GCITY OF BLAIR - 2023 PET LICENSE APPLICATION 6 -,
If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to:
City of Blair • 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: Thomas & Katherine Gattone
Owner Address: 1461 Mount Hope Cir
City/State/zip: Blair, NE 68008
Phone # 425-877-402
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 reauires 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 00 Dog ❑ Cat ❑ Spayed/Neutered License Fee $ 11.00
Pet Name Ripley Birthdate 11/2014 Sex Female
Color !lAblek GrP.AL— Breed** Husky Replacement $
Declared Dangerous or Potentially Dangerous Dog: ❑ Y 00 N
MICROCHIP # 982000365522603 (If applicable) SUBTOTAL: $ 11.00
RABIES VACCINATION DATE: 9/1/22 (3 yr) X (1 yr) City Tag # A l I
PET #2 ® Dog ❑ Cat ❑ Spayed/Neutered License Fee $ 11.00
Pet Name Kato Birthdate 2/2/15 Sex Male
Color brown & red Breed** Cattle dog Replacement $ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y LN N
MICROCHIP # 982000365622258 (If applicable) SUBTOTAL: $ 11.00
RABIES VACCINATION DATE: 9/1/22 (3 yr) X (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 #
*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 $ 22.00
If you have questions, please contact Blair Police Department at (402) 426-4747
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
NEW PEP/NEW RESIDENT LICENSING REQUIREMENTS(Maroh15late fee date notappllcablefor newpels/newre9dents)
Newly Acauired Pets: New Residents to Blair:
s Must be liamsed within 10 days of aAmship ■ Must regisber pets within 10 days of
■ <OR> at 6 months of age if puppy/kftben residency.
ClientlD: 19184
Client Name(s): Thomas Gattone
Kelly Gattone
Address: 13206 208th Dr SE
Monroe, WA 98272
Phone: (206) 276-7610
i w
ANIMAL CLINIC
www.cascadeanimalcMc.com
121 South Ferry Street
Monroe, WA 98272
(360) 794-6772
Rabies Certificate
Patient ID:
Name:
Species:
Breed:
Sex:
Color:
Markings:
Birthday:
Weight:
Microchip:
2665
Kato
Canine
Australian Cattle Dog Mix
Neutered Male
2/2/2015
57.4
982000365622258
Tag Number: 22-001424 Vaccination 9/1/2022
Date:
Lot Number: 566318 Expiration 9/1/2025
Date:
Rabies Vaccine: Defensor 3
Producer: Zoetis
I< / MLV / R: Killed Virus
Doctor Name: Catherine G. Clemmens
0
License Number: VT 61315586
Client ID: 19184
Client Name(s): Thomas Gattone
Kelly Gattone
Address: 13206 208th Dr SE
Monroe, WA 98272
Phone: (206) 276-7610
Tag Number: 22-00'4" .I
Lot Number:
55
1
Rabies Vaccine:
Defensu:
Producer:
Zoetis
K / MLV / R:
Killed Virus
Doctor Name: Catherine G. Clemmens
4 y
ANIMAL CLINIC
www.cascadeanimaklinic.com
121 South Ferry Street
Monroe, WA 98272
(360) 794-6772
Rabies Certificate
Patient ID:
3186
Name:
Ripley
Species:
Canine
Breed:
Siberian Husky Mix
Sex:
Spayed Female
Color:
Grey/white
Markings:
Birthday:
11 / 10/ 2014
Weight:
57.6
Microchip:
982000365522603
Vaccination
9/1/2022
Date:
Expiration
9/1/2025
Date:
License Number: VT 61315586
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 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 RENEWALS ARE DUE: March 15, 2023
Owner Name:
Owner Address: S ,
City/state/zip: Blair, NE 68008
Phone # I J ()- - ..�) _ c 1 �'
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 ) , . Birthdate S,
Color Breed** <> � L Replacement $ **
Declare` Dangerous or Potentially Dangerous Dog: ❑ Y N
MICROCHIP # c `"
'� "` � i 0 , r:� i ;�. f ,� � (��� �l I (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: - ,1 _ (3 yr) (1 yr) City Tag #
PET #2 bi Dog ❑ Cat P`Spayed/Neutered — R License Fee $
Pet Name Birthdate _ l Sex
Color \ \ a t V Breed** � I JC Replacement $ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y P N -� t,
MICROCHIP # () rF d (:> o �A (If applicable) SUBTOTAL: $ t _
RABIES VACCINATION DATE: I -- I I (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 $ ] .
*
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.
Client ID:
Client Name:
Address:
Phone:
Tag Number:
Vaccine:
Producer:
Brand:
Type:
inner of
Administration:
4514
Sara Getty
2238 Jackson Street
Blair, NE 68008
(402)237-9886
6218
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
Patient ID:
Patient Name:
Species:
Breed:
Sex:
Color:
Markings:
Birthday:
Weight:
Microchip ID:
Vaccination Date:
Expiration Date:
Lot Number:
Drug Expiration Date:
,6607
Sammy
Canine
German Shorthair Pnt
Spayed Female
Roan
04/09/2013
44.90 pounds on 11/15/2022
OA02004845
1 /11 /2021
1 /11 /2024
18473
7/3/2021
Client ID:
Client Name
Address:
Phone
Tag Number:
Vaccine:
Producer:
Brand:
Type:
anner of
Administration:
Staff Name:
License Number:
Doctor Signature:
4514
Sara Getty
2238 Jackson Street
Blair, NE 68008
(402)237-9886
7144
Imrab Rabies Vaccine
Merial
Imrab 3 TF
Killed Virus
Subcutaneously
David E. Johnson DVM
1893
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:
12650
Cooper
Canine
Golden Retriever
Female
Gold
03/26/2021
62.00 pounds on 11/15/2022
985112012026091
7/25/2022
7/26/2025
18535
11/17/2023
Mar 22 23 08;40a
P.1
If you live in Blair City limits and own a dog(5) and/or cat(s), complete this forth and return with check made payable to:
City of Blair • 218 S 16th St • Blain 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 }'�`� �'�L fti,:?� Dorene Gee
Owner Address:
2151Crestrid e Dr �-
City/state/Zip: Blair, NE 68�C18
Phone# )\�'-.r\ `Z"- `
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,
P LICENSES RENEWALS ARE DUE BY alIS/2023. The City shall
recognize a microchip identification number as the license number. it
shall be unf2wful 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 Dispection Program
PET # 1 , Dog ❑ Cat ❑ Spayed/Neutered License Fee $ l r .Ck'j\
Pet Nag e �;x Birthdate \i 12- Seat �.� a� L
Color Y �>. �� ' 'u �r�E'. 'Breed** Replacement $ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y TN
MICROCHIP # — (If applicable) SUBTOTAL: $
IO4
RABIES VACCINATION DATE: . J ,L -1 (3 yr) (I yr) `i, City Tag �# 4067
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)
(I yr)
License Fee $
Replacement $ * *
SUBTOTAL: $
City Tag #
License Fee $
Replacement $ __
❑N
SUBTOTAL: $
(I yr) City 'Tag #
*PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL
*,,(-Tpi9ffe`e 1s d"ong with License Fee if requesting at the time of license renewal.)
Do Not Send Cash by Mail TOTAL ENCLOSED $ Vu,- J 0
you4idve questions, please contact Blair Police Department at (402) 426-4747
...... *++.*++t.++ t++++.t+................++*.+t.+++...........................
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS(Ma/015late fee date notapplicallofor nex,pets/rrewresidents)
NewlyAcciuired pets: NW lies dents to Blair:
■ Mast be lnxised wiihh 10 days of owrlersNp ■ Must register pets within 10 days of
■ <OR> at6 months of age if puppy/fatten residency.
® 2023 PET LICENSE APPLICATION
le
CITY OF BLAIR 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 paya x `
City of Blair e 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 RENEWALS ARE DUE: March 15, 2023
Owner Name:
Owner Address: 3 ® 0li6r
city/state/zip: Blair, NE 68008
Phone # `-/n .. ` lir, 60 - .r�C"R/
191
LICENSE FEES: Dog or Cat: $16.00
Altered Do or Cat- $11 00
***PLEASE READ FULLY***
YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS.
