/1/2022 3/3/2023 313/2026 18535 11 /17/2023 Client ID: Client Name: Address: Phone Tag Number: Vaccine: Producer: Brand: Type: inner of /Administration: 7842 Myranda Brown 2347 Washington Street Blair, NE 68008 (402)210-0690 00000 Imrab Rabies Vaccine Merial Imrab 3 TF Killed Virus Subcutaneously Staff Name: David E. Johnson DVM License Number: 1893 Doctor Signature: Blair Small Animal Clinic PC David E. Johnson DVM 1734 Front Street Blair, Nebraska, 68008 (402) 533-2722 Rabies Certificate Patient ID: Patient Name Species: Breed: Sex: Color: Markings: Birthday: Weight: Microchip ID: Vaccination Date: Expiration Date: Lot Number: Drug Expiration Date 12182 Lettie Feline Domestic Shorthair Spayed Female Gray/White 10/23/2018 8.75 pounds on 3/1/2022 3/3/2023 3/3/2026 18535 11 /17/2023 ,�/f-71 - 2023 PET LICENSE APPLICATIONj n 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 2023 Owner Name: i dL '0�f bu-j n Owner Address: City/State/zip: Blair, 1NffE 62280108 Phone #)`I ` `� vJ T ® 03 U, 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. Laciplar.e.mar.1 Fee for List Tay': $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program ET # 1 Dog ❑ Cat Spayed/Neutered License Fee $ Ou Pet Na a Birthdate S � " Sex Color Breed** h '. LA Replacement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y �4 N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: 2 -,2l - I (3 yr)_ (1 yr) City Tag # Ail PET #2 �, Dog ❑ Cat ❑ Spayed/Neu ered License Fee $" Pet Name b-1 l� Birthdate t )Sex Color C i''�w, Breed** I r" . Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y N MICROCHIP # f applicable) SUBTOTAL: $ RABIES VACCINATION DATE "' (3 yr) '< (1 yr) City Tag # rrV PET #3 . D o g ❑ Cat ❑ Spayed/Neutered A License Fee $ ' Pet Nam 15 Birthdate 'ex Color Breed** n, L--w w Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ' 4 N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: ^ZQ -14 "-2? ;_ (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.) 00_. Do Not Send Cash by Mail TOTAL ENCLOSED $ If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date notappllcable fornewpets/newresidents) Newly Acquired Pets: New Residents to Blair: ■ Must be Iloansed within 10 days of ownership ■ Must register pets within 10 days of ■ <OR> at 6 months of age if puppy/Idden residency. 03/03/20,23 13:12 4024260101 HOLSTEIN VET CLINIC PAGE 01/01 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOGS) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO; CJTY OF BLAIR - 218 & 16TH ST - BLAIR, NE 138008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (�) ADULT DOGS OR THREE 0 ADULT CATS PER RESIDENTIAL OR DWELLING UNIT, *-**PLEASE READ CAREFULLY**" YOU ARE REQUIRECt 8Y LAW TO LICENSE YOUR �E I-S TWE CITY l7F BLAIR RE�1fIIRES PRC�?F OF Rl3BIES VACCINATION Failure to do so is a violation of City Ordinances 6.103 and carries a oellafty of a fine up to $150,00 per pet, The city shall recognize a microchip IQ number as the license number. It shall be unlawful for any dog or cat to Wear any license or other city IQ Dther than that issued by the City of Blair for such dog or cat. NEW PET -LICgN-$lNG Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten NSW RESIDE►y�5 i0 BLAIR Must register pets w)thln 10 days of residency Owner Name Shelley Brown Spouse John Owner Address 109 E Riverview Dr City/State/Zip Blair, NE 68008 Phone# 402-533-3411 I P . et Name: 1%fY Tag #3082 Agq: 3Y DOB: -10-26-19 Sex: Spayed Female Color: TO Color Breed. Corgi Microchip # 985112011537424 Rabies Tag # 18923 PI-rzASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE); A RABIES VACCINATION DONE ON 0-2.