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Sis I CITY OF BLAIR ® If you live in Blair City limits and own a clog(s) and/or cat(s), complete this form and return with check made payable to: City Of Blair 9 218 S 16th St @ Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2023 Owner Name:y"Io33`s 0-owl yl ` r f� Owner Address: I 9 Volcn 0 i V`t' Ie— City/State/Zip, Blair, NE ..11 LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 ***PLEASE READ FULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penaltyof 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 ®payed Neutered _. License Fee _ Pet Nam"—Z��IAYV'A Birthdate Se Color Breed** Replacement $ ** Declared Dangerous or Potentially Dangerousbog: ❑ Y U-N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # 553 PET # Dog ❑ Cat ®` Spayed/Neutered � License Fee $ Pet Name L""C' / Birthdate Sex Color Breed** Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y -1 MICROCHIP # (If applicable) SUBTOTAL: $ 8 RABIES VACCINATION DATE: '70 (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 $ rjjZAr If you have questions, please contact Blair Police Department at (402) 426-4747 .....++++++++++++++++++++++++++++++.......... ++++++..... ++++++++++++++. ++++++ + NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date notapplicable for newpets/newre5idenis) Newly Acquired Pets: New Residents to Blair: • Must be licensed within 10 days of ownership 0 Must register pets within 10 days of • <OR> at 6 months of age if puppy/Idtten residency. Holstein Vet Clinic 718 South 19th Street Blair, NE 68008 402-426-7387 Printed: 03-14-23 at 12:11p CLIENT INFORMATION Name Erin McGinn (8382) Address 1181 Voss Circle Blair, NE 68008 �iiL��iPI •' � • rr•7► Name Zoey (Record - 26161) Sex Female, Spayed Birthday 07-31-19 (unknown) ID 985141002132499 Color Reminded (none) Reminders for: Zoey 01-19-24 Vanguard® Rabies 3 (3 YEAR) 04-13-23 Vanguard® DAPP {Distemper} 11-16-22 Vanguard® B ORAL ( Bordetella MEDICAL HISTORY - Vaccination View Date By Code Description 04-13-22 KKH 410005 11-16-21 LS 410009 01-19-21 LS 4RAB3 410005 Patient Chart Species Canine Breed Eng Bulldog Age 3y (unknown) Rabies 18829 Weight 55.10lbs Codes Last done 01-19-21 04-13-22 11-16-21 Qty (Variance) Photo Vanguard® DAPP {Distemper} Vanguard® B ORAL { Bordetella } Defensor 3 (3 Year Rabies), #18829 Vanguard Plus 5 Holstein Vet Clinic 718 South 19th Street Blair, NE 68008 402-426-7387 Printed: 03-14-23 at 12:10p CLIENT INFORMATION Name Erin McGinn (8382) Address 1181 Voss Circle Blair, NE 68008 PATIENT INFORMATION Name Lucy (Record - 26370) Sex Female, Spayed Birthday 04-15-20 ID 985141002127874 Color Red and White Reminded (none) Reminders for: Lucy Species Canine Breed Cav KC Spaniel Age 2y Rabies 19324 Weight 28.50lbs Codes Last done 07-12-24 Vanguard® Rabies 3 {3 YEAR} 07-13-21 07-15-23 Vanguard@ DAPP {Distemper} 07-15-22 07-15-23 Vanguard® B ORAL { Bordetella 07-15-22 MEDICAL HISTORY - Vaccination View Date By Code 07-15-22 LS 410009 410005 07-13-21 KKH 4RAB3 410009 410005 Description Vanguard® B ORAL { Bordetella } Vanguard® DAPP {Distemper} Defensor 3 { 3Y RABIES ), #19324 Vanguard® B ORAL { Bordetella } Vanguard® Plus 5 { Distemper } Patient Chart Qty (Variance) Photo CITY OF BLAIR - 2023 PET LICENSE APPLICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair • 218 S 16th St • Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2023 Owner Name: ° e, �� C i.ki Irv) Owner Address: 9 City/State/Zip: Blair, NE 68008 Phone # ` 9 ? / — :3 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 State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program b PET # 1 Dog ❑ Cat Spayed/Neutered License Fee $ % 0 Pet Name_ ' ; Cj Birthdate �a Sex _ Color (��y j�/,� n -� Breed** �; oi(v/�{P� �/�7.> �/� Replacement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y _q-N MICROCHIP # S (If applicably SUBTOTAL: $ RABIES VACCINATION DATE: 4o ' (3 yr) (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 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 $m 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 for new pels/newresidents) Newly Acquired Pets: New Residents to Blair: ■ Must be licensed within 10 days of ownership ■ Must register pets within 10 days of 0 <OR> at 6 months of age if puppy/kitten residency. eMedical... This is a medical report for Olivia from Rockbrook Animal Clinic P.C.. Rockbrook Animal Clinic P.C. Page:1 Medical Records from 09/25/2022 to 0912512023 Olivia Owned by Cindy & Jeff Smith 09/2512023 01:21 PM Cindy & Jeff Smith Work: 3030 Westridge Dr. Cell: 402.981-3844 Blair, NE 68008 Pager: Home: 402-981-3844 Fax: Email: cjsmilh@abbnebraska.com Patient: Olivia Patient#; 10166.0001 Last Seen: 09/13/2023 species: Canine Bom: April 24, 2022 Age: 1 yr 5 mo Breed..: Goldendoodle Mini Chip ID: 985141006416888 Sex: Female -Spayed Color: Apricot File #: Weight: 20,40 Allergies: Rabies: Tag: Type: Last Given: Mfg: Next Due: Lot M Inoculations and Due Dales: Dale Due Action Date Due Action #01:11117/2023 Bordalella #02:06/2012024 Dhpcpv #03:06120/2024 Leptospirosis #04:0910512024 Heartwormllick disease test #05:06/20/2026 Rabies Inoculation 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 e 218 S i th St 9 Blair,, NE 68 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: �� )r city/state/zip: `lair, 6808 Phone # ` b2— rL 1r -� `"/(j 4 LICENSE FEES: Dog or Cat: $16.00 Altered Do or Cat. $11 00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/15/2023. The City shall recognize a microchip identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city Identification other than that Issued by the City of Blair for such dog or cat, The City of Blair requires aroof of rabies vaccination to be submitted with your license application. 9 • keplacement 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 $l Pet Name Birthdate Sex Color ' _ Breed** fit® l� EC-4+1- C Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y Q N MICROCHIP # '� ,r � �'�� (If Za�*ca�141e SUBTOTAL: RABIES VACCINATION DATE l (1 yr) City Tag #* 1" #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ W (1 yr) License Fee $ Replacement $ SUBTOTAL:$ *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) v ®o Not send Cash by Mail TALE L E ( ,�� If you have questions, please contact Blair Police Department at (402) 426-4747 +++++++++++++++++++++++++++++++++++++++++++++++++++++¢++++++++++++++++¢+++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Marchl5/ate fee date notapplicablefornewpets/newresldents) Newly Acquired Pets: New Residents to Blair: • Must be lioensed within 10 days of ownership 0 Must register pets within 10 days of • <OR> at 6 months of age if puppy/kitten residency. c p c (D 0 D v Ln (D (D x O z 0 O O O O O O O m 7 n c C C n m �°�' �°�' p ro m p 00 o Crt� D *� �_ Q m r�D rn to fD CL N x �, ~' Q Q (n N Ln Z Z O r� v Ocr m 0 Ln w cu 3 o n CD (D m m 3 3 v m c r+ 0 N h r-h v (D < ;c � O W fD ❑ \ \ w =3 O r+ N (D S VNi VNi LA ((DD UWi Z r+ N N rD O O O m Q (D tPr O N O N Q N 00 01 p * p (OD 00 =5 V (D 06) m r+ ' (D (D C� < < ❑ p p p p p p p p p v O o o O o — — �° a°o a°a = GQ m On uq voa Q °t 1+ 0- p N v; v; v; '^ v; m o oCL cp v v p7 o ro o> z V (D a) rn o 3 O . < p m N o- n —� — o. .. (D -s p (D m CL z rt 3 � z (D v � (D (Do v (D S S O m r=-h fD 0 p _t O LU O O �Q ❑ m p .. ❑ © w °' (D -- D v 0 77 N K (D n 0 (D W (D (D ~' r0 G m < m v m r+ Ln M (D < o O m D v v v w v v Ln C rt r+ rF nni rty rF ani r+ rh r+ nni rh p�j r+ n p (n to (A v; (A Lq vi u v v O Ln � (D (D v � Q Q 0 3, rt m �, - O (D v O O =3 O rD rF. v W r+ O p O r -n O m d �n x r+ D _ rD Ln K f RABIES VACCINATION CERTIFICATE Rabies Tag #: 230466 Date Vaccinated: FEB 6 23 Expiration Date: FEB 6 26 Owner HEATHER SARGENT 1329 LINDEN DRIVE BLAIR, NE 68008 402-350-1266 RABIES VACCINATION - 3 YR Date: FEB 6 23 Time: 11:12 Manufacturer: Zoetis Inc Lot / S/N: 595590 Discard Date: FEB 6 24 Patient Name: AVERY Species: CANINE Breed: MIX, LABRADOR RETRIEVER Color: BLACK Gender: FS DOB: AUG 3 13 Weight: 84 Ibs ID1: 985112000686663 ID2: 210518 I hereby certify that this animal has been vaccinated in accordance with the manufacturers recommendation for the vaccine used on the above date. DR. TIFFANY HUERTER License Number: 4060 c A rn O D v S (D Pr fD fD X O T Z O O O O O O O ® -n ::a ::ar Z r n r r r c c: rn m fD c 3 p Q s m m rn rn o m o m v LA a u, 3 m f D � OD (7 Dn ,� (-sD rn m m ran m ru m cnLAM (D o �' O N r+ rt _ Q - I m m xa n' c Z f ��= a)Q O_ fD N m Z z d�q �r d p fD a -h m Z r N c o p O 04 _. r N (D N r+ p rF r+ rD ❑ O O lND ram+ N IQ U (n r� N ;;aS Ul N Cn l0 CD U1 z r+ N C) o m Q N o N o N Q N Ql � W00 N "O al 0O 00 O p d cu `V -n rt O I im p p p p p p p p p v On _< O _< O O O % 3 �+ Q DOq OOU GQ UQ m m m m cn m V �q D m O O Q- p cn v to v Ui v r (W N Z (n N �D N m fD f') wW C� X OD (D 3 O < p �^ `^ y -I m p g( N Q 3 O m N C o r+ rD dD (D O N m G O "O O O C Q O C W O j N C fD p .. O °�' ❑ © W N r b W \ - - N pp O v_ N 3 \ D \ m No p0 No N w N a (n m m < -� m -o fD r. ::a s fD o O v v � v (n v t r r r+ r t r r I-t r+ r+ v r+ r+ v CD < < w r) N (D D z - n m m n nD O o w O �1 m '^ - i CL m -n 1 (D w -> O fD -s' (Dp r+ O 3 n' rt r0r rD < O rt r ( W rw+ O cn p O = ram+ r+ ❑ ❑ -n O X� r+ i D rD L L RABIES VACCINATION CERTIFICATE Walnut Creek Veterinary Clinic Date: FEB 6 23 11336 S. 96th St. Suite 106 Papillion, NE 68046 Time: 11:12 402-505-5445 402-934-6467 Rabies Tag #: 230465 Date Vaccinated: FEB 6 23 Expiration Date: FEB 6 26 Owner HEATHER SARGENT 1329 LINDEN DRIVE BLAIR, NE 68008 402-350-1266 RABIES VACCINATION - 3 YR Manufacturer: Zoetis Inc Lot / S/N: 595590 Discard Date: FEB 6 24 Patient Name: TIMBER Species: CANINE Breed:. MIX, LABRADOR RETRIEVER Color: BRINDLE Gender: MN DOB: MAR 20 13 Weight: 116 Ibs ID1: NO CHIP ID2: 210519 I hereby certify that this animal has been vaccinated in accordance with the manufacturers recommendation for the vaccine used on the above date. DR. TIFFANY HUERTER License Number: 4060 :;a Z O O O O O O O ® -n ::o �a r Z r r r r s O � -n n O 3 : : � (D m -o m -a (D A; o- m m m m (D "' m m m u (Ao �, O (D m= 70 m fD � p -z W o -i n D -s -c „ m ', n (Dm n (D m m (D rD Z (A M O G Q r + �^i Q —I v m "O c� _ Q Q