Failure to do so is a violation of City ordinances 6.103 and carries
a penalty of a fine up to $150.00 per pet.
PET LICENSES RENEWALS ARE DUE BY 3/15/2023. The City shall
recognize a microchip Identification number as the license number. It
shall be unlawful for any dog or cat to wear any license or other city
Identification other than that Issued by the City of Blair for such dog or
cat. The City of Blair requires proof of rabies vaccination to
be submitted with your license anDlication.
g
epiac amen! Fee for Losti —lag ' $5.00
Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program
PET # Dog ❑ Cat �9.Spayed/Neutered License Fee $ �� p
Pet Name Joe- ' <7:) Birthdate Sex
Color Breed** ,� 41Aril.lu' Replacement$ **
DeclarA Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N
MICROCHIP # �:�/� `s't''j (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: 1 s1 `'.o)93 (3 yr) X (1 yr) City Tag # _ 'rls_*
ET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered
Pet Name Birthdate Sex
Color Breed**
Declared Dangerous or Potentially Dangerous Dog: ❑ Y
MICROCHIP # (If applicable)
RABIES VACCINATION DATE: (3 yr) _
T #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered
Pet Name Birthdate Sex
Color Breed**
Declared Dangerous or Potentially Dangerous Dog: ❑ Y
MICROCHIP # (If applicable)
RABIES VACCINATION DATE: (3 yr) _
License Fee $
Replacement $
❑N
SUBTOTAL: $
(1 yr) City Tag #
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.)
r.
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 fornewpets/newre5ldenty)
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.
Client ID:
Client Name:
Address:
I91'M
Tag Number:
Vaccine:
Producer:
Brand:
T,cpe:
..,anner of
Administration:
4481
Susan & Steve Geise
2731 Colege Dr
Blair, NE 68008
(402)650-4649
7541
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
Patient ID:
Patient Name
Species:
Breed:
Sex:
Color:
Markings:
Birthday:
Weight:
Microchip ID:
Vaccination Date:
Expiration Date:
Lot Number:
Drug Expiration Date:
13164
Rock-o
Canine
Labrador Retriever
Neutered Male
Buff
09/19/2021
61.00 pounds on 3/28/2022
985141004842456
1 /31 /2023
1131/2026
18535
11 /17/2023
Feb 23 23 03:49p
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 madetpa ble 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
—� ***PLEASE READ CAREFULLY***
Owner Name;
{-� 4 �f tt q- YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS.
Owner Address: �J �O 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.
Cityfstate,/zip: Blair, NE 680i08� �7
Phone # 4 "' L, �/ r' PET LICENSES RENEWALS ARE DUEBY 31IS120". Tile City shall
recognize a mlcrochip identification number as the license number, It
shall be unlawful for any dog or cat to wear any license or other city
IdentificatlOn other than that Issued by the City of Blair for such dog or
LICENSE FEES' Dog or Cat: $16.00 cat. The City of Blair requires proof of rabies vaccination to
Altered Dog or Cat: $11.00 be submitted with your license application
Replacement Free 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 Do ❑ Ca 9 spa d License Fee $
Pet Na Irthdate , exAll
Color 1 Breed** Replacement $
Declared Dangerous or Potentially Dangerous Dog: ❑ Y ill N
MICROCHIP # (If applicable),SUBTOTAL: $_
RABIES VACCINATION DATE: (3 yr) (I yr) City Tag # 2243
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 NUMBERIF 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
+++td,+++++.....+....+++*+-h.+++...........+...... ..................... .......
NEW PET/NEW' RESIDENT LICENSING REQUIREMENTS (Afwo� 15127te kv date notappllca le It vnewpeis/newresidenis)
Newly Acquired PeitsL New Residents to Blair:
■ Must be liorlsed within 10 days of ownership ■ Must reglAer pets within 10 days of
■ <OR> at 6 months of age If puppWatten residency,
CITY OF BLAIR - 2023 PEW 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 1,
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 23
Owner Name:
Owner Address:
i�
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 Citv of Blair reauires 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 tD fund the Nebraska Dog & Cat OperatDr Inspection Program
PET # 1 Lf Dog ❑ Cat ❑ Spayed/Neutered License Fee $ ;Th
Pet Name b'�,00kl Birthdate Sex , 0vv)i tc'
Color i Breed** �~ o '��' ;�..y �r. Replacement $ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y 0"'N
MICROCHIP # `I a '), ( (If applicable) SUBTOTAL: $ it
RABIES VACCINATIONe DATE: 1 r ) (3 yr V (1 yr) City Tag #"
PET #2 ❑ Dog 0 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) _
❑N
(1 yr)
License Fee $
Replacement $
SUBTOTAL: $
City Tag #
*PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL
** (This fee is due along with License Fee if requesting at the time of license renewal.)
Do Not Send Cash by Mai/ TOTAL ENCLOSED $f
If you have questions, please contact Blair Police Department at (402) 426-4747
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Maroh 15/ate fee date notapp/icabie fornewpeWnewtesident!)
Newly Acquired Pets: New Residents to Blair:
■ Must be kensed within 10 days of ownership ■ Must register pets wthin 10 days of
■ <OR> at 6 months of age if puppy/khen residency.
Date of Rabies Vaccination: 12-22-21
Next Rabies Vaccination On: 12-21-24
VETERINARY CLINIC
Holstein Vet Clinic
718 South 19th Street
Blair, NE 68008
402-426-7387
Certificate No: 0
Previous Rabies Vaccination: 14485
OWNER OF ANIMAL
Marsha Gilliland
555 N 16th
Blair, NE 68008
County:
This is to certify...
THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW.
Patient information...
PATIENT: Maggie TAG NO: 19688
SPECIES: Canine WEI�CI- t: 1 ,80
SEX: S AGE::12 years
Color and markings... White/Gray
Signed
Krista Holstein , DVM
License: 3612
Rabies Vaccine Information...
MFG BY: ZOETI SER.NO: 500084
LOT EXP: 08/09/22 ADM: SQ
I LICENSE APPLICATION 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 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 AR DUE: March 15 2023
Owner Name:
Owner Address: to, l
city/state/zip: Blair, NE 68008
�/
Phone # Vd ®15) 13 f
LICENSE FEES: Dog or Cat: $16.00
Altered Do or Cat• $11 00
***PLEASE READ CAREFULLY***
YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS.
Failure to do so is a violation of City ordinances 6.103 and carries
a penalty of a fine up to $150.00 per pet.
PET LICENSES RENEWALS ARE DUE BY 3/15/2023. The City shall
recognize a microchip identification number as the license number. It
shall be unlawful for any dog or cat to wear any license or other city
Identification other than that Issued by the City of Blair for such dog or
cat. The City of Blair requires proof of rabies vaccination to
be submitted with your license application.
g
Replacement Fee for Lost Tag: $5.00
Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program
PET # 1 ❑ Dog Cat Spayed/Ne terecl j License Fee
Pet Nam Birthdate /o i a ex 1
Color 5 Breed** Rep/acement$ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y N
MICROCHIP # 910 9a a/ lSl (Ifapplicable) SUBTOTAL: $
RABIES VACCINATION DATE: r) (1 yr) City Tag # ®ov !L/
PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered
Pet Name Birthdate Sex
Color Breed**
Declared Dangerous or Potentially Dangerous Dog: ❑ Y
MICROCHIP # (If applicable)
RABIES VACCINATION DATE: (3 yr) _
(1 yr)
License Fee $
Rep/acement $
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 's due along with License Fee if requesting at the time of license renewal.)
r
Do Not Send Cash by Mail TOTAL ENCLOSED
olice De artment at 402 426-4747
If you have questions, please contact Blair P p ( )
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date notapplicable fornewpeis/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/kitten residency.
