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EAut-tiC l 0$`l37 CITY OF BLAIR - 2023 PET LICENSE APPLICATION -q-1- � If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City 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: (L'r I. %L- a 4tia ( Owner Address: t City/State/Zip: Blair, NE 68008 Phone # a 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 Fee for Lost Tag: $5.00 Included is a Skate Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET # 1 ❑ Dog P Cat O' Spayed/Neutered License Fee $ i Pet Name Birthdate i- °i 3 Sex Color Breed** t : J• (tea Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # `I � N1 )-1 1)' "11 (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: 3 , i s- , L 9 (3 yr) 1, (1 yr) City Tag # a&,00 PET # 2 ❑ Dog W Cat L3 Spayed/Neutered License Fee $ It yv Pet Name L- v `Birthdate tr-te r a Sex 1� Color j, (,i I w, Breed** S I -& Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # °I �- I`I V, I 1 -7 ) r (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: ? 1 t (3 yr) (1 yr) City Tag # 'k 1* PET #3 ❑ Dog t7 Cat ❑ Spayed/Neutered License Fee $ r �' Pet Name 1 ,, ti 1, Birthdate Sex Color Q I.- -r Breed** L,NO —, Replacement$ Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # a eta SPA,+ , 9 G 3 � w-, (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: ) - /) z 4 (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 $ " I ' If you have questions, please contact Blair Police Department at (402) 426-4747 ++.++.++++++++++.++++++++.++*...........++++.++++.+++..*.*++++++.....+++.++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March I5late fee date not applicable for new pets/new residents) Ngm t Acquired Pets: New Rgsid!gnts to Blair: ■ Must be I•loensed within 10 days of mmetship ■ Must register pets within 10 days of ■ <OR> at 6 months of age if puppy/lditen residency. Client ID: Client Name Address: Phone: Tag Number: Vaccine: Producer: Brand: Type: inner of Administration: 610 Ginger Edgell 1119 Fairview Blair, NE 68008 (402)426-4475 0000 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: 6806 Jack Feline Domestic Shorthair Neutered Male Orange 07/02/2013 16.56 pounds on 3/18/2023 985112001333764 3/18/2023 3/18/2026 18542 3/10/2024 Client ID: Client Name: Address: Phone Tag Number: Vaccine: Producer: Brand: Type: -inner of Administration: 610 Ginger Edgell 1119 Fairview Blair, NE 68008 (402)426-4475 0000 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 6923 Lucky Feline Domestic Shorthair Spayed Female Calico 09/11 /2013 8.25 pounds on 3/18/2023 985111000168788 3/18/2023 3/18/2026 18542 3/10/2024 Client ID: Client Name Address: Phone: Tag Number: Vaccine: Producer: Brand: Type: -inner of Administration: 610 Ginger Edgell 1119 Fairview Blair, NE 68008 (402)426-4475 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 I D: Patient Name Species: Breed: Sex: Color: Markings: Birthday: Weight: Microchip ID: Vaccination Date: Expiration Date: Lot Number: Drug Expiration Date 7999 Tigger Feline Domestic Longhair Neutered Male Gray 04117/2015 15.62 pounds on 3/18/2023 985112005030760 3/18/2023 3/18/2026 18542 3/10/2024 (4a'� 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 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: : 0f11 �-&J4 Owner Address: 7 J—�� vA City/State/Zip: Blair, NE 68008 Phone # VOIL 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 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 Spared License Fee $ 6-- Pet Name Birthdate �� LQ� Sex MA 1. Color �- I nr - I I e Breed** Vr n r Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y LA' N MICROCHIP # 0) � C(, Of 0 (If applicable?SUBTOTAL: $ RABIES VACCINATION DATE: 2 (3 yr) (1 yr) City Tag # '3 � 1; 3 �m PET #2 Ul Dog ❑ Cat W Spaye 4/Neutered License Fee $Pet Name i Birthdate I Sex M.1 I Color Breed** r- r, ' . Rep/acement $ ** Declared Dangerous or Potentially Dangerous Dog: b Y L N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: Z 1_(3 yr) _Z- (1 yr) City Tag # ` £ i PET #3 ❑ Dog I Cat P Spayed/Neutered License Fee $ r Pet Name Birthdate Sex (C Color Breed** Replacement $ ** Declared Dange ous or Potentially Dangerous Dog: ❑ Y Pd N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) X- (1 yr) City Tag # 3) 5 `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.) 