rDD Ln rD Z Z ~' Q on O + -s v O m o- —h r a ° N 3 c nli o, o m GQ m 00 W 3: (D (DD S Nj p U.) � lNri Lrl Z NO NO n O m (D N N O = O � w N cu CY) O O O j p 00 vLn � % rt 'n I 3 (D ;M ci o < < ❑ p p p p p p p p p n O 3 o' — o — ET O op O ao o ao o v4 O m O cm O (m O as O m O �_ 3_ 3 m rt O O 0- p v, V v � � W � V, N �^ vi- Z O N m to � m v rD w m m On — O X = (D w—o-, 3 O < " p �^ v Ln o- n - I n m m m m Q Z rD m 3 CJ n rt_ m m O m m < p O o o c CL m Q w O L m O \ N r m 3 v NJO \ (D (D CD 0 m 0 m Ln Ul O O 7 m I m r+ Ul (D L7 m O O r3D D n v v rr v C nni nni nni ani oni oni s cu � v v Ln v V) p7 Ln 0 LA Ln D Ln z 3 � m (D < m r� m x rogD °' O� 3 rt m `^ CL - I 3' CL fD 3 -n D m �, �' � z m m h o O w c 0 _+ 3 p p O rt r p (Dw m a =3 v m(D f+ ❑ ❑ -n O X 13 I D 0 m N 01/27/2023 11:64 4024260101 HOLSTEIN VET CLINIC 2023 PET LICENSE PAVE U11UZ VERIFICATIONIAPPLICATION FOR CITY OF GLAIR IF YOU LIVE IN 13LAIN CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHr:(.K PAYABLE TO: CITY OF SLAIR - 218 S. 16TH ST - BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION Or- FOUR (4) ADULT PETS, BUT NO MORE THAN`THREE(3) ADULT DOGS OR THREE (3) ADULT CAT$ PER RE51UENTIAL OR DWELLING UNIT. "**PLEASE READ CAREFULLY"" YOU ARE REQUIRED Y LAW TO LICENSE VINF ID 01 ty afi 0 P a 16 , 0 a Failure to do so 1.9 a violation of City Ordinances6.103 and carries a penalty of n u t $ 0 0 per pet. PET JLIQENSE RENEWALS ARE. I D'L!E BY 3z75/2023, The city shall rGoognize a microchip ID number as the license number. It shall be LlhlgWfU) for any dog or cat to wear any licenro or other olty ID other than that issued by the City of Blair for such dog or cat. ��K LICENSING Must be lioensed within 10 days of ownrrshjp,'(0R) at 6 months of ago if puppy or kitten aW_RESIDENT 3j,Q_BtA(R Must register pets within 10 days of residency Owner Name Spouse James Satterfield Mary Lou Owner Address 350 S 12th Street citylstate/zip Blair, NE 68008 Phone # 402-427-4672 Pet Nariie- Bear a #1914 Aqe,. 12Y Sax, Mole Color: Brown 0013: -05.01-10 Breed: Chihuahua Microchip # Rabies Tog 4 17966 PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE)# RABIES VACCINATION DONE ON 06-05-20 Rabies Description: I YEAR YEAH Holstein Veterinary Clinic Dr, Lisa Schrum 0 VM : Dr. Krista Holstein D V114 718 South 1911 Street Blair, NE 68008 402-426-7387 402-426-0101 Fax hQ1steinqh.nic@ gma il-com LICENSE F Dog Altered Dog or cat,. $11.00 Replacement 7-09 . $5,00 Total $-Au— TSTHAT ARE ON THE ACTIVE f yfJTENT1ALty pANGER0�15 (}R DANGEROUS DOG LIST NEED TO 1?05giLTEER6LRD'jatgn)A G•r�HALL. FAXED 01-27-23 01-27-2 BY L -141 0— 6' J. 01/27/2023 11:04 4024260101 HOLSTEIN VET CLINIC PAGE 02/02 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR Ir YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(Sj, COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OE BLAIR — 218 S. 16TH ST — SLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CArs PER RESIDENTIAL OR DWELLING UNIT, ***PLEASE READ CAREFULLY*** ,YQU ARE REQUIREDRV LAW T- LICEN$ YOUR Pt^ S CITY aF EMI IaIR REQUIRES PRdC1F ©E RABIES VACCINATIIN. Failure to do so is a violation of City Ordinances 6.103 and carries a penalty of a fine Lip to $150,00 per pet, PST' LICENSE �tENEWAL� ARE bUE BY 3/75/20�3. The city shall recognize a microchip ID number as the license number. It shall he unlawful for any dog or oat to wear any license or other city ID other than that issued by the City of Blair for such dog or cat. NF,PET Llav, NSWG Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten Must register pets within 10 days of residency Pet Name; Baby Girl Age 16Y DOB: —10-01-06 : Chihuahua, Microchip # Sex: Spayed Female PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RhWE7 RABIES VACCINATION DONE ON T05-05-20 Rabies Description: 1 YEAR Tag #1913 1 Color:Black .Holstein Veterinary Clinic Or. Lisa .Schrum D VV : Dr, krista Holstein D VM 718 South 1 91hStreet Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteinclinic@grnail.coni Rabies Tog # 17995 (IF AVAILABLE): YEAR PETSTHATARE ON THE A C77VEPOTE L&N Q LICENSE FEIES Intact Dog or Cat: $16.00 AZ Dog o cat: $11 0 kt�y '96plavarnent Tag $5.00 Total FAXED 01-27-23 BY '419' ITY ." 02 ALL! 4— C +j to U a .0 r- m E 0 4— r— E m uo Z < x a) Ln 0 (U U CO Y) -� -N -� -� m m m m m u u u u u LU ca Z 0 i E -2 0 Ln U ca -�nN YI -�n Y, bo W W w tw 0 0 0 0 0 0 0 0 0 C) N 0 0 r,4 Ln Ln CY) 00 H �o -_ cq rf) r- rH [:] Q- u u u > > � a) V CL (1) (A M -N u u u u N O ('4 F] F] a) 4� m a) C: r-i 0 (3) -P 0- m Z -- s 1�1 u u cu m u u (1) m m m u a) V) C) -�n UD -v) W bio UO 0 0 0 0 0 0 C) 0 4-1 E -C u m I, u two > M (10 V) c 0 0 4� C: W E � E > > 0 u L: 0 0- c txo E m (D 41 m iE m E E E NI-- M u .2 z m m V) 41 w=5 0 4� bb 0 z z a) Ln E =$ Y 0- C: a) m 4- 4� +1 V) _0 Z V) Ln �E . 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N v c u 9 \ v N >l O _ U U U a) cn Z Q In U m > > Q a1 a 0 0 N _n � to _tn _tn v1 vI by (/') p w < M tea E f O O by O bA O bA O bA O W O by O O w O O O O O u Q p p p p p p p p p ❑ > > U ai a1 LL W L a1 •Q V C �I p O L p 00 O rn c Q N O O00 � O ® N N O a Cm i O 0 ON \ Vv 4J @ a1 ui z t0 N 0_ d i m c rn oc t_ ax1 N � \ N C a1 O +- _ C m -i ❑ (6 � � m m Q J p d L1 v N +1 n' m N N m L Q) � a) W V i = U L `� cn J O L O L C a L N Q b E Qj N � O a1 C Q i QJ m p U O .�..+ Cab f— Z L E m E a1 U J O 4—O @ Z (.n C f6 sa.1 Z � W 6 L n3 C °- U a1 N a) N a1 aJ U U L- LL J Q U m m p L a1 a1 � C a1 a1 �=3 (/) N Vl aJ V7 .Q In V !b V (6 N W L a1 c L (a) c L a1 c L a1 c L a) c L a1 c L a1 -Q c V C O a1 a1 a1C E a1C Q a a1 :3 LL LL ® O 0 0 0 0 O 0 Z 03/27/2023 15:54 4024260101 HOLSTEIN VET CLINIC PAGE 01/02 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /Ofl CATiS), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR - 218 S. 16T" ST -- BLAIR, NE 68006 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) AQQLT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR QWELLING UNIT, '"PLEASE READ CAREFULLY"" YdN. Failure to do so is a violation of City Ordinances 6-103 and carries a penalty of a fine up to $150,00 per pet. ,PET LICENSE RENEWALS ARE QU BY 3/16l2023 , Tl7e city shall recognize a microchip ID number as the license number. It shall be unlawful for any dog or cat to wear any license or other city ID other than that issued by the City of glair for such dog or cat, NEW PET I,I(:✓;N;SING Must be lit;ens9d within 10 days of ownership (OR) at 6 months of age )f puppy or kitten NEW HESIDENI,$ TO BLAIR Must register pets within 10 days of residency Owner Name Spouse Michaela Schenkelberg Brandon Hoesch - - Owner Address 734 S 21st ST City/Mate/Zip Blair, NE 68008 402-960-4775 Pet Name: Sprout Tag #3080 Age: 4Y DOB:—03-24-15 Sex: Neutered Male Color: Gray Breed: Domestic Longhair Microchip # 985141003117158 Rabies Tag /# PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): # RABIES VACCINATION DONE ON 03-27-23 Rabies Description: 1 YEAR 3 YEAR Holstein Veterinary Clinic Or. Lisa Schrum DVM Dr. Kris'ta P/olstein DVM 718 South lgtn Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteinolinic@gmail.com MEUSE FEES lrttact Dog or Cat: $16,00 A/ Dog o at,, $11.00 ReRlacament Tag $61.d0 V� Total $ p�Ts THAT Af;l: QN THE AGTfyln F'DTENTIACLY DANGERQU$ 2 OA GERDUSQpf,C(STNEEDTOREGISTERQIRG�TLYATC(TYNQLI. FAXED 03-27-23 - BY 03/27/2023 15:54 4024260101 HOLSTEIN VET CLINIC PAGE 02/02 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A L)OG(S) AND /OR CAT($), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR — 218 S. 1 ST" ST — BLAIR, NE 68068 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 R> SIDENTIAL OR DWFLL,ING UNIT. ""PLEASE READ CAREFULLY"* YOU ARE REQUIRED BY LAW TO LICENSE - OUR PETS. THE CITY LAMS -1R REQUIR96PROOF OF RAVACCINATIO Failure to do so is a violation of City Ordinanc4s 6.103 and carries 8 penalty of a fine Up to $150.00 per pet. PET LICENSE, (RENEWALS ARE DUE �Y 9/75/2023. The city shall recognize a microchip ID number as the ll.cefiso number. It shall be unlawful for any dog or cat to wear any license or other city ID other than that issued by the City of Blair for stich dog or cat NEW PET LICENSING Must be licensed within 10 days of ownership (OR) at 6 months of age it puppy or kitten NEW39-$IDENTS TO BLAIR Must register pets within 10 clays of residency Owner Name I Michaele Schenkelberg Sp6use Brandon Boesch Owner Address 734 S 219t ST City/State/Zip Blair, NE 68008 Ph6ne # 402-960-4775 Pet Name, Sunshine Age: 9Y Sex,, $payed Female 008, 07-01-13 • Tag #3048 Color: Black Breed: Border X Microchip # 985112002973844 Rabies Tag # 23204 PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE)- # RABIES VACCINATION DONE ON 03.27-2 Rabies Description: 1 YW 3 YEAR Holstein Veterinary Clinic ,Dr. Lisa Sdhruln D11M : Dr. Krista Holstein DV/VI 718 South 19t' Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteinclinic@gmail.com LICENSE FEES h7tact Dog or Cat: $16,00 • A �or d Dog or cat,. $11 -0 Replacement rag $5.00 Total $ DR DAN9 H) L ' C , If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair 9 218 S 16th St e Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS A E: March 15, 2023 Owner Name: �011 ` VIVA Owner Address: VLF city/state/zip: Blair, NE 68008 Phone # qa fir":5 r� -s— 86 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 3116/2023. 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 T #1 p9g ❑ Cat ' "Spayed/Ne to ed License Fee $ 8,0 Pet Name Birthdate Sex �_ Color Breed** Replacement$ ** Declared angerous or Potentially Dangerous Dog: ❑ Y �. N MICROCHIP # 9 �6' // Z OW SL�q 'T4 r (If applicable) SUBTOTAL: $ I t t'' RABIES VACCINATION DATE: Selz 1 (3 yr) (1 yr) City Tag # 6111 S 5 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 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 $P jt,00 If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++.++++++++++++++++++++++++++++++++++++++++++++++++++++++++¢++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date not applicable fornewpe&lnewresldents) 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. 01/06/2023 14:37 4024260101 HOLSTEIN VET CLINIC PAGE 01/02 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF SLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO; CITY OF BLAIR - 218 S. 16TH ST -- BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT. ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BYLAW TQ LICFNSE YOUR PETS. HE CITY OF BLAIR REQUIRES F OF ABIES VAGWEIAMNI, 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 LIQIENSE RENEWALS ARE QUE 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 glair for such dog or cat. NEW'PET LICENSING.Must be 04;ensed 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 r Owner Name Bob Schoby Spouse Shelly Owner Address 2924 Westridge City/State/zip Blair, NF, 68008 Ph�,ne # 402- Pet Name: Mya Tag ,#31 Age: 9Y DOB: 05-30-13 Sex: Spayed Female Color: Sable/Whit Breed: Shih Tzu Mix Microchip # Rabies Tag # 18304 PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): # RABIES VACCINATION DONE ON 09.25-20 Rabies Description' I' YEAR 3 YEAR Holstein Veterinary clinic Dr. Lisa Schrum V IA714 : Dr. Krista Holstein DVM 718 South 1911 Street Blair, NF 68008 402-426-7387 402-426-0101 Fax holstsincliriic@0meil.cem LICENSE FEES intact Dog or Cat: $16.00 Itered D g or cat: $11.00 ,Replace ag $6.00 Total $ PETSTHATAR�t;7NTN ACTIVE POTENTIALLYlSANGEROUSOR DANGEROUS DOG tl T NEED TO REGISTER D1R9CTLY T CITV HALL. FAXED 01-06-23 BY 01/06/2023 14:37 4024260101 HOLSTEIN VET CLINIC PAGE 02/02 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(5) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR — 218 S. 16T" ST — BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL, OIL DWELLING UNIT. ***PLEASE REAID CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS HE CITY OF BLAIR REQUIRES PROOF OF RABIES VAOOINATION. 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 RENEWAL ARE DUE BY 3/15/2023. The oity shalt 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 IA other than that Issued by the City of Blair for such dog or cat. Ngw 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 13ob Schoby Spouse Shelly Owner Address 2824 Westrldge City/State/Zip Blair, NE 68008 Phone # 402- Ipet Name: Bella Tag #3292 Age: 9Y DOB: 05 30-13 Sex: Spayed Female Color: White/Tan 8r6ed: Shih Tzu Mix Microchip # Rabies Tag # 18303 PLEASE INCLUDE CITY TAC NUMBEFt IF THIS IS A RENEWAL (IF AVAILABLE): # RABIES VACCINATION DONE ON 09-25-20 Rabies Description: 1 YEAR 3Y R Holstein Veterinary Clinic Dr. Lisa Schrum DVM : Dr. Krista Holstein DVM 718 South 101h Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteinclInic@gmaiI-com LICENSES Intact Dog or Cat; $16.00 D or .4/t cat: $ ed ,OO Replacement Tag $6.00 Total $ --- J PET THATARE ON THE ACTIVE POT$NTI LLY DANGEROUS OR DANGEROUS DOG LIST NEED TO RE�'1$1';Eii DI ECTLY AT CITY HALL FAXED 01-06-23 BY 4,;,' Jan 09 23 01;24p CITY OF BUIR - 2021 PET LICENSE APPLIC,A7ION If you live In Blair City limits and own a drag($) and/or cat(s), Complete this furrn and return with check made payable ta; City taf Blalr a 218 S 16th St • Blailrr 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. 2021 --**PLEASE RFgD CAREPIJLLY*** Owner Name:\ �% YOU ARE REQUIRED By LAWTO LICENSE YOUR PETS. Owner Address; WA U , Failure to do so is a violation of City ordinances 6,1A3 and carriesCity/statef Zip: Blair, NE 68008 Phone # a penalty of a Fine up to $130.00 per pet PET LICENSES RENEWALS ARE DUE 8Y3115/2021. The Cityshall recognize a microchip identification nuntbar as the license number. It LICENSE FEES: Dog or Cat: $16.00 LIde,ndrication all Ie unlawful for any dog or cat to wear any license or other city Altered Dog or Cat., $tI.00 other than that issued by the City of Blair for such dog or . The MY of glair requires proof of rabies vaccination. Replacement Fee for Lost Tag: $5.00 Included is a Shade Fee of $1.2.5 being aotiecbed to fund the Nebraska Dog & Cat Operator Insp ection Program PET #1 Dag.0 Cat Spayed/Neutered Pet NJBirthdate ! : f Sex License Fee $ _ Caior Breed** Lv Declared Dangerous or Potentially Dangerous Dog; ❑ Y N ReP�acement$ MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE;�?-T(3 ' yr) a yr) City Tag # PEA` *2� © Dog ❑ Cat 7 Spayed/Neutered Pet Name Birthdate License Fee $ Color Breed** Sex Declared Dangerous or Potentially Dangerous Replacement $ ** Dog; ❑ Y MICROCHIP # ❑ N (If applicable) RABIES VACCINATION DATE: SUBT®T�1L. $ (3 yr) (1 yr) CityTag TPET #3 CI Dog Q Cat Q Spayed/NeuteredName Birthdate License Fee $ Color Breed** Sex Declared Dangerous or Potentially Dangerous Dog: 0 Y ❑ N Replacement *� MICROCHIP # (If applicable) RABIES VACCINATION DATE; SUBTOTAL: $ (3 yr) *PLEASE INCLUDE THE CETYTAG NUMBER IF THIS Is A RENEWAL ** (This fee Is due (1 yr) _ City Tag # along with License Fee if requesting at the time of license renewal.) Do Not Send Cash byMafl TOTAL ENCLOcSED if you have questions, please contact Blair Police Department at (402) 426-4747 ++++4+............-I..........[•........+++++f....4.............................. NEW� NEWAr-z*, RESIDENT L3CEN5IWG, REQIJEREMENTS (Ma�zh ed Pets, 15/atefl�e datenotaWYka6le lix new�z;/rrAvrre�7c a MtEt tie fioa d witfren 10 d2ys ofIvvna ip ■ <pf at 6 monthsof at iI I A�'/tatta>tt its) mew Re 1111 nis tiD Blair - Must register pets Wlll7in 10 claysof ies4derry CITY OF BLAIR - 2023 PET LICENSE APPUCATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair o 218 S 16th St o Blair, ME 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6,103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/1512023. The City shall recognize a microchip Identification number as the 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. ment Fee for Lost Tag: $5.00 �;,F `Ii�){1J.' �7`',"<.1? 7 PET #1 Dog 0 Cat ASp yKTAI d VLicense Fee I,.,Pet Narne b � Birthdate�exe acement ColorBreed R p/ Declared Dangemus or Potentially Dangerous Dog: 0 Y gN MICROCHIP # N_ (If applicable U T 'T L: $ RABIES VACCINATION' DATE:' (3 yr)�' �� ►� (1 yr) CityTag #�* r PET #2 ® Dog 0 Cat 0 Spayed/Neutered Pet Name Birthdate Sex — Color Breed** Declared Dangerous or Potentially Dangerous Dog: 0 Y 0 N MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) License Fee $ Replacement $ *'^ S ,_ s$ i_stpa;.:, PET #3 ® Dog 0 Cat 0 Spayed/Neutered License Fee $ Pet Name Birthdate Sex ** Color Breed** Replacement Declared Dangerous or Potentially Dangerous Dog: 0 Y 0 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.) Oko Not Send Cash by Mail TOTAL • If you have questions, please contact Blair Police Department at (402) 426-4747 NEW PET/ NEW RESIDENT LICENSING REQUIREMENTS (March 15late fee date notappllcable fornewpets/new residents) Newlv Acqulred Pets: New Residents to Blair: Must be licensed whin 10 days of ownership m Must register pets within 10 days of <OR> at 6 months of age if puppy/kitten residency. Countryside Small Animal 1306 Stevenson PO Box 119 Fort Calhoun, NE 68023 402-468-4060 Printed: 07-20-23 at 10:41 a CLIENT INFORMATION Name Meadow Scott (3032) Address 2975 Southern Hills Dr Spouse Curt Blair, NE 68008 Phone 402 426-2542 PATIENT INFORMATION Name Louis (8116) Species Canine Sex Male, Neutered Breed Boxer Birthday 12-14-18 Age 4y ID Rabies 23-0122 Color Fawn and White Weight 68.00 Ibs Reminded (none) Codes Reminders for: Louis Last done 02-26-26 Canine Rabies, 3 y 02-27-23 06-22-24 Heartworm Test, Antigen 06-23-23 02-27-24 Canine DA2PP-L 02-27-23 05-01-20 Canine Bordetella Oral 05-02-19 HEALTH HISTORY SUMMARY Date Diagnosis 01-27-23 TOENAIL INJURY 5th digit, Left hind foot 03-23-21 TOENAIL INJURY Louis's weight history (in Ibs) 06-23-23 68.00 02-27-23 66.80 03-04-22 65.20 03-23-21 65.40 02-04-21 62.00 04-07-20 57.00 06-22-19 43.40 05-02-19 32.80 04-06-19 27.00 03-19-19 19.20 02-26-19 16.25 MEDICAL HISTORY Date By Code Description 07-05-23 VS0 VS0 [Order Shipped] Interceptor Interceptor 6 Flavor Tabs Dogs 51 -1 00lbs/Cats 12.1-25lbs (White) Tracking: 92748999984672553578878614 Patient Chart Oty (Variance) Photo Patient Chart for Louis Date: 07-20-23, Time: 10:41a Client: Meadow Scott Page: 2 Date By Code Description Oty (Variance) Photo Order #46956592 (Autoship) Prescribed by: Dr. Kaycee Points Quantity: 1, Amount: $68.79No refills GIVE 1 TABLET BY MOUTH EVERY 30 DAYS FOR PREVENTION OF HEARTWORMS & CONTROL OF INTESTINAL PARASITES, 06-23-23 KNP HWA Heartworm Test, Antigen Well CHECKIN Patient check -in 6/22/2023 10:42 AM: Appointment confirmed by text Age:4y Weight:68.00 SUBJECTIVE SECTION 6/22/2023 10:42 AM: Appointment confirmed by text PLAN SECTION TREATMENT PLAN Heartworm Test, Antigen Well 02-27-23 KNP RV3 Canine Rabies Vaccn, 3 Yr, #23-0122 DA2PL Canine DA2PP-L Vaccination EXAMV Examination w/ Vaccinations CHECKIN Patient check -in 2/26/2023 11:11 AM: Appointment confirmed by text Age:4y Weight:66.80 SUBJECTIVE SECTION 2/26/2023 11:11 AM: Appointment confirmed by text PLAN SECTION TREATMENT PLAN Canine Rabies Vaccn, 3 Yr Canine DA2PPL 01-27-23 KNP ZT1635 TOENAIL INJURY 5th digit, Left hind foot PREV227 Previcox 227mg Chewable Tablet 3 Give 1/2 (one-half) tablet by mouth every 24 hours for inflammation and pain. Give with food. Stop giving if vomiting, diarrhea, or decreased appetite occurs. Start: Friday, January 27. BAND1 Bandage Application, Level 1 EXAM2 Examination/Consult, Brief/Return CHECKIN Patient check -in broken nail vJu vaU turaer 5nippeal interceptor Interceptor 6 Flavor Tabs Dogs 51 -1 00lbs/Cats 12.1-25lbs (White) Tracking: 92748999984672553568621787 Order #42195091 (Autoship) Prescribed by: Dr. Kaycee Points Quantity: 1, Amount: $64.99 Fill 1 of 2; 1 remaining GIVE 1 TABLET BY MOUTH EVERY 30 DAYS FOR PREVENTION OF HEARTWORMS & CONTROL OF INTESTINAL PARASITES. 