Client ID:
Client Name:
Address:
I111170M
Tag Number:
Vaccine:
Producer:
Brand:
Type:
inner of
Administration:
5428
Tim & Jeanne Gentzler
806 N 13th St
Blair, NE 68008
(402)533-3128
000
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
4576
Cinnamon
Feline
Domestic Longhair
Spayed Female
Tortoise Shell
10/06/2010
8.18 pounds on 9/13/2022
3/18/2022
3/18/2024
18526
5/20/2023
02/10/2023 15:57 4024260101 HOLSTEIN VET CLINIC PAGE 01/01
2023 PET LICENSE
VERIFICATION/APPLICATION FOR CITY OF BLAIR APO
IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A 00(30 AND lOR CAT(S),
COMPLETE THIS F013M AND RETURN WITH A CHECK PAYABLE TO:
CITY OF BLAIR - 218 S, 16" ST - BLAIR, NE 68008
YOU MAY LEGALLY OWN A COMBINATION OF FOUR 14) ADULT PETS,
BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS KII RESIDENTIAL OR DVVI"LLiNG UNIT.
#9"PLEASE READ CAREFULLY"'
YOU ARE RgQUiRED BY 1.AW TO LICENSE YCi�IR RI:TS TH Ty of BIAIR FtECIUIgER PROOF OF IiA)�IES VA�CCiNA71C�Ns
Failure to do so i5 a violation of City Ordinances 6,103 and carrit3s a penalty of a fine up to $150,00 per pet,
PET LIG"fj1f8E RENEWALS ARE DUE RY 3![Q(,�Q7�.
-The city shall recognize a microchip ID number as the license number,
it shall be unlEtwful for any (Jog or oat to wear any license or other city ID ether than that issued by the City of glair for such dog or
NW PET LICENSI V(_G Must be licensed within 10 clays of ownership (OR) at 0 months of age if puppy or kitten
NEW RESIbENTS TO BLAI Must register pets within 10 days of residency
Owner Name
Jennifer Liebe
Spouse
Jesse Basch
Owner Address
1140 Park St
city/state/zip
Blair, N1= 68008
Phone #
402-237-9613
Pet Name:N Freckles
Tad #'251
Age: 4V
DOB: 07-21.18
Sep; Neutered Mate
Color; White
Breed: Terrier X,
Microchip #
Rabies Tag # 18844
PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVA(LABLE): #
RABIES VACCINATION CLONE ON
01-26-21
Rabies Description; 1 YEAR
YEAR
Holstein Veterinary Clinic
Dr: Lisa ,Schrum DVM : Or Kriste Holstein DVM
718 South 191h Street Blair, NE 68008
402-426-7887 402-426-0101 Fax
holsteinclinic@gmall.com
LICENSE FED
/ntaCt
Dog or Cat: $16.00
Dog r cat: $1 .00
Replacement 7'ay
$5.00
Total $ —I
—
PETS THAT ARE ON TH,- ACTIVE PQTENTIALQ' DANGER- _.- QR
DANGEROUS D09 ll$T NEED TD REGISTER DIRECTLYAT CITY HALL
FAXED 02-10-2
BY
"V� /C* k �2'
CITY OF BLAIR - 2023 PEW 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
Y u 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.
t (
LICENSE RENEWALS ARE DUE: March 15, 2023
Owner Name: l�l�CI i a C .i> 7( cJ� <�
Owner Address: L t3 f
city/state/zip: Blair, NE 68008
Phone # t t,-) J� 0 7
LICENSE FEES: Dog or Cat: $16.00
Altered Dog or Cat: $11.00
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_reauires 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 # Dog ❑ Cat4Stpad/ ed License Fee $Pet Name Y _ Biy euter
o Sex Lh
Color Breed** t Replacement $ **
Declared bang rous or Potentially Dangerous Dog: ❑ Y N
MICROCHIP # (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # 41
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 $
❑N
SUBTOTAL: $
(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 May TOTAL ENCLOSED $
If you have questions, please contact Blair Police Department at (402) 426-4747
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Mardi 15late fee date not applicable fnrnewpets/new residents)
Newly Acquired Pets: New Residents to Blair:
■ Must be lioer6ed within 10 days of ownership ■ Must register pets within 10 days of
■ <OR> at 6 months of age if puppy/kitten residency.
RECEIPT
Omaha Pet Vaccination Clinic
2911 S. 120th St.
Omaha, NE 68144
402-443-2006
OMAHA PET VACCINATION CLINIC - 84th & H - Omaha, NE (402) 443-2006
Printed: 01-21-23 at 9:20a
FOR: Maycee Godfrey Date: 01-21-23
1761 Park St Folder: 0
Blair, NE 68008 Invoice: 18017685
(402) 237-7086
Date For City Description Net Price
01-21-23 Charlie 1 Canine Rabies Vaccination, 3Y 28.00
01-21-23 1 Canine DA2PP + Lepto Vaccination 1Y 34.00
01-21-23 Visa payment -62.00
Old balance Charges Payments New balance
0.00 62.00 62.00 0.00
Reminders for: Charlie (Weight: 27.0 Ibs - 23m) Last done
01/26 Canine Rabies Vaccination, 3 Y 01-21-23
01/24 Distemper+ Leptospirosis Vacc 01-21-23
02/23 Canine Leptospirosis Vaccinati 02-05-22
Doctor's Instructions
Canine Rabies Vaccination, 3Y
A transient local reaction may occur at the injection site following subcutaneous
administration. In rare instances, administration of vaccines will cause lethargy, fever,
and inflammatory or hypersensitivity types of reactions. If you notice any other these
reactions, consult your veterinarian as soon as possible.
Omaha Pet Vaccination Clinic
84th & H Omaha, NE
(402) 443-2006
www.OmahaPetVaccinationClinic.com
CERTIFICATE OF VACCINATION Ad
Date of Rabies Vaccination: 11-30-22
Next Rabies Vaccination On: 11-29-25
VETERINARY CLINIC
Thone Animal Hospital
902 S Hwy 30
Blair, NE 68008
402-426-3630
This is to certify...
Certificate No: 2941
Previous Rabies Vaccination:
OWNER OF ANIMAL
Britni Gothier
2304 Nebraska St
Blair, NE 68008
County:
THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW.
Patient information...
PATIENT: Sid TAG NO: 008519
SPECIES: Canine WEIGHT: 46.00
SEX: N AGE: 21 months
Color and markings...
Signed
Dr.Kamala Freeman
Vaccinations done...
License: 3894
11-30-22 KF Rabies Vaccination (3 Year), #008519
11-29-25
11-30-22 KF DA2PPV 3yr 11-29-25
09-07-21 JRD Rabies Vaccination (1.Year), #007089
09-07-21 JRD DA2PPV
08-24-21 RXC Bordetella Oral
Rabies Vaccine Information...
MFG BY: ZOETI SER.NO: 583359
LOT EXP: 9-26-23 ADM: SQ
CERTIFICATE OF VACCINATION
Date of Rabies Vaccination: 03-26-21
Next Rabies Vaccination On: 03-25-24
VETERINARY CLINIC
Thone Animal Hospital
902 S Hwy 30
Blair, NE 68008
402-426-3630
This is to certify...
Certificate No: 2440
Previous Rabies Vaccination:
OWNER OF ANIMAL
Britni Gothier
2304 Nebraska St
Blair, NE 68008
County:
THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW.
Patient information...
PATIENT: Tim
SPECIES: Canine
SEX: N
Color and markings... Bk Tig/Org
Signed
Dr. Joe DiMari
Vaccinations done...
6�
y
TAG NO: 006573
WEIGHT: 62.00
AGE: 3 years
License: 3258
03-31-22
JRD
DA2PPV 3yr 03-30-25
03-31-22
JRD
Bordetella Oral 03-31-23
03-26-21
JRD
Rabies Vaccination (3 Year), #006573
03-25-24
03-26-21
JRD
DA2PPV
03-26-21
JRD
Bordetella Injectable 03-31-23
07-29-20
KF
Rabies Vaccination (I Year), #005972
Rabies Vaccine Information...