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 applicable fornewpefs/newresidenis) Newly Acquired Pets: New Residents to Blair: • Must be )loaned 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 APPLICATIONy 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 1®5, 2023 Owner Name: Owner Address: / / % ��� City/State/Zip: Blair, NE 68008 Phone # /Y 0 '? .= S / 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 Replacemene 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 v6- PET #1 Dog ❑ Cat Spayed/Neutered License Fee $ l) a._ — Pet Name Birthdate / / )- /y5ex Color 5Breed** CL , . - /-1 .s T rrN U�. y Rep/acement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y N MICROCHIP # r8 /D L 0,10 K 73`i (If applicable) SUBTOTAL: $ 0 �-- RABIES VACCINATION DATE: _ J (3 yr)i_ (1 yr) City 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 Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ License Fee $ Rep/acement $ ❑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.) ** �i Do Not Send Cash by Mail TOTAL ENCLOSED'. / .S-3 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 fornewpeis/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. f�� #- � �6 -7y T LICENSE 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 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, 202 Y�� e CC.h 1 .i x3 Owner Name: Lk ckM;R Owner Address: '�o3 FoxYL city/state/zip: Blair, NE 68008 Phone # -11'2- 3 (cP-i _- 2. /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 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 �C a t (KSpayed/Neutered License Fee $ J / . 0 CCU Pet Name Tc-c V— Birthdate Sex N\o..i e- Color c— rev +�,h�}e Breed** ra t yc� 1--"n hl,Xw%c� Rep/acement$ ** Declared or Potentially Dangerous Dog: ❑ Y ❑ N" MICROCHIP # 9?I0,2-uao1i'j-7(d0?.to (If applicable) SUBTOTAL: $ 1/> RABIES VACCINATION DATE: 3/1 S (3 yr) (1 yr) v' City Tag # 3221 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 m 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 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 notapp/icab/e 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. RABIES CERTIFICATE Patient and Owner Information Patient: Jack Breed: Domestic Longhair (DLH) (feline) Sex: Male (neutered) Color: Gray/white Age: 6 Years 10 Months 2 Weeks Birthdate: Apr 27, 2015 Weight: 10.3 Ibs Chip: Rabies Information Completely Cat Clinic 5060 South 108th Street Omaha, NE 68137 Phone: (402) 592-9001 Fax: (402) 592-2792 completelycatclinic@gmail,com www.completelycatclinic.com Owner: Karl Echtenkamp Address: 2038 Park Street Blair, NE 68008 Phone: 712-363-2513 / 712-363-2513 Email: kari.echtenkamp@gmail.com Tag Number: 224565 Product: Purevax Rabies 1 Year Date Given: Mar 18, 2022 Date Due: Mar 18, 2023 Lot: 17523B; Boehringer Ingelheim; Expires Aug 25, 2022 Veterinarian Information Signature: Name: Angela Kade License: 3439 Date: Mar 18, 2022 Veterinarian: Angela Kade, D.V.M. NE (3439) Jennifer Tracy, D.V.M. NE (3017) Page 1 of 1 CITY OF BLAIR ® 2023 PET LICENSEAPPLICATION 1 --, 3 --)-,3 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 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 ARE DUE: March 15, 2023 Owner Name: ? (fie Owner Address: %� 10 City/State/Zip: Blair, NE 68008 Phone # J-f / 7 / -99a --- LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 ***PLEASE READ CAREFULLY*** Vo YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries �y 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,Feq of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET #1 ` D g I Cat Spayed/Neutered License Fee $ Pet Name � Birthdate Sex Color - Breed** a Replacement$ ** Declared Dangerous or Potentially Dangerous g: ❑ Y ❑ N MICROCHIP # � (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: -/ - ;-�'-O (3 yr) (1 yr) City Tag # if PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ ❑N (1 yr) License Fee $ Replacement $ * * SUBTOTAL: $ City Tag # PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL f ** (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 