07-13-22 KNP HGL Heartgard Plus 51-1001b 6 HWA Heartworm Test, Antigen Well CHECKIN Patient check -in HWA Age: 3y SUBJECTIVE SECTION HWA PLAN SECTION TREATMENT PLAN Heartworm Test, Antigen Well 07-12-22 KNP PHONE DENIED INTERCEPTOR REQUEST Needs HWA test before she can purchase online 03-04-22 KNP NT35+ HWA BORD DA2PL EXAMV CHECKIN Age:3y Weight:65,20 SUBJECTIVE SECTION Nail Trim - 35 pounds or more DECLINED: Heartworm Test, Antigen Well DECLINED: Canine Bordetella Oral Vaccina Canine DA2PP-L Vaccination Examination w/ Vaccinations Patient check -in 3/2/2022 1:48 PM: Appointment confirmed by email 3/3/2022 1:48 PM; Appointment confirmed by text Patient Chart for Louis Date: 07-20-23, Time: 10:41a Date By Code Description Client: Meadow Scott Page: 4 Oty (Variance) Photo PLAN SECTION TREATMENT PLAN Canine DA2PPL 10-05-21 KNP HGL Heartgard Plus 51-100lbs 04.05-21 KNP HGL Heartgard Plus 51-100 Ibs 03-23-21 KNP ZT1635 TOENAIL INJURY PREV227 Previcox 227mg chew tab SIM200 Simplicef 200mg tab (Cefpodoxime) HWA DECLINED: Heartworm Test, Antigen Well BORD DECLINED: Canine Bordetella Oral NT Nail Trim DA2PL Canine DA2PP-L EXAMV Examination w/ Vaccinations CHECKIN Patient check -in Age: 2y Weight, 65.40 SUBJECTIVE SECTION declined Bord PLAN SECTION TREATMENT PLAN Canine DA2PPL 02-04-21 KNP OTIC Cytology, otic EXAM2 Examination/Consult, Brief/Return CHECKIN Patient check -in Age: 2y Weight:62.00 SUBJECTIVE SECTION Recheck ears 2/3/2021 7:43 AM: Appointment confirmed by email 2/3/2021 6:31 PM: Appointment confirmed by text 01-21-21 KNP AP016 Apoquel 16mg tab TRIZKE+4 TrizEDTA Keto w/ Animax 4oz OTIC Cytology, otic EXAM1 Examination/Consultation CHECKIN Patient check -in Age: 2y SUBJECTIVE SECTION check ears 2 6 5 10 14 Patient Chart for Louis Date: 07-20-23, Time: 10:41 a Date By Client: Meadow Scott Page: 5 Cade Description Qty (Variance) Photo 1 /20/2021 5:08 PM: Appointment confirmed by text 04-07-20 KNP HWA DECLINED: Heartworm Test, Antigen Well Attachments\3032\Louis\scan8116_04072020. pdf BORD DECLINED: Canine Bordetella Oral NT Nail Trim RV3 Canine Rabies Vaccn, 3 yr, #20-0315 DA2PL Canine DA2PP-L EXAMV Examination w/ Vaccinations FLGOLDLi Frontline GOLD 45-88 single HGL Heartgard Plus 51-100 Ibs CHECKIN Patient check -in Age:16m Weight:57.00 PLAN SECTION TREATMENT PLAN Canine Rabies Vaccn, 3 Yr Canine DA2PPL Canine Bordetella Oral Vaccination 06-28.19 KNP PHONE EMAIL TO OWNER PHONE PHONE CONSULTATION 06-22-19 KNP NEODXDR NeoPolyBw/Dex Ophthal Suspension FLU Fluorescein Stain, ocular STT Schirmer Tear Test MISC UNL Cytology Interpretation Attachments\3032\Louis\scan811636222019. pdf IMP Cytology, Impression EXAM1 Examination/Consultation CHECKIN Patient check -in Age:6m Weight:43.40 SUBJECTIVE SECTION check lump 06-12-19 KNP HGM NGL1 05-02-19 KNP NGL1 HGM PREV57 NT BORD HOME CAST50A KETNAL CHECKIN Age:19w Weight:32.80 SUBJECTIVE SECTION Heartgard Plus 26-50 Ibs Nexgard 24.1-601b Single Dose Nexgard 24.1-601b Single Dose Heartgard Plus 26-50 Ibs Previcox 57mg chew tab 4 Nail Trim Canine Bordetella Oral DECLINED: Microchip, Home Again Castration, Canine 26-50 Ibs <6mos Pre -anesthesia, IV Ketamine/Valium Patient check -in Patient Chart for Louis Date: 07-20-23, Time: 10:41a Date By Code Description Client: Meadow Scott Page: 6 Oty (Variance) Photo Neuter, Bord booster 04-06-19 KNP NT Nail Trim Age: 16w BORD-IN Canine Bordetella Intranasal Initial RV1 Canine Rabies Vaccn, 1 yr, #19-0347 DA2PL Canine DA2PP-L EXAMV Examination w/ Vaccinations CHECKIN Patient check -in Age:16w Weight:27.00 SUBJECTIVE SECTION adult vxn 03-19-19 KNP HGS Heartgard Plus 0-25 Ibs NEXFD2 Nexgard Free Dose 10.1-24 DA2PL Canine DA2PP-L EXAMV Examination w/ Vaccinations CHECKIN Patient check -in Age:13w Weight:19.20 SUBJECTIVE SECTION Booster 02-26-19 KNP NT Nail Trim , FEC-F Fecal Examination, Flotation DA2P Canine DA2PP EXAMN Examination -New Puppy/Kitten Attachments\3032\Louis\scan8116_02262019. pdf HGPFD25 Heartgard Puppy Free Dose 0-25 FLPFDI Frontline Puppy Free Dose 5-22 CHECKIN Patient check -in Age: 10w Weight:16.25 SUBJECTIVE SECTION Boxer new puppy fecal CITY F BLAIR® 2023 PET LICENSE APPLICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair 9 218 S 16th St e Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2023 Owner Name: —De n "''t s S Q Ho r1 Owner Address: i 0 2 Y N-2 9'ill 0 C- city/state/zip: Blair,, NE 688 Phone # go z- 4 2- l.. 4q t 7 LICENSE FEES: Dog or Cat: $16.00 Altered Do or Cat: $11 00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3115/2023. The City shall recognize a microchip Identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city Identification other than that Issued by the City of Blair for such dog or cat, The City of Blair reauires Proof of rabies vaccination to be submitted with your license application. g Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET #1 ® Dog ❑ Cat ❑ Spayed/Neutered License Fee $ 16 - o v Pet Name M a c Birthdate q ' s / Sex M o-1 e, Color yr lI Breed** ILa.. b Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y 0 N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: 10 -1 - s (3 yr) (1 yr) City Tag #'7 PET #2 ® Dog ❑ Cat W Spayed/Neutered License Fee r' ° o Pet Name 6. 17 Birthdate 'T . .6' Sex Color 6.p_,L Breed** 'La,b Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y N MICROCHIP # (If applicable) SUBTOTAL: $ r A/ • 0 O RABIES VACCINATION DATE: I -/ I (3 yr) ✓ (1 yr) City Tag # l 7 1 $ * PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate Sex — Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y U N MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) License Fee $ Replacement SUBTOTAL: $ (1 yr) City Tag *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not send cash by Mail TOTAL L ° T 6 b If you have questions, please contact Blair Police bepartment at (402) 426-4747 ++++++++++++++++++++++++++++++++++++++++++++++.+++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Marchl5/ate fee date notapplicablefor newpeis/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. 03/16/2023 16: 57 4024260101 HOLSTEIN VET CLINIC PAGE 04/04 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOOM AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO. CITY OF BLAIR — 218 S.'j$TH ST — BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, 13UT NO MOFIL THAN THREE (a) ADULT DOGS OR THREE (3) ADULT CATS PER RE51DENTIAL OR DWELLING UNIT, ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LIOENSE YOUR PETS. TH ION. Failure to do so is a violation of City Ordinances 6,103 and carries a penalty of a fine up to $150.00 per pet, PET LICENSE RENEWALS ARE DUE BY 3/15/2023, `rho city shall recognize a rnicrochip ID number as the license number. It shall he unlawful for any dog or cat to wear any license or other city ID other than that issued by the City of Blair for such dog or cat. NEW PET LICENSING Must be licensed within 10 days of ownership (OR) at 0 months of age if puppy or kitten NEW RESIDENTS TO BLAIR Must register pets within 10 days of residency Owner Name Tim Shaeffer Spouse Jenny Owner Address 1062 N 28th St Blair, NE 68000 City/State/Zip Phone# 40 -659-4878 Pet Name: Bella Tag #3423 Age: 14Y DOB: —07.04-08 Sex: Spayed Female Won White/Tan Breed: Shih Tzu Mix Microchip # Rahles Tag # 18018 PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE); # RABIES VACCINATION DONE ON 06-13-20 Rabies Description: 1 YEAR EAR Holstein Veterinary Clinic Or Lisa Schrum D VM : Dr. Kfista Holstein D VA4 718 South 1 91h Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holstainciii-iic@gmail.com LICENSE FEES Intact Dog or Cat: $16.00 Prer-1-7-) Dog cat; $jA0 Reptacement Tag $5.00 Total $ l t FET-5 THAT ARE ON THE ACTIVE F"TENTIA"y OANGERDU-' OR DANGEROUS DOG Ll LIST NEED To REGISTER DIREC7 _LYATCIIYHALL G 0 ER FAXED BY 03/16/2023 16:57 4024260101 HOLSTEIN DIET CLINIC PAGE 03/04 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY -OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND/OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYAI3LE TO: CITY OF BLAIR -.. 218 S, 16TH ST — BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING, UNIT. ***PLEASE READ CAREFULLY*"O ydU ARE. R)*QU1RC=b �tY LAW TO LICENCE YQUR PETB T(`#E CITY c�F �LAFR RPGtUI ES PFI[fc�F QF RAt31EB V�GDINATICaN, Failure to do so is a violation of City Ordinances 6,103 and carries a psnalty of a fine tip to $150.00 per pet. PET LICE SE RENEWALS ARE DUE BY 3/95/20�3 The city shall recognize a microchip ID number as the license number, It shall be unlawful for any dog or cat to wear any license or other city ID other than that issued by the City of Blair for such dog or cat. NEAPET LICENSING Must be licensed within 1D days of ownership (OR) at 6 months of age if puppy or kitten NEW RESIDENTS TO RLAIR Must register pets within 10 days of, residency Owner Name Tim Shaeffer Spouse Owner Address Jenny 1062 N 28th St city/State/Zip Blair, NE 68008 Phone # 402-659.4878 Pet Name: Luna Tag #454 Age: 12M D0 13: 02-25-22 Sex, Fernale Color: Gold Broad: Golder! Retriever Microchip ## Rabies Tag # 20448 PLEASE INCLUDE I;iT'Y TAG NUMBER IF THIS IS A AENFEVVAL (IF AVAILABLE): # RABIES VACCINATION DONE 0+6-23-22 Rabies Description: 11• YEAR 3 YEAR Holstein Veterinary Clinic Dr. Lisa Schrum DVM : Dr. Ktista Holstein DVM 718 South 19r' Street Blair, NE 68008 402-426-7387 402-426-0101 Fax h alsteinchnic@gmail,corn L( gN$E FEES et Do or Cat: $16. Altered Dog or cat: $11.00 Replacement Tarim/ $6,00 Total $ M BETS THAT ARF ON THEACTIVE, POTENTIALLY D. GEROUS OR DANGEROUS DOG US�O REGISTER DIREG7LYAT CITY HAbt. FAXED 03-1 6i-23 BY 03/16/2323 16:57 4024260101 HOLSTEIN VET CLINIC PAGE 02/04 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHI50K PAYABLE TO: CITY OF BLAIR - 218 S. 16Ta ST - GLAIR, NE 68008 YOU MAY LEGALLY QWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWFLLIN(3 UNIT. ***PLEASE READ CAREFULLY'*** YDU ARE RECI,�IIRED� TlJ LICENSE YQIJR PETS `iNE CITY t7F BlAIH �iEQU1RES PI�(�(]F OF RABIES VACCINATION. Failure to do so is a violation of City Ordinancos 6.103 and carries a penalty of a fine up to $150,00 per pet. PET LLQENSE RENEWg ARE 17UE ,t 3/ 15/20�3_ The city shall recognize a microchip ID number as the license number. It shall be unlawfu(for any dog or Gat to wean any lioenee or other city 1) other than that issued t y the City of Blair for Such dog or rat. NEW PE LICENSING -Must be liconsed within 10 days of ownership (OR) at 6 months of age if puppy or kitten R NEW ESIDENTS TC) FLAIR Must register pots within 10 days of residency Uwner Name Tim Shaeffer Spouse Jenny Owner Address: ry 1062 N 28tb St City/State/Zips Blair, NE 68008 Phone # 402-658-4878 Rat Name: Remi Tag 3424 Age: 23M 40 B: 04-02-21 Sex: Spayed Female Color. Gold Breed: Golden Retriever Microchip # Rabier, Tag # 20463 PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE)_ # RABIES VACCINATION DONE ON 0649-22 Rabies Description: 1 YEAR, 3 YEA \ J Hol te.in Veterinary Clinic Dr: Lisa Schrtmn DVM' ; Dr. Krisra Holstein DVA4 718 South 1911 Street'BIair, NE 68008 ' 402-426-7367 402-426-0101 Fax holsteinclinic@gmail.com LICENSE I�= Infect 00g or Cat: $16.QQ e Dog cat: $11. 