MFG BY: ZOETI SER.NO: 446459
If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made*- able to:
MR
City Of Blair 9 218 S 16th St e Blair,, NE 608
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: 61'16� ' 0
Owner Address: W U5 nS 2-?.>'Y�t
city/state/zip: Blair, NE 68008
Phone # LL6 Z-- 5-3-3 Zvi of %
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 anPlication.
Replacement Fee for Lost rag: $5.OU
Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program
D o ❑ Cat U(Spayed Neutered License Fee $ f I , 00
Pet Names � i - Birthdate � Zolu Sex AAa, [ ?-
Color !-� V6 u n Breed** Replacement $ * *
Declared Dangerous or Potentially Dangerou Dog: ❑ Y �( N
MICROCHIP # U 3 "5 4 1 (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: 3(ty 1 u L3 (3 yr) w� (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) _
(1 yr)
License Fee $
Replacement $
E ❑ 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 Q
If you have questions, please contact Blair Police Department at (402) 426-4747
....r..............++++++++++++++++++++++++++++++++++++.....++++++++++++.....
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date not applicable iornewpets/newresidenis)
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 W puppy/kitten 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,".
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 15,202
Owner Name:J,
Owner Address:
City/State/Zip: Blair, NE 6800
E t
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 renuires proof of rabies vaccination to
be submitted with your license application.
Replacement Fee for Lost Tag: $S.UU
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 N!
License Fee $ �
Pet N me , t..�".ti
Birthdate i ItieX`
Color A��_ I I
Breed**
Replacement $ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y N
MICROCHIP # 7 8, i 6 6 0 l 5
-� 1 57 (If applicable) ,
SUBTOTAL: $
RABIES VACCINATION DATE.
(3 yr) (1 yr)
City Tag #~
TTo 4-t�.i -1 S i
PET #2❑ Dog ❑ Cat ❑ Spayed06utered License Fee $ i 4
Pet Name Birthdate h°" � ` A
Color �)\<,, _ c v Breed** Replacement$ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y J N
MICROCHIP VACCINATION # 5i I t� d�. ! (If applicable) SUBTOTAL: $
ON DATE: I° e , (3 yr) (1 yr) City Tag #
t'�'r f4 � "C i t 9 `
PET # . _. ❑ Dog Cat ❑ Spayed/Neutered
Pet NameBirthdate Sex
Color Breed**
Declared Dangerous or Po Dangerous Dog: ❑ Y
tia
MICROCHIP # (If applicable)
RABIES VACCINATION DA (3 yr) _
W
i <` ' `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 L -
**
*
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/new residents)
Newly Acquired Pets: New Residents to Blair:
• Must be lioensed within 10 days of ownership m Must register pets within 10 days of
• <OR> at 6 months of age if puppy/kitten residency.
Patient,
Vaccination Records
Mar 17, 2023 at 2:56:04 PM
jogute@icloud.com
Created on Mar 17, 2023
Vaccination Records
Narne:BUDDY
Species: Dog
Broad- Sheltle
Gender: Neutered
DOB- 10/22/2016
Age: 6
Weight: 53.5lbs
Microchip #:
i981020015938157
Rabies Tag #: 000150
Bordetella 1 year Feb 28, 2023
Heartworm Test Vetscan In hous Feb 28, 2023
Client:
Jorls Gutowski
63-8N.-I.4thAve
Qlpir,._NF 68.008
Lepto - Cgip Vex (4 Way) Feb 28, 2023
Biannual Exam May 12, 2023
Rabies - 3Yr Feb 12,20124
I Dhp-Parvo(No Lepto) Adult 3Yr I Feb2.7, 2025
�A
PetDesk ti. "..,, : ,{
1,I�SVaccination Records
. Mar 17, 2023 at 2:43:05 PM
jogute@icloud.com
Patient:
Created on Mar 17, 2023
Vaccination Records
Client:
Narne: BEAR Joris Gutowski
Species: Dog 638 N.__1.4th Ave
Breed: Bernese Mountain Dog Blair, NE 680.08
Mix
Gender: Neutered
DOB- 8/23/2018
Age: 4
Weight: 97.51bs
Microchip #:
985112010441.109
Rabies Tag #: 001119
Intestinal Parasite Test Centr ( Feb 20, 2023 1
Bordetella Inj. 1 Yr Feb 28, 2023
Lepto - Cgip Vax (4 Way) Feb 28, 2023
Heartworm Test Vetscan In hous Mar 2, 2023
Biannual Exam May,12, 2023
Dhp-Parvo(No Lepto) Adult 3Yr Feb 12, 202.4
Rabies - 3Yr Nov 10,.2025
i
� ALL CREATURE
CITY OF BLAIR
® 2023 PET LICENSE APPLICATION 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 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 n �' t � l("f )t)
Owner Address:..IF.
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
Dog ❑ Cat ❑ Spayed/Neutered License Fee $ ).
Pet Na a Birthdate " - " Sex
Color l Breed** der" iF,rSE r Rep/acement$ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y LO N I
MCI BVACCINATION
(If applicable),,, SUBTOTAL: $ � � �°
N DATE: �_ ~ In =r 0 (3 yr) -L�— (1 yr) City Tag # 2 6,X *
ET # -_ ❑ Doc' ❑ Cat ❑ Spay `d/Neutered License Fee
Pet Name `� Birthdate Sex
Color (A° e/ V'i t i . Breed** Rep/acement $ * *
Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N
MICROCHIP # Jib i (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: ° l) I (3 yr) _ (1 yr) City Tag #
PET #3❑ DolW Cat ❑ Spayed/Neutered License Fee $ I )
Pet Name; I ��S ` � "I 7 Uift date q al -/ hex
Color Breed **k'Icy�P A Replacement $ **
Declared Dange olds 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 notappllcable fornewpeis/newresidents)
Newly Aiguired 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.
nt ID
1051
Phone:
Reminder Letter Report
Sorted by Client ID
Client Name Patient ID Patient Name Item ID/Description
Gibbs, Ronald & Ruth
(402) 533-9939
11939 Miss McGonagall 100 Rhino-Calici-Flu-PanLeu-Annual
84 Rabies Vaccination - Feline 3 year
3333 Rascal 100 Rhino-Calici-Flu-PanLeu-Annual
84 Rabies Vaccination - Feline 3 year
8825 Rowdy INTRA Oral Bordetella/Parainfluenza
86 Distemper/Parvo DAPP-Annual
151 Heartworm Test - Snap RT
82 Rabies Vaccination - Canine Syr
Type Date
L 4/13/2023
L 4/14/2023
L 3/5/2023
L 3/5/2024
L 2/4/2023
L 2/4/2023
L 2/4/2023
L 2/15/2023
Blair Small Animal Clinic PC Page 1 of 1 Date: 1/17/2023
/.)0Id
%S/
CITY OF BLAIR - 2022 PET LICENSE APPLICATION 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 • 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, 2022
Owner Name:
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 3/15/2022. 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 Flee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Prograr
PET # 1 ❑Dog ❑ Cat Spayed/Neutered License Fee $
Pet Name° Birthdate Sex
a "
Color Replacement$ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y 0 N
MICROCHIP # (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: _ (3 yr) (1 yr) ,f;; 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
(1 yr)