-24-21 Rabies Description: I YEAR 3 YEAR Holstein Veterinary Clinic Dr Lisa Schrutn DVM : Or. Krista Ho/stein VVIVI 718 South 1911 Street Blair, NE 68008 402-426-7387 402-426-0101 Fax hoisteinclinic@gmail.com kICENBE FEES Infect Do'g or Cat: $16.00 Altered D4or cat: $11 .00 t- ) Re,placement Tag $5.00 Total $--�A- ETS THA rA C LI ST IST NEED TO REGISTER DIREO'�YAT CITY HALL, L_ FAXED 03-03-23 BY 1 14, T VAAL 01/13/2023 15:42 4024260101 HOLSTEIN VET CLINIC PAGE 01/01 2023 PET LICENSE ' VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /08 CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR - 218 S. 16'T" ST - BLAIR, NE 11338008 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 ASE REQWREQ BY LAW TO L1C�NSE YOUR PETS TFIE CITY (1F BLAIR R>`QUIRE PROOF (P RABIES VACCINATION Failure to do so is a violation of City Ordinances 6,103 and carries a penalty of a fine up to $150.00 per pet. PEA' t ICENSE RENEWALS ARE DUE BY 3IJ5/2023. The city shall recognize a microchip 10 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 CitV,of Blair for such dog or cat, NEW PET LICENSING Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten NEW RESIDENTS TO BLAIR Must register pets within 10 days of residency Owner Name Spouse Owner Address City/State/Zip Phone # Tim Brown Lu 174 Ryan Drive Blair, NE 68 008 - 402-426-2692 LA 07-- (:P,50- ;3ff)(.p(0 Pet Name. Charli 138i Age: GIV Sex: Spayed Female Color: Cream DOB: 02-05.13 Broad: Doodle Microchip # 005633030 Rabies Tag # 18065 PLEASE INOLUDE C-1T--VTAG NUMBED IF THIS IS A RENEWAL (IF AVAILABLE); # RABIES VACCINATION DONE ON 06-27.20 YEAR Rabies Description: I YEAR 3 YEAR Holstein Veterinary. Clinic Dr, Lisa Schrum D V44 : Dr. KrIsts Holsteln D VM 718 South 1911 Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteinclinic@gmail.com I-ICENF&.FF,ES Intact Dog or Cat: $16.00 Dog or cat: $11,00 Replacement rfig $5.00 Total $ PETS rHATARE ON THE ACTIVE POTENTIALLY QANGEROUS QR 6ANaROUS DOG LIST NEED TO REGISTER QIREMY-ATC17-1 HALL FAXED 01-13-23 BY a•,¢ r • :1 t sk .' 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 e 218 S 16th St a Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2023 Owner Name: Owner Address: I l city/state/zip: Blair, NE 68008 ° '/r J, 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 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 requires proof of rabies vaccination to be submitted with your license application. Replacement Fcc for Lost Tag: $S.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat operator Inspection Program T #e ;, Do ❑ Cat Birthdate Spayed/Neutered License Fee $ 9 ' PetName � date 7" l r Sex ��� Replacement $ Color i' t+�" I ;, 1a. _ �- Breed** : � o sr r , Declared Dangerous or Potentially Dangerous Dog: ❑ Y ] N MICROCHIP # (If applicable), SUBTOTAL: $ i RABIES VACCINATION DATE: (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) _ License Fee $ Replacement $ ❑N SUBTOTAL: $ (1 yr) City Tag # m License Fee Replacement $ * * SUBTOTAL: $ (1 yr) City Tag # .,J) � �) *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL �_<�I ** (This fee is due along with License Fee if requesting at the time of license renewal.) ; Do Not Send Cash by Mail TOTAL ENCLOSED $ If you have questions, please contact Blair Police bepartment at (402) 426-4747 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date notappllcable fornewpets1newre51dents) 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. 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 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, 2023 Owner Name: �I.J k Ll f3p IIYVI m -e Owner Address: City/State/Zip: Blair, NE 68008 Phone # * -2 — 1 3 7 I-/ / 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 aroof 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 $ /_% v Pet Name r r I<k V- Birthdate -/ 9 - O'Sex �j! 6�ke r ** Color ,r-o /,p powAj Breed** ed)) a M Replacement $ L— Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # U �M 2�5- /V / / (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: -3 -/ 1 (3 yr) X (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 ❑ N MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) (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.) Do Not Send Cash by Mail TOTAL ENCLOSED $ If you have questions, please contact Blair Police bepartment at (402) 426-4747 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date notappllcab/e fornewpets/newres/dents) Newly Apguired 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 Page 1 / 1 Client ID: 9017 Gary Brummett Invoice #: 167195 1452 Wilbur Date: 3/12/2022 Blair, NE 68008 (402) 2374437 Patient ID: 13388 Weight: 30.50 pounds Patient Name: Barklee Birthday: 03/08/2016 Species: Canine Sex: Neutered Male Breed: Cavalier Mix Description 3/12/2022 Examination General Rabies Vaccination - Canine Syr Reminder 03/12/2025 Rabies Vaccination - Canine Syr Staff Name Quantity Total David E. Johnson DVM 1.00 $30.00 1.00 $30.00 Patient Subtotal: $60.00 Invoice Total: $60.00 Total: $60.00 Balance Due: $60.00 Previous Balance: $0.00 Balance Due: $60.00 Cash : ($100.00) Less Payment: ($100.00) Change Given: $40.00 Balance Due: $0.00 Order your pets supplies online now through our website www.blairsmallanimalclinic.vetsfirstchoice.com For questions contact us at 402-533-2722. 03/17/2023 16:46 4024260101 HOLSTEIN VET CLINIC PAGE 01/01 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S), COMPI-FTE THIS FORM AND RETURN WITH A CHECK PAYABLE TO; CITY OF BLAIR - 218 $. 1 6TH ST - BLAIR, N F 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DQQ$ OR THREE (3) ADULT CATS PkR RESIDENTIAL OR DWELLING UNIT. ***PLEASE READ CAREFULLY*** YOU ARE REG IREL) BY LAW TO LICENSE YOU 8TS, THE CITY OF ' BLAIR REC2 P Failure to do so is a violation of City Ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet, PET LICENSE RENEWALS ARE I)LIE BY 3/15/2023- The city shall recognize a microchip ID nurni or as the license number. It shall be unlawful for any dog or cat to wear any license or other city 10 other than that issued by the City of Blair for such dog or C-pt- W P�T LICENSING Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten NEW R5SIDENTS TO BLAIR Must register pets within 10 days of residency Ow"er Name Spouse Owner Address City/State/Zip Phone # Pot Name, Are Age: 10Y Sax: Neutered Male DOE: 07-12-12 1 Breed:. Aussie X Microchip # PLFASEINCL Paul Buckingham Chris 1217 Fairview Dr Blair, NE 68008 402-533-2234 Rabies Tag # 18168 DE CITY TAG NUMBER IF THIS I$ A RENEWAL (IF AVAILABLE)* # RABIES VACCINATION DOME ON Rabies Description; 1 YEAR 1j 3 YEAR Holy t ' ein Veterinary Clinic A9/', LisaS017rU177 DVM : Dr. Krista Holstein DVM 718 South 1 91h Street B I a i r, NE 68008 '402-426-7387 402-426-0101 Fax holsteinolil 1111 C @ 9 Mail -COM LICENSE FEE Intact Dog or Cat: $1B-00 -ef r��-- 'roa ' D 9 �zftteidy r cat. $11,00 Replacement 7,89 $5.QQ Total PET5 THAT ARE Q.LJ,,T QANGERQQSt5QLtjSTNEED TO REGISTER DIRECTLY AT CITY —HALO. FAXF-D 03-17-23 BY , CITY F BLAI - 2023 PET LICENSE APPLIATIO / 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 Owner Name: Owner Address: V"', �_- city/state/zip: Blair, NE 68008 Phone # > 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 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 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 g p y d/ utered License Fee $ I i PET #1 ❑ Do ❑Cat ❑.S a ed Ne Pet Named ,E .'.,E , Birthdate I } rt Sex Color Breed** I70,, —Replacement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y O'N MICROCHIP # (If applicable) SUBTOTAL: $ �=�a RABIES VACCINATION DATE: (3 yr) % (1 yr) City Tag # PET #2 tZl Dog ❑ Cat ❑ Spayed/Neutered; License Fee $ Pet Name Birthdate > _, tv,< '3 Sex Color 6,t Breed** Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable SUBTOTAL: $ RABIES VACCINATION DATE: 1 - - a(3 yr) (1 yr) City Tag # -11 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) 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 $ If you have questions, please contact Blair Police bepartment at (402) 426-4747 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March IS/ate fee date notapplicable fornewpets/new resident;) 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/khen residency. 