0 Replacement Tag $5.00 Toted $ �. PETS TN AT 4RE DN TNEACTA/E PQ% �NTIALLY DANGERfJIJS 4R DANGEROUS aQG UST NEED TO REQI$STER DfRECTLY AT CITY NAL1. FAXED 03-16-23 BY CITY;) A.. 03/08/2023 11:43 4024260101 HOLSTEIN VET CLINIC PAGE 01/01 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMIT5*AND OWN A DOG(S) AND /OR CAT($), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR - 218 8.16"" ST - BLAIR, NE 68009 YDU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT D003S OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLINO UNIT, ***PLEASE READ CAREFUILLY'4" Yf1U ARE REc)UIRED Bl(�.AW 70 LICENSE YQ4R LETS THE CITY OF LA(3 IR REC�UIRES PI�U(�F OF RABIES VA�CINA710N, Failure to do so is a violation of City Ordinances 6.103 and tarri95 a penalty of a fine up to $150.00 per pet, PE'T LICENSE FkENEWgLS ARE DUB BY 3/15/2U23. The city shall recognize a microchip 10 number as the license number. It shall be unlawful for any dog or cat to wear any license or other city 10 other than that issued by the City of Blair for such dog or cat, NEW PET LICENSING Must be licensed within 10 days of ownership (OR) at 6 months of age if PUPPY Dr kitten NSW RESID.IyTS TQ BLAIR Must register pate within 10 days of residency Owner Name Mary Shanks Spouse Rockford Owner Address 1850 Park St city/State/Zip Blair, NE 68008 Phone # 402-426-8208 Pet Name: Molly a #1081 AO: 11Y Sex: Spayed Female Jor: Gold DOB: '-12-03-11 ! — —r Breed: GaIden Retriever Microchip # Robles Tag # 20314 PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IP AVAILABLE): # RABIES VACCINATION DONE ON 05-04-22 Rabies Description: 1 YEAR 3 YEAR Holstein Veterinary Chnic DV-, L1.50 Schrum DV : Dr. lWsra Holotein DVM 718 South 1n111 Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteinciil-lic@gmaii.com FAXED 10-08- LICENSE FEES Intact Dog or Cat: $16,00 Aftetwd or cat: $1 11.0Q. Replacement Tag $5.00 Total $—� 15: 55 4024280101 HOLSTEIN VET CLINIC PAGE 01,101 2023 PET LICENSE VERIFICATIONIAPPL ICATi ION FOR CITY OF GLAIR IF YOU LIVE IN GLAIR CITY LIMITS AND OWN A DOG(S) AND /OF( CAT($), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: GITY OF BLAIR - 218 $. '16TH ST - BLAIR, N5 68008 YOU MAY LEGALLY OWN A COMBINATION Or FOUR (4) ADULT PETS, BUT NO MORE THAN THREE 13) .ADULT DOGS OR'THREE, (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT. **'hPLEASE DEAD CAREFULLYd°** YOU AR RE Et1UJN,FD BY l�W Id LI EG NSI; YQUI RE1 i H>: �1TY dF 13LAIR REaUIRES PRddF Eta RABIES VACGINA7I�D(,I Failure to do so is a violation of City Ordinances 6,103 alid carries a penalty of a find up to $160.00 per pet, PET f.i( ENSE F IUEWAL AItE Dl IE !3Y 3/�5/2023 The city shall recognize a microchip I0 number as the license number. It shall be unlawful for any dog or cat to wear any license or other city 10 ether than that issued by the City of Rlair for such dog or cat. NEW PET LICENSING Must be licensed Within 10 days of ownership (OR) at 6 months of ape if puppy or kitten NEW_ R SIF BENT TO BLP�I_R Must register pots within 10 days of residency Owner Name Spoilse Owner Address City/State/Zip Phone # Stavy Shearman Scott 1960 Grant St, Blair, NE 68008 402-651-5347 Pet Name: Herhle Tag #3475 , Ago: 10Y Sex: Neutered Male Color: TO Color DOB: 06-27-12 Breed: Beagle Mlerochip # Rabies,Tag # 25203 ILL' EASE INCLUDE CITY TAG NUMBER IF T141S IS A RENEWAL (IF AVAILABLE): # RABIES VACCINATION DONE ON 03-27-23 Rabies Description: 1 YEAR 3 YEAR I Holstein Veterinary Clinic Dr. Lisa Schrum DVM : Or. Kristo Holstein DVM 718 South 1911 Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteinckille grnail,com Intact Dog or Cat: $16.00 A/#ed Do Qr cat: $1 0 Replacement 7'ap $5.00 Total $, PETST ATAREONTNEAC•TlVEPOTEN7IQLLYOAN�aEROUSC�a DANGiEROUSUO6i ISTNEED7 REG15Tf,RDIRECrLY iTCITYH FAXED 03-27-23 BY .. ,,,:., - L`? GULJ lb:12 4024260101 HOLSTEIN VET CLINIC PAGE 01/01 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /bR CAT(S), COMPLETE THIS FORM 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 (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT. *"PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. THE CITY OF BLAIR IREQ IRES ROO OP RABI SSVVA_CCINATION Failure to do so Is a violation of City Ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. P,FT LICENSE RENEWALS ARE pUE Y 3J75/2�3 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 10 other than that issued by the City of Blair for such dog or cat. NEW PET LICENSIN 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: Win► ile Age: 2Y DOB:—07-25-20 Breed: • Lab Sex: Spayed Female Microchip # 985141002843745 PLFASE INCLUDE CITY TACK NUMBER IF THIS IS A RENE' ------- F RABIES VACCINATION DONE ON 01-15.22 Rabies Description: "I YEAR Holstein Veterinary Clinic Dr Lisa Schrum DVM ; Dr. Krista Nolstoin DVM 718 South 1811' Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteinciinic@gmail.com Elwin Shepard 1403 Colfax St Blair, NE 68008 402-533-3006 Color: Yellow Rabies Tog # 20033 AVAILABLE): # LICENSE FEES Intact Dog or Cat: $16.00 AI 009 0 c t: 11.00 Replacement Tee $5.00 Total $ 1 CITY OF BLAIR - 2023 PET LICENSE APPLICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City Of Blair @ 218 S 16th St o Blair, NE 68008 You may (legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March IS 2023 Owner Name: r Owner Address: LQ 4-` City/State/Zip: Blair, NE 68008 l/ Phone # LICENSE S: 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 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 Dog ❑ Cat ❑ Spayed/Neutered License Fee k� Pet Nam Birthdate r\ a Sex Color Breed** Rep/acement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y WN MICROCHIP # (If applicable) SU TOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # l 0' * 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) S TOTAL: $ 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) RABIES VACCINATION DATE: (3 yr) 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.) M. Do Not Send Cash by mail TOTAL L ' b tD. If you have questions, please contact Blair Police Department at (402) 426-4747 ++.+.+.....++++++..............++..+++++.......+++.+++...++++++++++++.++++.... NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (march 15late fee date not applicablefor newpets/newresldenW Newly Acquired Pets: New Residents to Blair: Must be lioensed within 10 days of ownership n Must register pets within 10 days of Bill <OR> at 6 months of age if puppy/lditen residency. CERTIFICATE OF VACCINATION Date of Vacci ation: 04-29-23 Certificate No. 34433 Next Vaccin ion on: 04-28-24 Previous Vaccination: VETERINARY INIC OWNER OF ANIMAL Pet Vaccination tixr' Todd & Sheryl Shepherd 2911 S. 120th St. 641 S 17th St Omaha, NE 68144 Blair, NE 68008 402-480-3393 (402) 699-1940 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Rosie TAG NO: 235163 SPECIES: Canine BREED: Boxer Mix SEX: Female AGE: 17 weeks WEIGHT: 0.00 Ibs COLOR: White and Tan MICROCHIP: MFG'BY: ZOE7 SERIgk"5�4384, EXPIRES/Qd//23, ADMI : SQ Signed: / _ I K&vin Dobesh, DVM Other Vaccinations... Vaccinated By 04-29-23 KD 7 Vaccination Next due Canine DA2PP Vaccination, 1Y 04-28-24 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: 04-29-23 at 8:56a FOR: Todd & Sheryl Shepherd Date: 04-29-23 641 S 17th St Folder: 0 Blair, NE 68008 Invoice: 18022984 (402) 699-1940 Date For Qty Description 04-29-23 Rosie 1 Canine Rabies Vaccination, 1Y 04-29-23 1 Canine DA2PP Vaccination, 1Y 04-29-23 Visa payment Old balance Charges Payments 0.00 58.00 58.00 Reminders for: Rosie Last done 04/24 Canine DA2PP, 1 Y 04-29-23 04/24 Canine Rabies Vaccination, 3 Y Doctor's Instructions Canine Rabies Vaccination, 1Y 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.OmahaPetVaccinationCIinic.com 6;r t- Z d OA 7,W 6U (f ot �� I Z- A`�5 7111— Net Price 29.00 29.00 -58.00 New balance 0.00 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: 09-03-22 at 9:02a FOR: Todd & Sheryl Shepherd Date: 09-03-22 641 S 17th St Folder: 0 Blair, NE 68008 Invoice: 18011855 (402) 699-1940 Date For Qty Description Net Price 09-03-22 Hopper 1 Canine DA2PP + Lepto Vaccination I 34.00 09-03-22 %2 �Visa payment -34.00 Old balance Charges Payments New balance 0.00 34.00 34.00 .'f `" 0.00 Reminders for: Hopper (Weight: 102.0 Ibs - 3y) Last done 08/24 Canine Rabies Vaccination, 3 Y 08-06-21 09/23 Distemper + Leptospirosis Vacc 09-03-22 Omaha Pet Vaccination Clinic 84th & H Omaha, NE (402) 443-2006 www.OmahaPetVaccinationClinic.com CITY OF BLAIR ® 2023 PET LICENSE APPLICA77ONIf If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: city of Blair 9 218 S 16th St e Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2023 Owner Name: Owner Address: city/state/zip: Blair,, NE 600 Phone # i I ty LICENSE FEES: Dog or Cat: $16.00 Alt d D ol• 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 Cityof Blair reauires Proof of rabies vaccination to be submitted with your license application. ere og . Rep+iacement 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 0 Dog ❑ Cat Spayed/Neutered License Fee $ a � Pet Name Birthdate 7-,),,1,)2 Sex Al Color 1)7I& L- Breed**61e_ Rep/acement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ; J-N / MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: �� .