License Fee $
Replacement $ * *
SUBTOTAL: $
City Tag # *
PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $
Pet Name Birthdate Sex
Color Breed" Replacement $ * *
Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N
MICROCHIP # (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag #
*PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL
** (This fee is due along with License Fee if requesting at the time of license renewal.)
Do Not Send Cash byMa;f TOTAL ENCLOSED $
If you have questions, please contact Blair Police Department at (402) 426-4747
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Mard715late fee date not applicable for new pets/new residents)
Newly Acquired Pets: New Residents to Blair:
■ Must be lioansed whin 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
DovidE. JohmmoOvM
17u4Front Street
Blair, Nebraska, 68000
(*02)533-2722
Nbnteesa Munoz
1344Skyline Or
Blair, NEG8OO8
Client ID: 8824
Invoice #: 171405
Date: 1/3/2023
Patient ID: 14046 Weight: 70.00 pounds
Patient Name: Rk. Birthday: 12/20/2018
Species: Canine Sex: Neutered Male
Breed: Mixed Breed
Description
1/3/2023 HeodmmnnTeot-QnopRT
Emam|nation-VVeUnaas
LaotoeponuoiaVaccination annual
Diotempar/pon/oOAPP+Annuo|
[)na| Bondohe||o/Pona|nf|uenza
Rabies Vaccination -Canine 1yr
Microchip Implant & Enrollment
Reminder
O103/2024
O103/2O26
HearbwonnTeo -GnopRT
{]na|Bovdoba|la/PooainOuenzo
Rabies Vaccination - Canine 3yr
Lephooponoe|oVaccination annual
Distemper/ PamoDAPP-3year
Staff Name Quantity
Total
David E.Johnson DVM 1.00
$38.00
1.00
$30.00
1.00
$30.00
1.00
$40.00
1.00
$35.00
1.00
$30.00
1.00
$50.00T
Patient Subtotal:
8253.00
Invoice Total:
$253.00
default Tax Rate:
$3.50
Total:
$256.50
Balance Due:
$258.50
Previous Balance:
00.00
Balance Due:
$258.50
VISA Card Number: ... XXXX722S:
Less Payment:
($256.50)
Balance Due:
$0.00
Order your pets supplies online now through our websue www.bialrsmalIanlmalclInlc.vetsfirstchoice.com For questions contact
Blair Small Animal Clinic PC
Client ID:
Client Name:
Address:
Phone:
Tag Number:
Vaccine:
Producer:
Brand:
Type:
)nner of
Administration:
Staff Name:
License Number:
Doctor Signature:
8924
Montessa Munoz
1244 Skyline Dr
Blair, NE 68008
(402)224-0583
7339
Imrab Rabies Vaccine
Merial
Imrab 3 TF
Killed Virus
Subcutaneously
David E. Johnson DVM
1893
David E. Johnson DVM
1734 Front Street
Blair, Nebraska, 68008
(402) 533-2722
Rabies Certificate
Patient ID:
14046
Patient Name:
Ryr
Species:
''Canine
Breed:
Mixed Breed
Sex:
Neutered Male
Color:
White
Markings:
Brown Spots
Birthday:
12/20/2018
Weight:
70.00 pounds on 1/3/2023
Microchip ID:
Vaccination Date: 1/3/2023
Expiration Date: 1I3/2024
Lot Number: 18535
Drug Expiration Date: 11/17/2023
CITY OF BLAIR - 2023 PET LICENSE APPLICATION V* Lk -')-
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 lair 9 218 S 16th St e Blair, NE 68008A
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: `� �ur2 -►'t.�
Owner Address:
city/state/zip: Blair, NE 68008
Phone #
LICENSE FEES: Dog or Cat: $16.00
Altered Dog or Cat: $11.00
Replacement Fee for Lost Tag: $5.00
Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program
Dog ❑ Cat ❑ Spayed�leLicense Fee
Pet Name Birthdate r Sex
Color ^� Breed** L�i�►�cl 1 and Replacement $
Declare Dangerous or Potentially Dangerous Dog: ❑ Y !tN
MICROCHIP # (If applicable) SUJ TOTAL: $ T-6
RABIES VACCINATION DATE: (3 yr) 74(1 yr) City Tag # ,
ET #2 I111 Dog ❑ Cat a Spayed/ eut License Fee n
Pet Name Birthdate Sex **
Color Breed** Rep/acement $
Declared ang ous or Potentially Dangerous Dog: LY Y CYN
MICROCHIP # (If applicable) Sl! TOTAL: $
RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag #
❑ Dog ❑ Cat ❑ Spayed/Neut
Pet Name Birthdate
Color Breed**
Declared Dangerous or Potentially Dangerous Dog:
MICROCHIP # (If appli
RABIES VACCINATION DATE: (3
License Fee $
Replacement $
❑Y
abl SUIBTOTAL: $
r ( 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
***PLEASE READ FULLY***
YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS.
Failure to do so is a violation of City ordinances 6.103 and carries
a penalty of a fine up to $150.00 per pet.
PET LICENSES RENEWALS ARE DUE BY 3/15/2023. The City shall
recognize a microchip Identification number as the license number. It
shall be unlawful for any dog or cat to wear any license or other city
Identification other than that Issued by the City of Blair for such dog or
cat, The City of Blair requires proof of rabies vaccination to
be submitted with your license application.
I �
3yl
If you have questions, please contact Blair Police Department at (402) 426-4747
+++++++++a.+.++++.....+.++.+.....++++++++++++++¢+++++++++++++++++++++++++++++++
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March15/ate fee date notapplicablefornewpets/newre5ldents)
Newly Acquired Pets: New Residents to Blair:
• Must be licensed Wthin 10 days of ownership E Must register pets within 10 days of
• <OR> at 6 months of age if puppy/Idtten residency.
MILLARD VETERINARY CLINICS PC
5757 S. 144th St. & 17935 Welch Piz &
1515 S. 204th St Omaha, NE 68137
(402) 895-9595
Client ID:
27276
Patient ID:
Client Name:
Susan Gilstrap
Patient Name:
Address:
315 S. 20th St.
Species:
Breed:
Blair, NE 68008
Sex:
Color:
Phone:
(402)981-1557
%IarKings:
B rthday:
''.'eight:
.iicrochip ID:
Tag Number:
121819
Vaccine:
RABIES CANINE 3 YEAR
Producer:
Boehringer ingelheim
Brand:
Rabvac
Type:
Killed Virus
'inner of
Subcutaneously
Aministration:
Staff Name: Matthew S. Wrich:.
License Number: 3051
Doctor Signature:
27276-1
Leopold
CANINE
NEWFOUNDLAND
Neuter
Bik/wht
09,1912019
175,03 oourcv c , 9,19/2022
Vaccnat'c- 2-
Expiration Date: 9 19 2G25
is:',,.-----= _","Z=� CS
E, _ _ _ _- _ � _ _ _ 2325
MILLARD VETERINARY CLINICS PC
5767 S. 144th St. & 17935 Welch Piz &
1515 S. 204th St Omaha, NE 68137
(402)895-9595
Susan Gilstrap
315 S. 20th St.
Blair, NE 68008
Page 1 / 1
Client ID: 27276
Invoice #: 441923
Date: 10/11 /2022
(402) 981-1557
Patient ID: 27276-2 Species: CANINE Weight: 140.00 pounds
Patient Name: Flynn Breed: IRISH WOLFHOUND Birthday: 09/19/2020 Sex: Neuter
Description
10/11/2022 EXAMINATION W/VACCINATIONS
HEARTWORM/SNAP PRO TEST
ProHeart 12 (Moxidectin) 51-100 Ibs
BORDETELLA BOOSTER
Staff Name Quantity
Total
Sam L. Sroczyk, DVM 1.00
$42.50
1.00
$44.00
1.00
$102.98
1.00
$35.50
Patient Subtotal:
$224.98
Instructions
HEARTWORMS ARE PARASITES THAT LIVE IN THE HEART. THEY ARE TRANSMITTED BY MOSQUITO BITES
FROM ONE DOG TO ANOTHER. WE RECOMMEND THAT YOUR PET BE TESTED FOR HEARTWORMS
YEARLY AND PLACED ON A PREVENTATIVE MEDI- CATION. HEARTWORNI DISEASE IS SERIOUS AND IS
MUCH EASIER TO PREVENT THAN TO TREAT.