appllcablefornewpets/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. Ms, Paulette Eckersay 1270 Deerfield Blvd Apt 105 Blair, NE 68008 �M 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 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: Owner Name: C. dt41 1, e A Owner Address: city/state/zip: Blair, NE 68008 Phone # —� ***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 LICENSE FEES: Dog or Cat: $16.00 l be submitted with your license application. Altered Dog or Cat: $11.00 - --- lZepiacement 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 F " Bi date Sex Color n z Breed** �v Replacement ** Declared Dangero s or Potentially Dangerous Dog: ❑ Y XN MICROCHIP # /V & M e (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: �, f (3 yr) (1 yr) City Tag # `y PET #2 _ ❑- Spayed/Neutered License Fee .$ Pet Name�2 l Birthhda e ��- -Sex-- _-__ _ Color -Breed**°" Replacement $ ** Declared Dangerous-or-P-otentially Dangerous Dog: ❑ Y N MICROCHIP-4 /t/ C9 h _ (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: On A b (3 yr) (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 notapplicable fornewpet5/newre5ldenis) 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. 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 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: 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 311512023. The City shall recognize a microchip identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city Identification other than that issued by the City of Blair for such dog or cat. The City of Blair requires proof of rabies vaccination to be submitted with Vour 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 # 4 o g ❑ CatS a ec�/N utered W, License Fee $ Pet Name Bi�hXdate f 11 ;NSe Color Breed** Replacement $ ** Declare Dangerous or Potentially Dangerous Dog: ❑ Y N MICROCHIP # tJ ), (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 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 $ 1 ( . If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++.....++++++..........+++++t...............+++++++......++++++++++++..... NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March15late fee date not applicablefor newpetsInewI-esidents) Newly Acquired Pets: New Residents to Blair: a Must be licensed within 10 days of ownership is Must register pets within 10 days of ■ <OR> at 6 months of age if puppy/kitten residency. Blair Small Animal Clinic PC David E. Johnson DVM 1734 Front Street Blair, Nebraska, 68008 (402) 533-2722 Rabies Certificate Client ID: 312 Patient ID: 7075 Client Name: Scott Suverkrubbe Patient Name: Remington Address: 2165 Park Street Species: Canine Breed: Labrador Retriever Blair, NE 68008 Sex: Spayed Female Color: Yellow Phone: (402)427-3609 Markings: Birthday: 06/11 /2011 Weight: 72.00 pounds on 6/19/2023 Microchip ID: Tag Number: 7742 Vaccination Date: 6/19/2023 Vaccine: Imrab Rabies Vaccine Expiration Date: 6/19/2026 Producer: Merial Lot Number: 18567 Brand: Imrab 3 TF Drug Expiration Date: 9/28/2024 Type: Killed Virus Manner of Subcutaneously Administration: Staff Name: David E. Johnson DVM License Number: 1893 Doctor Signature: 1 �� 4 � " 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 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: ACA(tiWX Owner Address: city/state/zip: Blair, NE 68008 Phone # NaH2 -30 5 (20 212- 0) G O 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. J Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3115/2023. The City shall recognize a microchip Identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city Identification other than that Issued by the City of Blair for such dog or cat, The City of Blair renuires proof of rabies vaccination to be submitted with your license application. 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 Y o g ❑ Cat ❑ Spayed/Neuterj j i `23 License Fee $ t . Pet Name � Birthdate ' c m r ex .Y Color P21le Breed" Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y W-A1— MICROCHIP # (If applicable) SUBTOTAL: $ ` RABIES VACCINATION DATE: e5-7-7 (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) License Fee $ Replacement $ * * SUBTOTAL: $ / City Tag #116* 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 $ j i, 2 S 11 If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++++++++.