�; _— (3 yr)(1 yr) City Tag # rrT., _.._. PET #2 1A1Dog ❑Cat Spayed/Neutered License Fee $ Pet Name F� ' / >, Birt�date Sex Color -9 . Breed** r j�z I L- Replacement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y ..4 N f MICROCHIP # (If applicable) SU TOTAL: $ ' L' RABIES VACCINATION DATE: 3 yr) -- (i yr) City Tag #* PET # 3 ❑ Dog ❑ Cat ❑ Spayed%N utered Lj cense Fee $ Pet Name Birthdate Sex- ** Color Breed" =7 - Replacement $ Declared Dangerous or Potentially Dangerous Dog: ❑ N MICROCHIP # (If a cable) �'` ,,,,. SUBT TAL: $ RABIES VACCINATION DATE: (3 yr) (�-Yil) 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 $ )-, , (11' I 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 fornewpets/new residents) Newly Agguired Pets: New Residents to Blair: • Must be licensed within 10 days of ownership E 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: 4171 Patient ID: 10459 Client Name: Elizabeth Shields Patient Name: Bella Address: 325 North 21st Street Species: Canine Breed: Labrador Mix Blair, NE 68008 Sex: Spayed Female Color: black Phone: (402)426-4239 Markings: Birthday: 07/02/2018 Weight: 57.70 pounds on 3/14/2022 Microchip ID: 985112010057246 Tag Number: 5698 Vaccination Date: 3/11/2020 Vaccine: Imrab Rabies Vaccine Expiration Date: 3/11/2023 Producer: Merial Lot Number: 18438 Brand: Imrab 3 TF Drug Expiration Date: 5/21/2021 Type: Killed Virus Ianner of Subcutaneously tlministration: 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 Client ID: 4171 Patient ID: 6994 Client Name: Elizabeth Shields Patient Name: Bolt Address: 325 North 21st Street Species: Canine Breed: Labrador Retriever Blair, NE 68008 Sex: Neutered Male Color: Black Phone: (402)426-4239 Markings: Birthday: 08/17/2013 Weight: 114.40 pounds on 2/4/2015 Microchip ID: Tag Number: 6923 Vaccination Date: 3/14/2022 Vaccine: Imrab Rabies Vaccine Expiration Date: 3/14/2025 Producer: Merial Lot Number: 18526 Brand: Imrab 3 TF Drug Expiration Date: 5/20/2023 Type: Killed Virus ;`tanner of Subcutaneously Administration: Staff Name: David E. 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N ru 3 CD O (D D: Ln V.... pryy�� in O CIQ -e, O 3 0. f7 v r+ -r, O 3 O� CITY OF BLAIR - 2021 PET LICENSE APPLICATION I ok i r �,, If you live in Blair City limits and own a clog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair • 218 S 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, 2021 Owner Name: r hf(5 0_J P.Mer JOElfe f'I '2M(4k Owner Address: .15415 bt 4. r City/State/Zip: Blair, NE 68008 Phone # tf ®2 • IM - 5 I (ate 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 3/15/2021. The City shall recognize a microchip Identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city identification other than that issued by the City of Blair for such dog or cat. The City of Blair requires proof of rabies vaccination. Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET # 1 C \ D o g ❑ Cat Spayed/Neutered License Fee $ Pet Name Lba Bidate N !3 1 Sex Color Td*i �- tic. Breed** Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y A N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: � i 1 t; [ , ", (3 yr) '(1 yr) City Tag #g" 7 PET #2 Dog ❑ Cat Spayed/Neutered License Fee $�1 Pet Name�A Birt date 01Zo Sex ►ale. Color Breed** �-->'— Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y IN MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: � (3 yr) (1 yr) City Tag # �, r § ; 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 # *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 notapplicablefor new pets/new residents) Newly Acquired Pets: New Residents to Blair: ■ Must be licensed within 10 days of ownership ■ Must register pets within 10 days of ■ <OR> at 6 months of age if puppy/kitten residency. Countryside Small Animal Patient Chart 1306 Stevenson PO Box 119 Fort Calhoun, NE 68023 402-468-4060 Printed: 04-06-23 at 11:26a CLIENT INFORMATION Name Christopher Siemer (2213) Address 1645 Butler St. Blair, NE 68008 Phone 402 709-5166 PATIENT INFORMATION Name Logan (9548) Species Canine Sex Male, Neutered Breed Shepherd, German Birthday 06-14-19 Age 3y ID Rabies Color Black and Tan Weight 84,80 Ibs Reminded (none) Codes Reminders for: Logan Last done 06-13-23 Heartworm Test, Antigen 06-13-22 06-13-23 Canine DA2PP-L 06-13-22 06-10-23 Canine Rabies, 3 y Logan's weight history (in Ibs) 06-13-22 84.80 MEDICAL HISTORY - Reminder View Date By Code Description 06-13-22 KNP HWA Heartworm Test, Antigen Well negative KRJ DA2PL Canine DA2PP-L Vaccination Age:3y Weight:84,80 (Additional history not shown) Qty (Variance) Photo Date of Rabies Vaccination: 04-06-23 Certificate No: 0 Next Rabies Vaccination On: 04-05-26 Previous Rabies Vaccination: 16-1070 VETERINARY CLINIC OWNER OF ANIMAL Countryside Small Animal Christopher Siemer 1306 Stevenson 1545 Butler St. 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: Hemi TAG NO: 23-0225 SPECIES: Canine WEIGHT: 48.80 SEX: S AGE: 7 years BREED: Shepherd, German Microchip Number: Color and markings... Black Signed Kaycee Points License: 3770 Vaccinations done... 04-08-23 KNP Canine Rabies Vocnn.3Yr.#23-O225 O4'U5-2O 04'06-23 KNP CanineDA2PPL 04-05-24 09-15-15 JJS Canine Rabies Vaccn.1yr.#1G-UA75 08-20-15 JJG CaninnDA2PP Rabies Vaccine Information... K8PC;BY: ZOET SER.N0:53S242 LOT EXP: 18APR23 /\DKO:Gq 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 @ 216 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:` arch 15 2023 Owner Name: Owner Address: 6r^GS 4 ti sf city/state/zip: Blair, NE 66006 Phone * faA -5"3 3 --Zi1t3` LICE SE FEES: Dog or Cat: $16.00 Altered Poo or Cat- t11 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 1� Dog ❑ Cat P Spayed/Neutered License Fee $ /!, 0"o Pet Name / W r /'.e Birthdate Zvi Sex Al It Ile Color ►3 tc T�►� l3reed** d� 5L uA2 i x Rep/acement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y 4 N MICROCHIP # (If applicable) SUBTOTAL: RABIES VACCINATION DATE: 5 1 2b (3 yr) _ X (1 yr) City Tag # ? 1' #2 Dog ❑ Cat Spayed/Neutered License Fee $ /l, oa Pet Name Harr a Birt date $o hi Sex W* e Color (4sc o e 4 e-Breed** r Replacement S.Da Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ /G,iV RABIES VACCINATION DATE: 6 la2--(3 yr) X (1 yr) City Tag # ? PET #3 Cd Dog ❑ Cat I Spayed/Ne tered License Fee $ 11,06 Pet Name Fran. ;,L BirthdE 23 Sex l4le Color 61r, r Breed** of Rep/acement $ t�- ,O6 * * Declared Dangerous or Potentially Dangerous Dog: ❑ Y LYN MICROCHIP # IKI# l od k194711 (If applicable) SUBTOTAL: 14 419 RABIES VACCINATION DATE: L41"- RI (3 yr) X (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 $ 0,00 If you have questions, please contact Blair Police Department at (402) 426-4747 +++++++++++++++++++++++++++++++++++++++++++++++++¢++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date notapplicable for newpe&lnewresldents) 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. i Date of Rabies Vaccination: 06-28-22 Certificate No: 0 Next Rabies Vaccination On: 06-27-25 Previous Rabies Vaccination: 19-0402 VETERINARY CLINIC OWNER OF ANIMAL Countryside Small Animal Tony Silva 1306 Stevenson 1154 Nebraska 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: Harley TAG NO: 22-0507 SPECIES: Canine WEIGHT: 71.00 SEX: N AGE: 4 years BREED: Retriever, Labrador Microchip Number: 985112009377201 Color and markings... Chocolate Signed Kaycee Points License: Vaccinations done... 06-28-22 KNP Canine Rabies Vaccn, 3 Yr, #22-0507 06-27-25 06-28-22 KNP Canine DA2PPL 06-28-23 02-09-18 KNP Canine Rabies Vaccn, 1 yr, #18-0156 12-16-17 KNP Canine Parvovirus Vaccination (CPV) Rabies Vaccine Information... MFG BY: ZOET SER.NO: 535242 LOT EXP: 18APR23 ADM: Sq 02/22/2023 16:31 4024260101 HOLSTEIN VET CLINIC PAGE 01/02 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAIS), COMPLETETHIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR - 218 S. 16TH ST - SLAIIII, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MONV THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT. ***PLEASE READ CAREFULLY*** YOU ARE REQUIREIa By LAW TO LICENSE YOUR PETS.. Y 1F 6LAlR REQUIRES PRQ R1ES V CCINATION. Failure to do so is a viotaftn of City Ordinances 6.103 and carries a penalty of a fine up to $150,00 per pet. PET LICENSE RENEWALS ARgSUE 3ff-3-1-1512023, The city shall recognize a microchip ID number as the license number. It shall be unlawful for any (109 or cat to wear any license or other city ID other than that Issued by the City of Blair for such dog or cat. NEW PET LICENSING Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten NEW RESIDENTS TO BLAIR Must register pet: within 10 days of residency Owner Name Brian Smith Spouse Maggie Owner Address 2287 Fieldcrest city/state/zip Blair, NE 68008 —Rhone # 402-332-9986 Pet Name; Sophie Age: .11Y POE: 06-20-11 Breed: Min Pin Sex:, Spayed Female Color: Black and Tan Microchip # Rabies Tag # 20203 L .r$E II�CLUOC CITY TAG NUMBER IF THIS IS 4 RENEWAL or AVAILABLE): # RABIES VACCINATION DONE ON 1 03-28-22 Rabies Description: 1 YEAR � - 3 YEAR Holstein Veterinary Clinic Dr, Lisa Schrum D VM ' Or. KrIsta Holstein D VM 718 South 19t' Stroet Blair, NL 68008 402-426-7387 402-426-0101 Fax hoisteinclinic@gmaii.com LICENSE FEES Intact Dog or Cat: $16,00 � �fe-r-Z5� Dog r cat: $11 -OW ROPMVOMORt T09 $6.00 Total $ PETS THAT ARE ON THE ACTIVE POTEMLIALLY DANGEROUS OR DANGEROUS 006 LIST NEED TD REGISTER DlRE4TLYA�CJTYHALL. FAX::T— 02-22-23 .By Q 49 02/22/2023 16:31 4024260101 HOLSTEIN VET CLINIC PAGE 02/02 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF GLAIR IF y6U 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 BLA,IR — 218 S. 16T" ST I-Alli, NE 6$00 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT OATS PER RESIDENTIAL OR DWELII ING UNIT, **10PLEASE READ CAREFULLY"* YOU ABE REQUIRED eY LAW Q LICENSE YOUR PETS- THE CITY OF 13LAIR REQUIRUTflQ0F OF RABIES VAC�� Failure to do so is a violation of City Qrdinanoes 6,103 and carries a penalty of a fine up to $160-00 per pet. PET LICEN$.)r RENEWALS ARE DUE BY U1112023. The city shall recognize a microchip ID number as the license number. It shall be unlawful for any dog or cat to wear any license or other city ID other than That issued by the City of Blair for such dog or cat. NEW PET LICENSING Must be licensed within 10 days of ownership (RJR) at 6 months of age if puppy or kitten NEW RESID NTS TQ LAIP Must register pets within 10 days of residency Owner Name Brian Smith Spouse Maggie Owner Address 2287 Fieldcrest � City/State/Zip Blair, NE 68008 Phone # — 402-332-9986 Pat Name: Bella Tag #2295 Age:. 