BORDETELLA-1ST: BORDETELLA IS A VACCINATION WHICH PROTECTS YOUR DOG AGAINST KENNEL
SOUGH. THIS VACCINATION IS RECOMMENDED FOR DOGS WHO MAY BE EXPOSED IN A KENNEL,
SOOMING PARLOR, DOG SHOW, OR BY HOSPITALIZATION. A BOOSTER IS RECOMMENDED EVERY 6
ivIONTHS IF ANIMAL MAY BE EXPOSED,
Reminder
02/01/2023
DHLPP VAC
04/11/2023
BORDETELLA BOOSTER
10/11/2023
HEARTWORM/SNAP PROTEST
1-100 Ibs
11/29/2024
RABIES CANINE 3 YE
Invoice Total:
Total:
Balance Due:
Previous Balance:
Balance Due:
Elkhorn South MasterCard:
Less Payment:
R R R
$224.98
$224.98
$224.98
$0.00
$224.98
($224,98)
($224,98)
$0.00
FOR YOUR PETS SAFETY WE CANNOT ACCEPT RETURNS ON DISPENSED DRUGS. HAVE YOU HUGGED Yoh io p--r
RABIES VACCINATION CERTIFICATE Tag tee:
ADAPTED NASPMV FORM 51 Tag #:
PRINT - use ballpoint pen or type Cert. Serial #:
Owner's Name & Address
PRINT LAST
FIRST
MI
TELEPHONE
� t CITY ��' (/t Y
NObi t7 S STREET c� S
STATE
ZIP , U vV cu
•
U�/VR
r
(. f llll
SPECIES: SEX:
AGE: I SIZE;
PREDO:.'JNANT BREED:
COLORS:
Dog G Male ❑
Months Uoc='" 20 lbs. O
Cat ❑ Female F 20-50 Ibs. Q
NAr:'e
Other Q Altered Years -1 I C, r 50 Ibs.
(Specify)
DATE VACCINATED:
PRODUCER:
Vet _- an's
License No.
1
Ir
Month Day Year
PRODUCT NAME:
Ve;❑'s Name (please print)
VACCINATION EXPIRES:
1
Si -3 _ ✓ r
I`llI EVFrF3N,',
1 yr. Lic/Vacc.
3 yr. Lic/Vacc. D
Month Day Year
ELKHORN. NE
Vacc, ,!al (Lot) No. }
y,
USCAHNON02066
VACCIN ON RECORD
Name
O RABIES
❑ LYME DISEASE
❑ CANINE DISTEMPER
ID CANINE PARAINFLUEN17A
❑ CANINE ADENOVIRUS 2
D CANINE PARVOVIRUS
D CANINE CORONAVIRUS
J CANINE BORDETELLA
D LEPTOSPIROSIS
❑ FELINE LEUKEMIA VIRUS
J FELINE PANLEUKOPENIA
FELINE RHINOTRACHEITIS
J FELINE CALICIVIRUS
J FELINE CHLAMYDOPHILA
W
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 28 S 16th St e Blair, NE 600
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: P rn G l A S ly-
Owner Address: 7`) ) ND ?-)'CA e)ILY- iWEL 0 ON
city/state/zip: Blair, NE 68008
Phone# 46A- &(�-6q34
LICENSE FEES: Dog or Cat: $16.00
Altered Do or Cat• $1i 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
PET #1 CND o g ❑ Cat ['Spayed/Neutered r License Fee $
Pet Name Mil 1 i Birthdate g 0 "1 Sex
Color (,'Td,p,tvk Breed** 1)6 Ltt)L Replacement$ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y N
MICROCHIP # 995 1 � 10 0 5 o 14 3t'aX (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: j - 9 `l —A 4 (3 yr) ' (1 yr) City Tag # not) *
PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered
Pet Name Birthdate Sex
Color Breed**
Declared Dangerous or Poter�tlally Dangerous Dog: ❑ Y
MICROCHIP # <j (If applicable)
RABIES VACCINATION DAT : (3 yr) _
(1 yr)
License Fee $
Replacement $
SUBTOTAL:$
— City ,.
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 NCL r
If you have questions, please contact Blair Police Department at (402) 426-4747
++++++++++++++++++++++++++++++++++++++++++..........+++++++++++++++++++++++++
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date notapplicable for newpefs/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/Idtten 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 16h 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 O adult cats per residential or dwelling unit.
LICENSE RENEWALS ARE DUE: arch 15. 2023
Owner Name:
Owner Address:
xz
city/state/zip: Blair,, NE 68008
Phone #
LICENSE FEES: Dog or Cat: $16.00
Alt d n^ or Cat• 11 00
***PLEASE 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 rgciuires proof of rabies vaccination to
be submitted with your license application.
ere g .
Repialcernent Fee for Lost .Tag: $5.luo
Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program
PET #1 ❑ Cat )4 Spa..ed/Neutered License Fee $
Pet Name Birthdate ' ' (Sex L
Color k - i ' Breed** IN' 'C'f , "") Replacement $ **
Declared Dangerous or Potentially Dangerous Dog: 0 Y ❑ N
MICROCHIP # (If applica7) SUBTOTAL: $
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 ❑ N
MICROCHIP # (If applicable)
RABIES VACCINATION DATE: (3 yr)
(1 yr)
License Fee $
Replacement $
., •
T #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 I5/ate fee date notapplicable for newpets/newresidenl;)
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.
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 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:;,
(o)
Owner Address:
i '
City/State/Zip:
Blair,, NE 68008
h
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 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 Mate Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program
T # 1 Dog ❑ Cat E Spayed/Neutered License Fee $
Pet Name Birthdate Sex \ **
Color Breed** Replacement
Declared Dangerous or Potentially Dangerous Do ❑ Y N
MICROCHIP # (If applicable) SUBTOTAL. $_ !
RABIES VACCINATION DATE: (3 yr) Y (1 yr) City Tag #
PET # 2 '' Dog ❑ Cat r_Spay d/Neutered License Fee $
Pet Name 0\�v Birthdate I Sex
�**
ColorBreed** Replacement $
Declared Dangerous or Potentially Dangerous Dog: ❑ YN•��
MICROCHIP # (If applicable)} . SUBTOTAL: $
RABIES VACCINATION DATE: ).'R ; a-' (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 LI 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
++++++.......++++++.....r+++++......+++++....................+++++++++++.....
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (/March i5late fee date not applicablefor newpet5/new residents)
Newly Acquired Pets., New Residents to Blair:
• Must be lionised within 10 days of ownership N Must register pets within 10 days of
■ <OR> at 6 months of age if puppy/kitten residency.
CERTIFICATE OF VACCINATION
Al
Date of Va ccin tion: 07-26-23ID d'
Next Vaccination on: 07-25-26
VETERINARY �dU1 IG-- -
Pet Vaccination Clinic
2911 S. 120th St.
Omaha, NE 68144
402-480-3393
Certificate No. 36287
Previous Vaccination:
OWNER OF ANIMAL
Sondra Godfrey
1761 Park St
Blair, NE 68008
(531) 209-0362
This is to certify...
THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES.
Patient information...
PATIENT: Monroe TAG NO: 238406
SPECIES: Canine BREED: Beagle
SEX: Neutered Male AGE: 24 months
WEIGHT: 0.00 Ibs COLOR: Tri Color
MICROCHIP:
MFG BY: ZO TI, SERIAL: 694846I PIRES:'03195124, ADMIN: SQ
Signed: r \ ✓'� ` �'
korde,Pduli, DVM icense: 1614
Other Vaccinations...
CERTIFICATE OF VACCINATION
Date of Vaccin��}}ti' n: 07-26-23 )
Next Vaccinati� on: 07-25-26 , 0
VETERINARY CLII�I'
Pet Vaccination Clinic
2911 S. 120th St.
Omaha, NE 68144
402-480-3393
Certificate No. 36288
Previous Vaccination:
OWNER OF ANIMAL
Sondra Godfrey
1761 Park St
Blair, NE 68008
(531) 209-0362
This1s to certify...
THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES.
Patient information...