+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 151ate fee date notapplInable 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 David E. Johnson DVM 1734 Front Street Blair, Nebraska, 68008 (402) 533-2722 Page 1 / 1 Client ID: 6730 Adam &Trish Egan 1451 Jackson St Invoice #: 168316 Blair, NE 68008 Date: 5/25/2022(531) 212-0160 pugsly83860-gmail.com 4/1 /2020 5/25/2022 Reminder 10/03/2015 11 /25/2022 05/25/2023 05/25/2025 Patient ID: 7854 Weight: 81.80 pounds Patient Name: Dakota Birthday, 09/30/2012 Species: Canine Sex: Spayed Female Breed: Labrador Mix Description Blood Profile Chem 15 Electrolytes Heartworm Test - Snap RT Examination General Intranasal Bordetella/Parainfluenza Distemper Hep Lep Parvo-Annual Pedicure Simple Pet License -Altered Pet City of Blair Interceptor Plus 51-100# x 6pk Credelio Tab 50.1-100lbs x dose (Blue) Rabies Vaccination - Canine Syr Sentinel Heartworm Pills Interceptor Heartworm Prev. Reminder Heartworm Test - Snap RT Distemper Hep Lep Parvo-Annual Intranasal Bordetella/Parainfluenza Rabies Vaccination - Canine 3yr Staff Name Quantity David E. Johnson DVM 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 6.00 1.00 Patient Subtotal: Invoice Total: default Tax Rate: Total: Balance Due: Previous Balance: Balance Due: VISA Card Number: ... XXXX7004: Less Payment: Balance Due: Total $81.97 $33.48 $38.00 $30.00 $35.00 $40.00 $16.00 T $11.00 $60.08 T $120.42 T $30.00 $495.95 $496.95 $13.76 $509.71 $509.71 $0.00 $509.71 ($509.71) ($509.71) $0.00 Order your pets supplies online now through our website wwwi.blairsmallanimalelinic.vetsfirstchoice.com For questions contact us at 402-533-2722. it I -II ` ( a S, 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 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 A I Owner Name: r O fa f I Q l.� C0 o� Pr -�- Owner Address: 15 � ', I (L "64- t+ IS I City/state/zip: Blair, NE 68008 Phone # Y 0 2- U I% - •7 -7 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 anDlication. Replacemient 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 $ o 0 Pet Name Birthdate b6l 9.()1 ISex aI Color 1?? ) (i e Breed** Replacement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y 14 N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: b Z.) b 2- I zo � (3 yr) (1 yr) x— City Tag # 0 © Zqq 2* 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) (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 I0- 00 If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Marcie 15/ate 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. The Pet Clinic 2509 S. 140th Cr. Omaha, NE 68144 402-330-3096 FOR: Natalie Eggert 758 S 16th st Apt 351 Blair, NE 68008 Date For www.petclinicomaha.com Qty Description Printed: 2/2/2023 at 10:23a Date: 2/2/2023 Account: 11589 Invoice: 469134 Price Discount Price 2/2/2023 Dixon 1 Annual Wellness Exam 54.50 2/2/2023 1 Rabies Vacc Purevax 1yr 32.00 2/2/2023 1 FVRCP Vacc Syr 33.00 Total charges, this invoice... 119.50 Your old balance... 0.00 Total payment(s) received... 119.50 2/2/2023 Visa payment 119.50 XXXXXXXXXXXX5610 Approval code: 009233 Card Balance: N/A X 1 agree to pay above total amount according to card issuer agreement. (Merchant agreement if credit voucher). Your new balance... 0.00 Patient Total charges Dixon 119.50 Reminders for: Dixon (Weight: 14.3 Ibs - 8y) Last done 2/1/2026 FVRCP - 3 year Vaccination 2/2/2023 2/2/2024 Rabies Vaccination Purevax 2/2/2023 2/2/2024 Annual Wellness Exam 2/2/2023 If your pet requires after-hours emergency care, please contact Urgent Pet Care at 402-991-9444 or Midwest Vet Emergency Center at 402-614-9000 The Standard of Veterinary Excellence VETERINARY CLINIC The Pet Clinic 2509 S. 140th Cr. Omaha, NE 68144 402-330-3096 CLINK ESTAIBL -.1 SHED1982 CERTIFICATE OFVACCINATION OWNEBOE AP Natalie Eggert 758 S 16th st Blair, NE 680C County: Wasl- Phone; 618-7 j This is to certify... THAT I HAVE VACCINATED AGAINST RABIES THE AN -AL DESCBIBEDBE1.01 Patient information... PATIENT: Dixon