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 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 RENEWALS AREI DUE: March 15, 2023 Owner Name: tt F 4'� I "�iII .� ,( C� � Owner Address: city/state/zip: Blair, NE 68008 Phone # LA 04 _ S U 0 '. 0307 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 PET #1 Dog ❑ Cat Spayed/Neutered License Fee $ Pet Name Ll ' C'l�4 Birthdate FIA019 Sex 1- -emote-Color l3l C,C,K Breed" @,3idyndU0dd.y- Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y t:I�N MICROCHIP # (If applicable), . SUBTOTAL: $ RABIES VACCINATION DATE: QTj)'7030 (3 yr) (1 yr) City Tag # PET #2 Dog ❑ Cat Spayed/Neutered License Fee $ Pet Name R 'Y1 Birt date I I-&,� )l> '� Sex 1572m c�L Color (�,, G i.rA Breed** (Ao 0 ndoorllz., Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y 4 N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag #' `> PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate Sex _ Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) (1 yr) License Fee $ Replacement $ SUBTOTAL: $ City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++++++++++++++++++++++++++++++++......++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date notapplicable for newpets/newresldenly) 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 W puppy/kitten residency. ol (D -0 O 0 o (D O. (D -0 0 0 4 (D 0 -0 " '0 3 O O x (D V) L- z 0 0 0 0 0 0 0 0 7-1 E� Z 17 E� E -n. c: :� :E :E :E :E :E :E (D n c r) n n 3 (D 3 mcr 0- M (D m m m m rD u ET E=Al o- (A w (A PO (D . . . m r) n m (D m(D m (D co -0 > (D o- (D m 0 0 Z 0 0- Ln LA CL (D =- = C: (D 3 CL (D (D z 0 r+ 0 o- w r+ 1+ Ln 3 Z r) (D c 3 C: 0 r+ (D 3 rn(D (D 3 (A a- r+ cr, :3 (D mr+ r+ Cn 00 co a (D =3 w F" Ln cr cu Nj CY) cn r+ — �6 w w Ln (D (D Ili z 0 0 Ili m SD t1i 0 1 C') 0 I CL Ul U.) CY) 00 CO LU C < LU 0 CL 00 r+ rD (D < < El 0 0 & 6, 0 0 0 0 0 0 0 0 0 0 3 ET ET > UQ O'Q O'Q UQ aq On m m 0-0 CL 3 = + CL Ln '0 V;- vi, V� V� V� (A > V� m0 o w < Ln m w 0 m 0 V) a) (D m 0 3 w fD (D n CL z ::a (D rD m0 (D r) yQ c r+ 0 (D m (D r— co Ln V) (4 EA (n ul V) _0 < < co n v) > z 3 =3 n n w l< w w rD 0 rD go w (D (D (D w (D n r) n rD 3 =3 m x (A (D CL CL (D 0 'o Ln '0 CL z r+ (D (D C: (D r+ 1+ (D (D LU r+ 0) p Q rD r+ (D (D (D r+ El El -n 0 1 3 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 DWlr 0 2118 S 16th St o Blair, CMG 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 c ARE UE March 15, 2023 owner O; t, dd citylstate/zip: Blair, NE 68008 Phone # y �) ), L. `, 1 7 � . 3 V LICENSE FEES: L♦DiliCi or Ca $1 6,00 1, D(1) Cis or Cat; `x 11.00 .00 .,. ;Iloilo � k � ., � ' .�� L s 4- . i11111 tl fl1 17 PET 1 Dog ® Cat : Spaded/Neutered Pet Name ._� �. _ Blrt date "t1 Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ® Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: - (3 yr) r PET #2 ® Dog ® Cat ® Spayed/Neutered Pet Name Birthdate Sex Color Breeden* 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: El Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ ***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 $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/1512023. The City shall recognize a microchip Identification number as the Ilcense number. It shall be unlawful for any dog or cat to wear any license or other city Identification other than that issued by the City of Blair for such dog or cat. The City of Blair requires proof of rabies vaccination to be submitted with your license application. License Fee Replacement$ N (1 yr) City 'Tag # Replacement ** El SUBTOTAL-. � (1 yr) City Tag # ' Replacement $ '* ®N _; s r $ City Tag Alig *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 MaY TOTAL ENCLOSED $ If you have questions, please contact Blair Police Department at (402) 426.4747 .