PATIENT:
Mayor
SPECIES:
Canine
SEX:
Neutered Male
WEIGHT:
0.00 ibs
MICROCHIP:
TAG NO:
238406
BREED:
Beagle Mix
AGE:
24 months
COLOR:
Tri Color
MFG BY: ZO TI, SERIAL: 594846, ')EXPIRES: 03/05/24, ADMIN: SQ
Signed:
o4te�Pauli, DVM ' L cense: 1614
Other Vaccinations...
k
i b
Red Barn Veterinary Clinic & Farmacv, PC
101 E. 10th
Oakland NE.68045
(402) 685-5202
Rabies Certificate
Client ID:
6775
Patient ID: 102332 r
�.
Client Name:
Tim & Maria Goede
Patient Name: Betty
Address:
2812 Larsen Drive,
Species: Canine
Blair NE 68008
Breed/Color: Retriever, Labrador,
Sex: Spayed
yellow
Female
Phone:
(402) 649-7044
Date of Birth: 12/15/2012
Weight: 50.6
Microchip ID:
Rabies Vaccine Information:
Vaccine Date:
2/21/2023
Date Due:
2/21/2024
Tag Number:
230502
Lot Number:
536061
MFG By:
Zoetis - IMRAB 3
Lot Exp:
3/28/2023
ADM:
Subcutaneous)
I have vaccinated against Rabies for the specified animal as described above.
Dr. James F. Unwin, DVM
Dr. Patrick T. Maline, DVM
Dr. Kellie M. Wise, DVM
Dr, Alyssa K. Hiatt, DVM
Red Barn Veterinary Clinic & Farmacy, PC
101 E. 10th
Oakland NE.68045
(402) 685-5202
Rabies Certificate
Client ID: 6775 Patient ID: 119529 5
Client Name: Tim & Maria Goede Patient Name: Smooch
Address: 2812 Larsen Drive, Species: Canine
Blair NE 68008 Breed/Color: Aust. Red Heeler, Sex: Spayed
Female
Phone: (402) 649-7044 Date of Birth: 1/11/2020 Weight: 34
Microchip ID: 981020045533585
Rabies Vaccine Information:
Vaccine Date:
2/21/2023
Date Due:
2/21/2024
Tag Number:
230501
Lot Number:
536061
MFG By:
Zoetis - IMRAB 3
Lot Exp:
3/28/2023
ADM:
Subcutaneous)
I have vaccinated against Rabies for the specified animal as described above.
Dr. James F. Unwin, DVM
Dr. Patrick T. Maline, DVM
Dr. Kellie M. Wise, DVM
Dr. Alyssa K. Hiatt, DVM
BUD uln% Page 1/2
VETFmmARY CLINIC & F4nmAcvP.Q.
\ 13` E|oTH ^ om<LA.!.u�soacmo
Client ID: G775
llm&M��Go�e
Invoice 2812Larsen Dhva.
�
Blair, NE 68008 Date: 2/21/2023
CanineWeight:34�o poundsP���|D: i1�28 Species:
Patient Name: Smooch Breed: Aust. Red Heeler Birthday: 01/11/2020 Sex: Spayed Female
Description Staff Name Quantity Total
2/21/2023 Annual Vaccinations Canine Kellie M. Wise DVM 1.00 $0.00
Office Call/Exam with Vaccinations 1.00 $13.00
RABIES CANINE 1 YEAR BOOSTER 1.00 $15.00
PROCESSED BY ST-THANK YOU-- Julie Themes, LVT 1.00 $0.00
Patient Subtotal: $327.70
— uctions
-----�AYEXPERIENCE G0K8ELETHARGY AND SORENESS FRONlTHE VACCINATIONS, THIS IS
'--'' —� �WITH VERY YOUNG ANIMALS. |FTHIS PERSISTS LONGER THAN 24HOURS, PLEASE CALL OUR
OFF|CE,
HEARTWORMS ARE WORMS THAT LIVE IN THE BLOOD AND ARE TRANSMITTED BY MOSQUITO BITES. WE
RECOMMEND THAT YOUR PET BE TESTED FOR HEARTWORMS YEARLY AND PLACED ON A PREVENTATIVE
MEDICATION. HEARTVV{)R&1DISEASE |SSERIOUS AND |SMUCH EASIER T{)PREVENT THAN T(}TREAT.
Reminder
01/20/2023
KENNEL COUGH, N1UC0GAL
02/21/2024
DHLPPANNUAL (Oist&Penm)
RABIES CANINE 1YEAR BOOSTER
02/21/2025
HEARTVVORK8TEST /RAP|D\
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CITY OF BLAIR - 2023 PET LICENSE APPLICATION 0
If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to:
City of Blair • 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: te,�
Owner Address:
city/state/zip: Blair, NE 68008
Phone # 44a 41617e,
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 reauires 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 o g ❑ Cat ❑ Spayed/Neutered License Fee $
lwl-
Pet Name Birthdate liglzllz, Sex 4-1
Color �w4Tf
Dangerous o Breed** o � Replacement **
r Potentially Dangerous Dog: ❑ Y ®mN
MICROCHIP # (If applicable) SUBTOTAL: $ 3 1`
RABIES VACCINATION BATE: 101ly-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
MICROCHIP # (If applicable)
RABIES VACCINATION DATE: (3 yr) _
JIM
License Fee $
Replacement $
SUBTOTAL: $
(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(Mard715late fee date notapplicablefor newpels/newresideMs)
NewlYAcquired Pets: New Residents to Blair:
■ Must be liioff� within 10 days of ownership ■ Must register pets within 10 days of
■ <OR> at 6 months of age if puppy/ldtten residency.
Client ID:
Client Name:
Address:
Number:
Vaccine:
Producer:
Brand:
-rvpe:
fanner of
Administration:
4479
Jeff & Erin Goldyn
814 Meadow Drive
Blair, NE 68008
(402)650-8790
6287
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
Patient ID:
9042
Patient Name:
Rocky
Species:
Canine"
Breed:
Australian Shepherd Mix
Sex:
Neutered Male
Color:
Tri
Markings:
Australian Shepard/Beagle Mix
Birthday:
08/31 /2016
Weight:
76.10 pounds on 10/29/2022
Microchip ID:
981020017696802
Vaccination Date:
2/27/2021
Expiration Date:
2127/2024
Lot Number:
18490
Drug Expiration Date: 7/3/2021
Blair Small Animal Clinic PC
David E.Johnson OVM
1734Front Street
l Blair, Nebraska, 88008
�
Client ID:
4479
Patient ID:
Client Name:
Jeff & Erin Goldvn
Patient Name:
Address:
814Meadow Drive
Species:
Breed:
Blair, NE08OO8
Sex:
Color:
Phone:
(402)650-8790
Markings:
Birthday:
Weight:
|
Microchip ID:
Tag Number: 6785 Vaccination Date:
Vaccine: |nnnabRabies Vaccine Expiration Date:
Producer: Merial Lot Number:
Brand: \nlnab3TF Drug Expiration Date:
/ Killed Virus
,,annorof Subcutaneously
Staff Name: David E.Johnson OVM
License Number: 1893
| Doctor Signature:
12258
Ruby
7
Canine
Mixed Breed
Spayed Female
Black
OS/OG/2O2O
62.GOpounds on0/1 D22
981028037002580
-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 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 ARE DUE:���, arch 15, 2023
n
Owner Name: �AOL "tl 6�(�+�' wa)� .x
Owner Address: 10, -1 01 V .nth U'rG,� -
city/state/zip: Blair,, NE 68008
Phone # LI' Uj - ;.I fib,- �),5 � �-
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 recluires 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 # Dog ❑ Cat Spayed/Neutered License Fee $
Pet Name ' Bir&ate Sex !®
Color Breed** /? ; ,x Replacement $
Declared Dangerous or Potentially Dangerous Dog: ❑ Y N
MICROCHIP # (If applicable) SUBTOTAL:$ 16, U
RABIES VACCINATION DATE: Z 2 2 (3 yr) 9 (1 yr) City Tag # 2-
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) _
■W
(1 yr)
License Fee $
Replacement $
SUBTOTAL: $
City Tag #
❑ 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 15late fee date not applicablefornewpets/new residents)
Newly Acquired Pets: New Residents to Blair:
• Must be lioansed within 10 days of ownership m Must register pets within 10 days of
• <OR> at 6 months of age if puppy/kitten residency.