TAGN0;02' SPECIES: Feline WEIGHT:14, AGE: 8Y SEX; Neuter( BREED: Domestic Shorthair Color and markings: Black Veterinarian: Glenna Rasmussen, DVM Vaccination and Services History... Ntense Date Done Doctor Services Due Dale 2/2/2023 GR FVRCP Vacc 3yr 211/2016 2/2/2023 GR Rabies Vacc Purevax 1yr, #02 6-23 2/212021 2/17/2018 BT Rabies Vacc Purevax 3yr, #03 2-18 8/4/2014 VT FVRCP Vacc 6/2/2014 TE FVRCP Vacc (Temp) Rabies Vaccine Information... MFG BY: MERIA SER.NO: 17 51A LOT EXP: 2/25/24 ADM: SQ CITY OF BLAIR - 2023 PET LICENSE APPLICATION o P, 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: a 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 $iS0.00 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 F1 Dog ❑ Cat 3 Spayed/Neutered License Fee $ l / Pet Name t < Birthdate q - to 13 Sex Y Color bir'% lz- e, z Breed" e -Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y 0 N MICROCHIP # (If applicable) SUBTOTAL: $ / RABIES VACCINATION DATE: (3 yr) X (1 yr) City Tag # PET #2 ® Dog ❑ Cat Spayed/Neutered License Fee $ Pet Name Birthdate la >;>/ Sex /1") Color Breed**y-) 1,�h V:,2 �.14A C iO(', /7 Rep/acement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y -1211 N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: 11.26(3 yr) (1 yr) City Tag # PET #3 ❑ Dog Z1 Cat 0 Spayed/Neutered License Fee $ Pet Name Birthdate Sex t'yi Color 6TM - Breed** /�-x= Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y 3 N MICROCHIP # (If applicable) SUBTOTAL: $ 1/=` RABIES VACCINATION DATE: i 1-) , (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.) rtF Do Not Send Cash by Mail TOTAL ENCLOSED $ fi(' `i `1151`0 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/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. v} CPII �L,u��lCc%1 k� �1' t t f ._�r, 4 v �,JC 'CGS 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 paya' eo!/ City Of Blair o 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 IS. 202 Owner Name: J4 Owner Address: City/state/zip: Blair, NE 68008, Phone #• LICENSE FEES: Dog o. C k ***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 Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program r, A?% PET 1 r 4, LIDog P-C a t ® Spayed/Neutered License Fee Pet Named v Birthdate Sex t' Color' Breed** " r . ` ' y _( g Replacement $ y� dy-� w.. =-s-- Declared Dangerous or Potentially Dangerous Dog: ® Y ® N ' MICROCHIP # (If applicable) ,SUBTOTAL: $ '� RABIES VACCINATION DATE: ��' '— (3 yr) (1 yr) a City Tag # ET #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) SU TOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # ® Dog Ll 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 ®epartment 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 Is Must register pets within 10 days of • <OR> at 6 months of age if puppy/Idtten residency. Client ID: 9297 Client Name: Jarald Elvers Address: 805 N. 22nd Street Apt 1 H Blair, NE 68008 Phone: (402)426-0186 Tag Number: 0 Vaccine: Imrab Rabies Vaccine Producer: Merial Brand: Imrab 3 TF Type Killed Virus Manner of Subcutaneously Administration: 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: 14069 Jeri Feline Domestic Shorthair Female Tabby 01 /06/2021 1 /9/2023 1 /912024 J 18535 11 /17/2023 03/09/2023 13:16 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 CATM, COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR — 218 S. 161H 8T — 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 RESIDENTM OR DWELLING UNIT. —PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENY[UR 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 $15Q.00 per pet. PST L,IC�NSE REiVEWALS ARE DUE BY $/'ire/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 glair for such dog or cat. NEW PET LICENSING Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten NEW }RESIDENTS TO BLAIR Must re0ister pets within 10 days of residency Owner Name George Ely Spouse Owner Address 1028 Park Street City/State/Zip Blair, NE 68008 Phone # 533-777-9636 Pet Name: Lily ..