+........................................................................... NEW PET/ NEW RESIDENT LICENSING REQUIREMENTS (march 15late fee date not applicable fornewpets/new resldents) Newly Acquired Pell: New Residents to Blair: Must be licensed within 10 days of ownership ® Must register pets within 10 days of o <OR> at 6 months of age If puppy/ldtten residency. vca,hospitals onhno VCA8ODodge Animal Hospital DOZlWest Dodge Road Omaha, NE 68114 (402)899-8100 Pet's Name: Leia Owner: Mathew Burbach Species: Canine 2845Krejci Blvd Breed: Retriever, Labrador; Mixed Breed Blair, NE68O0U (531)777-5333 Sex: Female (|n\a/1) B|rthdate:O1/O9/2023 Color: Brown; Black Weight: 42.00(b Vaccination Information Date ufVaccination: 7/9/2023 Date Due: 7/9/2024 Mbmchlp� Duration: 1 year Verified at VCA 80 Dodge Animal Hospital By: Batenhorst DVM, Lynn Manufacturer: Zne{|sVANGUARD Rabies lyr LnUSeria|Nunnber: 595590 Lot Expiration: 2/6/2024 Tag Numbec23401D61 License Number: NE 3137 For information rnhow wecollect and use information about you and your pet, and how you ma mw-mx of some uses, please see our Privacy Policy at vcahospitals.corti/pt,lvacy-policy. ` CITY OF B AI ® 20PET 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 o 218 S 16th St o Mr, HE 66008 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 unfit„ LICENSE RENEWALS ARE DUE: March 112023 Twneir Name: r Address: City/State/Zip,. Blair, NE 68008 Phone LICENSE FEES: Dog or i,.,3;; x ,.il0 A, f 7 ? ***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. M°� i?t i� (i,�� �i i� of �tr.)!r' `c-` (��1 "ri,? b-`I;'.Cit att� i:-:ir �; rt17 ft`,t:i' ti-tr � t"i�,; alti(,: C�tr � �' C.l. ��)�� ".4`�I), �.'l�h - ,�fi1" � (f•�Ii .;!17 PET #1 Dog ® Cat 0 Spayed/Neutered License Fee $ Pet Name �v\ Birthdate ; , Sex Color Breed** Replacement $ m* Declared Dangerous or Potentially Dangerous Dog: ® Y ® N ' MICROCHIP # (If applicable) SUBTOTAL: � RABIES VACCINATION DATE: ? s (3 yr) (1 yr) City Tag # r 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) _ WE Replacement ** y Tag ° ' #3 ® Dog ® Cat ® Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Replacement $ 'x* Declared Dangerous or Potentially Dangerous Dog: ® Y ® N MICROCHIP # (If applicable) SU TOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # *PLEASE INCLUDE THE CITY 'TAG NUMBER IF THIS IS A RENEWAL ** (This tee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED $ It you have questions, please contact Blair Police Department at (402) 426-4747 .+......+........a...........¢....a............................................ NEW PET/NEW RESI®ENT LICENSING REQI.IIREIv1ENT� (March 15late fee date notappllcable fornewpeis/newresldenis) Newiy Acquired Pets: New Residents to Blair: a Must be licensed within 10 days of ownership m Must register pets within 10 days of n <OR> at 6 months of age if puppy/ldtten residency. owners Name & Address LAST 11 2 Hills Do&, Rescue Briggs STREET 3175' [A Avenue FIRST chud"', 9, Nola CITY Walthill TELEPHONE 402-846-5100 STATE ZIP PET'SNAME: EIARIE5Thtiri4-: // �y ILI SPECIES SEX AGE SIZE PREDOMINANT BREED COLORS Canine r- e 11A mos, >6p Il M 9 DATE VACCINATED: ­7 /a (-)/,] 3 VACCINATION EXPIRES: �// 'A o /,� ly VACCINATION PRODUCER: 13 0 E, VACC SERIAL NO: J 95 7 0 VETERINARIAN LICENSEM 3681 VETERINARIAN'S SIGNATURE: VETERINARIAN'S ADDRESS: 1(8nneth A, i'Vililler DVNI Nia1"iche5ter's ArdrnLA i'viedical 1634 22W, Streaet Mandiester, Iowa 52051 Lcan-Lgrip-Lict L N CDV-CAV2- CPIV-cpv < Lporn Bacterin RECOMWEV J, 10 Lu Vaccine mL1/ LV CP0XV'Vecldr RFCOMBITEK- c)3 C3 so M . tq�. AImM Hh'W An (�.h IHealthA0 RM2171R3 M L RN760R10 fa - tia,