Blair Small Animai, Clinic PC
David E. Johnson DVM
1734 Front Street
Blair, Nebraska, 68008
(402) 533-2722
Client ID:
2502
Patient ID:
9076
Client Name:
Adam & Jennifer Grabowski
Patient Name:
Lexi
Address:
1027 Mary Beth Circle
Species:
Canine
Breed:
Labrador Mix
Blair, NE 68008
Sex:
Spayed Female
Color:
Black
Phone:
(402)426-5552
Markings:
Birthday:
12/19/2012
Weight:
72.80 pounds on 2/14/2023
Microchip ID:
AVID016054036
Tag Number:
6861
Vaccination Date:
2/11/2022
Vaccine:
Imrab Rabies Vaccine
Expiration Date:
2/11/2025
Producer:
Merial
Lot Number:
18520
Brand:
Imrab 3 TF
Drug Expiration Date:
5/22/2023
Type:
Killed Virus
..fanner of
Subcutaneously
Administration:
Staff Name: David E. Johnson DVM
License Number: 1893
Doctor Signature:
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 2181th St 9 Blair, NE 6808
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: arch 15, 2023
I
Owner Name: \ CNA{L F K" Co , CC- CO
Owner Address: 3 r C_l
city/state/zip: Blair, NE 600
Phone # L4 0(a - (9 S �- ?q y
LICENSE FEES: Dog or Cat: $16.00
Altered Do or Cat: AM 00
***PLEASE READ FULLY***
YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS.
Failure to do so is a violation of City ordinances 6.103 and carries
a penalty of a fine up to $150.00 per pet.
PET LICENSES RENEWALS ARE DUE BY 3/15/2023. The City shall
recognize a microchip identification number as the license number. It
shall be unlawful for any dog or cat to wear any license or other city
Identification other than that Issued by the City of Blair for such dog or
cat. The City of Blair requires proof of rabies vaccination to
be submitted with Tour 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 $ �� G
Pet Name Birthdate ) uvu 2 -1 Sex
Color Breed** h.hr..d,)v- Replacement$ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y A N Gd
MICROCHIP # (n po _ � � Y U (If applicable) SUBTOTAL: $ _/_
RABIES VACCINATION DATE: q . q Zo tit (3 yr) (1 yr) City Tag # 2 9 1/ -7.-*
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)
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
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.
Date of Rabies Vaccination: 09-09-22
Certificate No: 0
Next Rabies Vaccination On: 09-08-26
Previous Rabies Vaccination: 19-0951
VETERINARY CLINIC
OWNER OF ANIMAL
Countryside Small Animal
Mike Green
1306 Stevenson
2382 Grant Circle
Fort Calhoun, NE 68023
Blair, NE 68008
402-468-4060
County:
This is to certify...
THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW.
Patient information...
PATIENT: Sammie
TAG NO: 22-0721
SPECIES: Canine
WEIGHT: 72.60
SEX: S
AGE: 4 years
BREED: Retriever, Labrador
Microchip Number: 600335868
Color and markings... Chocolate
Signed
Kaycee Points
License:
Vaccinations done...
09-09-22 KNP Canine Rabies Vaccn, 3 Yr, #22-0721
09-08-25
09-09-22 KNP Canine Bordetella Oral Vaccination
09-09-23
09-09-22 KNP Lyme Disease Vaccination 09-09-23
09-09-22 KNP Canine DA2PPL 09-09-23
Rabies Vaccine Information...
MFG BY: ZOET SER.NO: 536242
LOT EXP: 18APR23 ADM: Sq
01/12/2023 16:15 4024260101 HOLSTEIN VET CLINIC PAGE 02/02
2023 PET LICENSE
VERIFICATION/APPLICATION FOR CITY of BUIR
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. 16T" ST — BLAIR, NE 168008
YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS,
BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT,
***PLEASE READ CAREFULLY***
YOU ARE REQUIRED BYLAW TO LICENSE )LOUR PETS TIE CITY OF BLAIR REQUIRES PROOF OF RABIE$ VACCINATION
Failure to do so is a violation of •City Ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet.
PET LICENSE tj�111EWALS ARE DI1t: C3Y 3/15/20�.,
The city shall recognize a microchip ID number as the license number.
It shall be unlawful for any dog or cat to wear any license or other city ID other than that issued by the City of Blair for such dog or oat,
NEW PET -LICENSING Must be licensed within 10 days of ownership (OR) at 6 months of age If puppy or kitten
NEW RESIDENTS TO BLAIR Must register pets within 10 days of residency
Owner Name
Spouse
Owner Address
City/State/zip
Phone #
Pet Name: Bella Mae
Age: 7Y
DOB: 03�19-16
Breed: Pug
Sex: Spayed Female
Microchip 0 985112004608003
Esther Gunderson
909 N 26th Ave
Blair, NE 68008
402-426-5956
Tag # 1763
Color: Fawn
Rabies Tag # 23010
PLEASE INCLUDE CITY TAG NUMBER, IF THIS IS A RENEWAL (IF AVAILABLE). #
RABIES VACCINATION bdNE ON 01-12-23
Rabies Description; YEAR 3 YEAR
Holstein Veterinary Clinic
'Dr. Lisa Schrum DVM Dr. Krista Holstein DVM
71$ South 191" Street Blair, NE 68008
402-426-7387 402-426-0101 Fax
holsteinclinic@gmail.com
LICENSE FEES '
lorect
Dog or Cat: $16,00
Bred
Dag o at: $1 .00
Replacement rag
$6.00
+
`1
Total $
PETS THAT ARE 0 THE ACME POTENTIALLY DANGE OUS OR
AANGEROUS vog LIST NEED TO REGISTER DIRECrLYAT CITY HALL,
FAXED 01-12-23
BY
•.'ii. :.:}:. �n.�',5:•r.l"ti, r, :••,•i 'a.:.�Yi:., ri; .a.`.R',
01/12/2023 16:15 4024260101 HOLSTEIN VET CLINIC PAGE 01/02
2023 PET LICENSE
VERIFICATION/APPLICATION FOR CITY OF BLAIR
IF YOU LIVE IN BLAIR CITY LlmrrS AND OWN A DOGS) AND /OR CAT(S),
COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE T0:
CITY OF BLAIR - 218 S- 16T" ST - BLAIR, NE 68008
YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS,
BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT.
***PLEASE READ CAREFULLY'
UU H CLLUID vy I.IYYYj
-
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 LI_CgNSE REN.WALS ARE RUE 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.
n FW PET LICENSING Must be licensed within 10 bays of ownership (OR) at 6 months of age if puppy or kitten
NEW RESID,(~ NTS TO GLAIR Must register pets within 10 days of residency
Owner Name
Spouse
Owner Address
CitylState/ziip
.Phone #
Pat Name: Pugs
Age: JY
DOB: ' 07'-07-13
Breed: Pug
(Microchip #
Sex: Spayed Female
Esther Gunderson
909 N 26th Ave
Blair, NE 68008
402-426-5956
Color: Black
llabies Tag # 17832
PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): #
RABIIES VACCINATION [BONE ON 03-24-20
Rabies Description: • 1 YEAR
H01stein Veterinary Clinic
'-Dr. LISa Schrum DVM . Dr, Krista HD/ateln DVM
718 South 1911 Street Blair, NE 68008
402-426-7387 402-426-0101 Fax
holsteincliniC@grnail.com
EAR
LIG NE M FEEB
Intact
Dog or Cat: $16.00
ereDo�,A
r cat: $11. 0
Replacement Tap
$5.00
Total $ 1
E7 THAT ARE pN THE AC71VE POTEN71'ALLY DANGEROUS OR
ANGE OU5 DOS Gt T NEED T4 EGISTER P! EC7LYA7 CITYHALL.