� Tad -#4055 ,Age: 16M DOB---11-08-21 Sex: Spayed Female Color: Brn Tab/W* u Breed: DSH Microchip #/ Rabies Tag # PLEASE INCLUDE CITY TAG NUMDER IF THIS IS A, RENEWAL (IF AVAILABLE): # RABIES VACCINATION DONE O 06-16.22 Rabies Description: YEAR YEAR Holstein Veteribary Clinic pt /isa Schrutn DVM : Dt. Kilsta Holstein DVM 718 South 19►h Street Blair, NE 68008 402-426-7387 402-426-0101 Pax holsteinclinic@gmail.com LicuiSE FEES Intact Dog orG#t9 Altered og or cat. $11.00 n#PLW&n7V1"—t Tag $5.00 Total $ PETS THAT ARE ON THE ACTIVE POTENTIALLY WNGEROUS OR DANGEROUS DOG LIST NEED TO REO&TER D11tECTLYAT CITY HALL. FAXFD 03-09-23 BY 1-4b :`ELT Ll`;`:4"0=?IJS,,. Feb 03 23 02;02p P.1 CITY OF BLAIR - 2023 PET LICENSE APPLICATION If you five 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 1.5, 2023 Owner Name: l%; �n'-1 Owner Address: city/State/zip: Blair, NE 68008 Phone # ) 2 — 1, 9 _'ID2 L Cl-_ LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BYLAW To LICENSE YOUR PETS. lraiiure to do so is a ViMation of city ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 9/1512023. The Crty shall recognize a microchip identifrcatlon number as the license number, it shall be unlawful for any dog or cat to wear any license or other city identincatlon other than that Issued by the City of Blair for such dog or cat. The City of Blair requires proof of rabies va cination to be submitted with your license abuliptidn. 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 Dig ❑ Cat O Spaye N uter d V� License Fee $ ! Pet Nam Birthdate ex Color _ Breed** 1ti Replacement $ ** Declare � Dangerous or Potentially Dangerous Dog: LI YKN MICROCHIP # If applicabl SUBTOTAL: $ RABIES VACCINATION DATE: 3 yr) (1 yr) City Tag # 3036 PET #2 og El Cat payed/Neutered ,- License Fee $ Pet Na e Birth ate G ex Color Breed** Replacement $* Declared Dange us or Potentially Dangerous Dog: ❑ MICROCHIP # (If applicable) SUBTOTAL: $� RABIES VACCINATION DATE: 0-,2- J,,2 —d-0 (3 yr) �IX (I yr) City Tag # 2339 PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee Pet Name Birthdate Sex Color Breed** Replacemeott $ 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.) DoNot Send Cash byMail TOTAL ENCLOSED $ If you have questions, please contact Blair Police Department at (402) 4264747 +t+t...++.+t.++t. *+t *.+++++.....++++4...4..*..........+++.....+++.+f....+++.. NEW PET/NEW RESIDENT LICENSING REQUIRPMENTS (Mard7 i5/aLefee date notapp/icablefor newpels/newresidentg) NewlvAalui Pets' New Residents to Blair: a Must be liceri Win 1.0 days oFowrotlrilp ■ Must register pets within 10 days of ■ <OR> at 6 months of age if puppy/biten residency, Feb 02 23 01:35p p.1 CITY OF FLAIR - 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: Qonjc-� r5�s Owner Address: citylstatelzip: Blair, NE 68008 Phone # (w O-) g,Llci�2 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 5o 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�23. 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 `nlre 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 Operatflr Inspection Program PET #1 ❑ Dog U`Cat 2/'S ay /Neutered License Fee $_(j_` Pet Name i�+nt Birthdat �v15-Zi Sex Color , qe -f b �j Breed** 6s Replacement $ Declared Dangerous or Potentially Dangerous Dag: ❑ Y ❑'N MICROCHIP # cl$1o2 0bgG l$14UL, (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: _ �<_ (3 yr) (1 yr) City Tag # 3787 PET #2 ❑ Dog CsCa t LQ55 y /Neutered License Fee $ ° p Pet Name Lei If_u1 Birthdate� Sex Color oi, t r,c� I wE, t Breed** Replacement$ ** Declared Dangerous or potentially Dangerous Dog: O Y Ef N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: _ X (3 yr) (1 yr) City Tag # 3465 PET #3 ❑ D o g C Cat L3S d/Neutered License Fee $ Pet Name l6V_l Birthdate Sex F Color I cIL Breed** Ol51► Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y WN MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: _ .. )< (3 yr) (1 yr) City Tag # 3466 *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) 4264747 +.+.++.++........++.*++.....+.+..............+.+•r................+++t......+++. NEW PETINEW RESIDENT UCENSING REQUIREMENTS (MaraJ1.5jat-fvrdatenot a0iwtlefornewpei5/new1e577dentr) Newly Acquired Pets: New Residents to Blair: r Must be licensed within 10 days ofawlership ■ Must register pets within 10-days .of ■ <0R> at 6 moriiins of age if puppy/ften residency.