8Y Sex: Spayed Female (Color: Blk Tan DOB: 11-28-14 Breed: Min Pin Microchip # 985112007970239 Rabies Tag # 20204 PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE). # MYr RABIES VACCINATION DONE ON 03-28-22 llebies Desedp' tion: 1 YEAR r3Y A.I� Holstein Veterinary Clinic Dr, Lisa SChtum DVM Dr. Krista Holstein DVM 718 South 19t' Street Blair, NL 68008 402-426-7387 402-426-0101 Fax holsteinclinic@grnail.com LWX ,,E FEES Intact Dog or Cat: $16.00 Dog at: $11.Q4 Replacement Toy $6.00 Total $ \ 1 PETS THATARE ON Tj ($ACTIVE POTENTIALLY DANGEROUS OR' DANGEROUS DoG USY New TO REGISTER DIRECTLYAT OTY HALL. FAKED 02-22-23 BY 03/07/2023 17:1:3 4024260101 HOLSTEIN VET CLINIC 2023 PET LICENSE PANE 01f02 VERIFICATION/APPLICATION FOR CITY OF SLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(8) AND /OR CAT(5), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TQ: CITY OF BLAIR — 218 •$. 16T11 ST — BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADL14T DOGS OR "THREE (3) ADULT CATS PER RESID)=NTIAL OR DWELLING UNIT. 1. ***PLEASE READ CAREFULLY*** YOU ✓1R�REQU1$ED E3Y LAW TO L1�EYV�E YOUR pE7S. THE CITY OF RLA! R.�Fs� PRODF OF RABIES VACCINAT(C1tV Failure to do so is a violation of City Ordinances s.103 and carries a penalty of a find rap to $'Ibo.00 per pet. PET LICENSE: RNEWS ARE D v- RY 319519023. The city shall recognize a microchip ID number as the license number. it shall be unlawful for any dog or cat to wear any liconse or other city ID other than that issued by the City of Blair for such dog or cat. NSW PET LICENSING Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten ]NEW RESINNTS TO BLAIR Must register pets within 10 days of residency Owner Name Christie Smith Spouse Mike Gwnor Address 2416 Elm Street Gitylstate/zip Blair, NE 68008 Ph6ne # 402-981-51510 Pet Name, Kiki Tag #2783 Age: 4Y DOS:—10-11-18 Sex: Neutered Male Color: Black and White greed: Domestic Shbrtheir Microchip # �a Rabies Tag # PLEASE INCLUDE CITY TAG NUMBER iF THIS IS A RENEWAL (IF AVAILABLE): # RABIES VACCINATION DONE ON 03.07-23 Rabies Descriptiof YEAR 3 YEAR Holstein Veterinary Clinic Dr: Liso Schivn7 pVNI : Dr. Krr;�ts Holstaln DVM 7'18 South 1911 Street Blair, NE 68008 402-426-7387 402-426-0101 Fax hoisteinclinic@gmaii.com LICENSE FEES /ntaat Dog or Cat: $16.00 a DO 0 cat; $11. 0 RePlac 8g1 $5.00 Total $—Aj PETS TH/ TA t ON THE ACTIVE POTENTIALLY DANGEROUS OR DANGEN_QS DOG LIST NEEp 7Y7 REGISTER D1RE�Tf YAT G1TV HALL. FAXED 03-07-23 BY ��Iy.�l;'1(!;;I41��A��L'L��,,, �'(RiK:��'4,�Cw�U►`'1'�1�;Y��''i�;':,,:;`, 03/07/2023 17:13 4024260101 HOLSTEIN VET CLINIC PAGE 02/02 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR OAT(8), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR - 218 S. 16TH ST - BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR W) ADULT PETS, BUT Nil MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT, *4*PLEASE READ CAREFULLY*** YOU Pai(ure to do so is a violation of City Qrdinance& G,103 ant Garrios a penalty of a fine up to $150.00 p4r pet. ThQ city shall raragttiize a microchip (b number as the license r�umb$r. It shall be unlawful for any dock er cat to wear any Iicer7se or other city E4 other than that S$ y the Ity of Blair ol, suc5h drag or cat. XE_W pE7 �ENS�ING Must be licensed within 10 clays of ownership (OR) at 6 M011thS Of age if puppy or kitten NQ_ARESIDENTS T�LAIR PAwA register pets within 10doys of residency Pet Name: Zeus Age: 6Y DOB: 01-05-17 Breed; , FrHulldog Sex: Neutered Male Microchip # 985112007455992 PLEASE INCLUDE CITY TAG NUMBER ir RABIES VACCINATION DONE ON Rabies Description: 1 YEAR • Color, Dk Brindle Rabies Tag # 19139 IS A RENEWAL or AVAILABLt):# 05-07-21 Holstein Veterinary Clinic & Lisa Schrum D VM : D1. Krista Holstoln D VM 718 South 1 9th Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteine,liniG@gMall.COM 3 YEAR LKEN$IE ME-5- Intact Dog or Cat, $16,00 r cat: $11,00 floplacalnent Tag $5.00 Total $—H— FAXED 03-07- 3 BY OT :10 51 01/10/2023 11:28 4024260101 HOLSTEIN VET CLINIC PAGE 04/04 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR 218 S. IVH 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 C,RtREFULLY%*x YOU ARE R 5QUIRED 8Y LAW TO LICENSE YOUR PETS. THE CITY t)F SLAIR RE_ FtES PROOF OE RABIES VACC1NATiON. Failure to do so is a violation of City Ordinances 0,103 and carries a penalty of a fins up to $150.00 per pet. PET LICENSE RENEWALS ARE DUE BY 3116/2023. The city shall reoognize 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 then that issued by the City of Blair for such dog or cat. NEW PET LICEN51N-Q-Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten NEW FIESIDENTS Tt BLAtR Must register pets within 10 days of residency Owner Name Denle8 Smith Spouse Bob Owner Address 153 East Baronage Drive City/State/zip Blair, NE 68008 Phone # - 402-- CozT0 --- {058'0 Pet Name: Alile Age., 5V DOB: 00.04-1a Breed: Papillon Sex: Spayed Female Microchip # 985112010030583 NCLUDE CITY TAG RABIES VACCINATION DONE ON Rabies Description-, 1 YEAR Tag #2253 Color: Tri `' Rabies Tag # 19707 'A RENEWAL. (IF AVAILABLE): # t2-30-21 (3 YEAR Holstein Veterinary Clinic Dr. L&O Schrum DVM : Or. Kr/sta Holereln DVM 718 South 191h Street Blair, NE 68008 402-426-7387 402-426-0101 Fax ' hoisteinclinic@gmail.com LICENSE FEES Intact Dog or Cat; $16.00 Altere og ar cat: $11.00 Replacement Tag $6.00 Total $ + PETS THATARE ON THE ACTIVE POrENTIALLY DANE,EROUSPR DANGEROUS DOG NEED TO REGISTER DIRECTLYAT Gf H LL. FAXE D 01-10-23 BY CITY HALL @ 402-426-4165 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 lair 9 218 S 16th St e Blair,, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2023 Owner Name: e� �' ail% 171 Owner Address: 11M W, V -c'' City/state/zip: Blair, NE 6800 Phone # 3 _5 f�` LICENSE FEES: Dog or Cat: $16.00 Altered Do or Cats $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 3/16/2023. 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 ,a PET #1 # Dog ❑ Cat * Spayed/Neutered License Fee $ Pet Name Birthdate - a Sex Color` t Breed**.dam ,r) Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y tt N MICROCHIP # /' 0 At)() D, I Q`3: 3If applicable) / SUBTOTAL: $ RABIES VACCINATION DATE: 23®. _ (3 yr) ✓ (1 yr) City Tag #dddffik* T #2 0 Dog Cat Spayed/Neutered License Fee $ Pet Name -, Agz?e ' Birthdate/ Sex M4 f - Color c �" Breed** i Rep/acement$ ** Declar d ba'llg6bus or Potentially Dangerous Dog: ❑ Y N MICROCHIP # T95' // ). C/O If applicable SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # d PET #3 ®D o ❑ �` gL Cat ❑ Spayed/Neutered Li_ �..,.._ _ `4cense Fee $ Pet Name Birthdate Sex ** Color ` , re Re; ement $ Declared Dangerous or Potentially Danger usl ® Y ❑ N If a licabTe SUBTOTAL: MICROCHIP # ( pp � ��`"~-� � =°--- * RABIES VACCINATION DATE: (3 yr) (1 yr1. 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 fornewpets/newresldents) Newly Acquired Pets: New Residents to Blair: • Must be licensed within 10 days of ownership m Must register pets within 10 days of • <OR> at 6 months of age if puppy/kitten residency. 01/09/2023 16:55 4024260101 HOLSTEIN VET CLINIC PAGE 01/02 2+023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF 131-AIR IF YOU LIVE IN 13LAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S), COMPLETE THIS FORM ANP RETURN WITH A CHECK PAYASLn TQ: 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 13) ADULT CATS KH RESIDENTIAL, OR DWELLING UNIT. —PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YQUA FRETS 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 $160.00 per pet. PET LICENSE RENEWALS ARE DUE BY 3115/2023. The oity shall recognize a microchip ID number as the license number. It shall be'uniawful for any dog or cat to wear any license or other city ID other than that issued by the City of Blair for such dog or cat. NEW PET LICENSING Must be licensed within 10 days of owhership (OR) at 6 months of age If puppy or kitten NEW RESIDENTS TO BLAIR Must register pets within 10 days of residency Owner Name Katie Sorensen Spouse Owner Address 1760 Butler City/State/Zip Blair, NE 68008 Phone 9 402-306-9266 Pet Name: Cleo Tag #3299 Age: 3Y DOS: 06-02-13 Sex: Spayed Female Ga10r: Seal Breed: Slam/Him Microchip # Rabies Tag # PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): # RABIES VACCINATION DONE ON 01-09-23 Rabies Description: YEAR 3 YEAR Holstein Veterinary Clinic Dr,'Liss Schrum DVM : Dr, Krists Holstein DVM 718 South 18t" Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteinclinlc@gmail.com /ntaGt • Dog or Cat: $16.00 �41rvm Dog(() r cat: $1 .00 Relalacsrt�snlr rah $5.00 Total $—X— PETSTHATARE ON THE ACTIVE POTENTWLLYDANGEROUS OR Qq E O�J.S DOG LIST NEED TO REGISTER DtREGTLYAT GfTY HALL FAXED 01-09-23 BY q.j:;, 01/09/2023 16:55 4024260101 HOLSTEIN VET CLINIC PAGE 02/02 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR - 218 S. 16TH ST - BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CAT$ PFR RESIDENTIAL OR DWELLING UNIT. 1h"PLEASE READ CAREFULLY' YOU E REQUIRED BY LAW TO 410ENSIv YOUR PETS. THE CIT O REQUIRES PROOF QF 13ABIESVACCINATION, Failure to do so is a violation of City Ordinances 6,103 and carries a penalty of a fine up to $160,00 per pet. PET LICENSE RENEWALS ARE QVgAy 3LI5023. The city shall recognize a microchip ID number as the license number. it shall be unlawful for any dog or cat to wear any license or other city ID other than that issued by the City of Blair for such dog or oat, NEW PET L�Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten NEW RES DE TS Must register pets within 10 days of residency Owner Name Katie Sorensen Spouse Owner Address 1760 Butler .City/State/Zip Blair, NF, 68008 Phone # 402-306-9266 Pst,Name: Olivia Tag Age: 7Y DO& 04-13-16 Sec: Spayed Female Color: Blk & Wht Breed: Domestic Shorthair Microchip # Rabies Tag # PLEASE INCLUDE CITY TAG NUNI$ER IF THIS IS A RENEWAL (IF AVAILABLE): # RABIES VACCINATION (?ONE ON 01-09-23 RWes description: YEAR 3 YEAR Holstein Veterinary Clinic Or, 1-Isa Schrum DVM : Dr. Krists Holstein DVA4 718 South 181h Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteinclinic@0mail.com LICENSE FEES Intact Do0 or Cat: $16.00 D or cat: $1 .00 Rip/acement Taq $5.00 Total $ LETSTHATAREONTHE ACTIVE Pd ENTIALLYDANGEROUS 01 VANGER9US JDQG LIST EED TO REG,ISTeR PIKE LY AT CITY HALL. FAXED 01-09-28 BY CITY OF B $TR - 2023 PET LkENSE APPLICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable t .1 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE ALS AREDUE: March 15, 2 Owner blame: Owner Address: City/State/Zip: Blair, NE 68008 Phone #$x- LICENSE FEES., Dog or Cat: $16.00 Replacement Fee for Lost: F . <.1'0 to ***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. P ZD o g ® Cat 'Q. Spa ed/Neutered License Fee Pet Name it ' u. Birthdiate &' 2 Sex _ Color Breed** s V,V k'fV-- IVI k Replacement $ Declared-- ecl d--Dangerous or Potentially Dangerous Dog: LlY 1 1 y ROCHIP # (If applicable) SUBTOTAL: $ `' pp RABIES VACCINATION DATE: ,. (3 yr) _ (1 yr) City Tag #* PET #2 LaD o g Ll Cat Ll Spayed/Neutered � License Fee $ Pet Name Birthdate �Sex Color Breed" �� > i < Replacement $ Declared Dangerous or Potentially Dangerous Dog: ® Y Ll N MICRJOCHI,P' # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: F (3 yr) (1 yr) City Tag #* PET #3 ® Dog LI Cat LI 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 S T TAL: $ (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.) �T,o 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 notappll ble fornewpels/newresidents) Newly Acquired Pets: New Residents to Blair: Must be licensed within 10 days of ownership In Must register pets within 10 days of <OR> at 6 months of age if puppy/kitten residency. Date of Rabies Vaccination: 10-27-22 Certificate No: 0 Next Rabies Vaccination On: 10-27-23 Previous Rabies Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Countryside Small Animal Aurora Soto 1306 Stevenson 666 S. 10th 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: Rocko TAG NO: 22-0836 SPECIES: WEIGHT: 73.00 SEX: M AGE: 14 months BREED: Rottweiler Microchip Number: 985141004676586 Color and markings... Black and Rust Signed Kaycee Points License: 3770 Vaccinations done... 10-27-22 KNP Canine Rabies Vaccn, 1 Yr, #22-0836 10-27-22 KNP Canine DA2PPL 10-27-23 Rabies Vaccine Information... MFG BY: ZOETI SER.NO: 569634 LOT EXP: 15AUG23 ADM: Sq Date of Rabies Vaccination: 06-07-22 Next Rabies Vaccination On: 06-06-25 VETERINARY CLINIC Countryside Small Animal 1306 Stevenson Fort Calhoun, NE 68023 402-468-4060 Certificate No: 0 Previous Rabies Vaccination: OWNER OF ANIMAL Aurora Soto 666 S. 10th Blair, NE 68008 County: This is to certify... THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW. Patient information... PATIENT: Mala SPECIES: Canine SEX: S BREED: Terrier, Staffordshire Mix Color and markings... Grey and White Signed Kaycee Points Vaccinations done... TAG NO: 22-0457 WEIGHT: 57.80 AGE: 2 years Microchip Number: 985141003424677 License: 3770 06-06-23 KNP Canine DA2PPL 06-05-24 06-07-22 KNP Canine Rabies Vaccn, 3 Yr, #22-0457 06-06-25 Rabies Vaccine Information:.. MFG BY: ZOET SER.NO: 535242 LOT EXP: 18APR23 ADM: Sq 31A1�-3 cash CITY OF BLAIR - 2023 PET LICENSE APPLICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair • 218 S 16th St • Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2023 Owner Name: Owner Address: " City/State/Zip: Blair, NE 68008 Phone # LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/15/2023. The City shall recognize a microchip Identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city identification other than that issued by the City of Blair for such dog or cat. The City of Blair requires proof of rabies vaccination to be submitted with your license application. Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET #1 q y o g �1' � Cat spayed/Neutered Pet Name °` Birthdate Sex Color , i x Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: ' (3,yr) f License Fee $ i ** Replacement $ ❑N SUBTOTAL: $ (1 yr) City Tag # PET # 2 ❑ Dog Q Cat 0' 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: 1j),11 (3 yr) (1 yr) City Tag # PET #3 ❑ Dog LJ Cat 1 Spayed/Neutered License Fee $ Pet Name Birthdate , ,. / Sex Color ,„ '/ Breed**' Replacement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED $ If you have questions, please contact Blair Police Department at (402) 426-4747 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15late fee date not applicable for newpets/newresidents) Newly Acquired Pets: New Residents to Blair: ■ Must be licensed within 10 days of ownership ■ Must register pets within 10 days of ■ <OR> at 6 months of age if puppy/kitten residency. Client ID: Client Name: Address: Phone: Tag Number: Vaccine: Producer: Brand: Type: Manner of Administration: Staff Name: License Number: Doctor Signature: WILLOW PARK VETERINARY CLINIC 415 EAST ERIE ST. MISSOURI VALLEY, IA 51555 (712) 642-3815 308 Lori Spears 1666 Park Street Blair, NE 68008 (402)278-2640 24504 Rabies Vaccine Merck Nobivac 3 Killed Virus Subcutaneously Jack D. Gochenour, 5146 Rabies Certificate M Patient ID: Patient Name: Species: Breed: Sex: Color: Markings: Birthday: Weight: Microchip ID: Vaccination Date: Expiration Date: Lot Number: Drug Expiration Date: 15552 Mama Emily FELINE DOMESTIC SHORT HAIR Spayed Tabby 09/14/2016 12.22 pounds on 2/24/2021 2/24/2021 2/24/2024 WILLOW PARK VETERINARY CLINIC 415 EAST ER;E ST. MISSOURI VALLEY, IA 51555 (712) 642-3815 Client ID: 308 Client Name: Lori Spears Address: 1665 Park Street Blair, NE 68008 Phone: (402)278-2640 Tag Number: 24493 Vaccine: Rabies Vaccine Producer: Merck Brand: Nobivac 3 Type: Killed Virus Manner of Subcutaneously Administration: Staff Name: Jack D. Gochenour, D.V.M. License Number: 5146 Doctor Signature: Rabies Certificate Patient ID: Patient Name Species: Breed: Sex: Color: Markings: Birthday: Weight: Microchip ID: Vaccination Date: Expiration Date: Lot Number: Drug Expiration Date: 15551 Pepper FELINE DOMESTIC SHORT HAIR Spayed Tortoise 4 - footed declaw 05/21 /2016 10.28 pounds on 2/17/2021 2/17/2021 2/17/2024 WILLOW PARK VETERINARY CLINIC 415 EAST ERIE ST. MISSOURI VALLEY, IA 51555 (712) 642-3815 Rabies Certificate Client ID: 308 Patient ID: 8920 Client Name: Lori Spears Patient Name: M.J. Address: 1665 Park Street Species: FELINE Breed: DOMESTIC SHORT HAIR Blair, NE 68008 Sex: Neutered Color: black & white Phone: (402)278-2640 Markings: Birthday: 10/01 /2009 Weight: 10.48 pounds on 3/25/2017 Microchip ID: Tag Number: 23633 Vaccination Date: 3/25/2020 Vaccine: Rabies Vaccine Expiration Date: 3/2512023 Producer: Merck Lot Number: Brand: Nobivac 3 Drug Expiration Date: Type: Killed Virus Manner of Subcutaneously i Administration: Staff Name: Jack D. Gochenour, D.V.M. License Number: 5146 j Doctor Signature: Reminder Lotter Report Sorted by client ID Client Name Patient ID Spears, Lori Phone: (402) 278-2640 f (o G 5 pcxg4Z S �-1120 AlE %'Z 00 9 a7 �-� d6 v Patient Name M.J. Item ID/Description Type Date 106 FEL-O-VAC IV LEUKU L 4/22/2012 141 RABIES CANINE 3 YEAR BOOSTER L 3/25/2023; M , j , ri " 'at )Val'& d i L- Fv d ad M `U`iL �i �isi`L �iL��,cj J, R .�f�.A ti j 6vL . � V V. U ®C� s /u e�U' c p `� kiL 6-#-c"o ,�.� C ei ?�2 6y2. 3"?/5 i Willow Park Veterinary Clinic I Jack Gochenour, D.V,M. 415 East Erie Street Missouri Valley, IA 51555 712/642-3815 WILLOW PARK VETERINARY CLINIC Page 1 of 1 Date: 81712023 01/05/2023 16:05 4024260101 HOLSTEIN VET CLINIC PAGE 06/06 2023 PET LICENSE VERIFICATION/',APPLICATION FOR CITY OF GLAIR, IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(5), COMPLETE'rHIS FORM AND RETURN WITH A CHECK PAYABLE T0: CITY OF BLAIR — 218 $- "I6T" $T — DI -AIR, N1- 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADW DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT. —PLEASE READ CAREFULLY"' Y RE R UIRED Y LAW ICEN OU PETS. T ITY GLAIR 1=QUIR PRO RA � VAC INATIO 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.LIGENS7~ RENEWALS ARE DUE BY 3116i2d�3. The city shall recognize a rnicrochip ID number as the license number. It ehnii he unlpwfui for-anv dog or cat to wear any license or other city ID other than that issued by the ti ��,ofBlair for 5u41l slog or cat. NEW PET LICENSING Must be licensed within 10 days of ownership (OH) At 6 months of age If PUPPY Ul uMnLRF�glnF1\171� TO RLAIR Must resister pets within 10 days of residency i avvi-ri rYnnoc Spouse Owner Address City/State/zip Phone # �Ch:rlayr Qtarllr�r 750 Garfield Blair, NE 68008 402-426-4741 pet Name: ' Addie Tag #2200 Aga: 5Y Sex: Spayed Female color: Yellow DOB: 03.14-17 Breed: Lab A lliaroohip sr! siesa �Isoo�Qsa I i� I Rabies Tag # 19259 PLEASE iNCLUDC CITY TAG NUMBER IF TM19 IS A RFr\ir=VVAL (IF AVAILABLE): # RABIES VACCINATION DONE ON 106-16-21 Rabies Description: 1 YEAR L1C SE F� Intact Dog or Cat: $16.00 /1111 tere' D& or cat: 01 Replacement Tag $5.00 Total $ 11.u) PE THAT AR ON THE ACTIVE POTENTIALLY DAN EROUS O DANG6ROU5 DOC LIST NEED TO REG1,5 R DIRECTLY AT CITY HALL• .Holstein Veterinary Clinic FAXED 01-05-23 ,Rr, Lisa Schrum OVM : or, Krista Holstein DIAM BY' 718 South 190 Street Blair, NE 68008 •, n 01 O1 k' 402-42O-7:1F37 40� 4.6 fax I '"r hClsteinelinic@gMail-COO 01/05/2023 16:05 4024260101 HOLSTEIN VET CLINIC PAGE 05/06 2W PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG($) AND !OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO; CITY OF BLAIR - 218 S, 16TH ST - BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OP FOUR (4) ADULT PETS. BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DVV5LLiN(3 UNIT. ***PLEASE READ CAREFULLY' Y OF BLAIR QUIRES P1300F D_F_R��CIN �10& Y ARER IRED LAW ICEN YOUR Failure to do so Is a violation of City Ordinances 6.103 and carries a penalty of a fine up to $160.00 per pat. PET LIQLNSE RIENEWALS.ABE DUE 311513S 2 - The city shell recognize a microchip 11) 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. WA� �ENSI �Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten NEW REF21DEN rS TO SLAIR Must register pets within 10 days of residency Owner Name Spouse Owner Address City/State/Zip Phone # Shirley Stadler 750 Garfield Blair, NE 68003 402-426-4741 Pot Name: Gypsy Tag #2750 qge: Sex- Spayed Female Color: Gray 00B: -(none) Breed-, Domestic Shorthair Microchip # PLEASE INC)LUDE CITY TAG NUMBER IF (IABIES VACCINATION DONE ON Rabies Description: / I YEAR Rabies Tag # IS A RENEWAL (IF AVAILA13LE): # 12-19-22 3 YEAR Holstein Veterinary Clinic. Or. Lisa Schrum L)IAM : L)r, KrIsta golstofn DVM 118 South 1 91h Street Blair, NE 68008 402-426-7387 402-426-0101 Sax hoisteinclinic@gmaii.com UGENSE,K—PS Intact Dog or Cat: $16.00 r ocatAltered . E) r c, $1 0 Replacement rag $6rOO Total $11 Vo_ PL$ THAT ARE ON THE ACTIVE POTENTIALLY DAN13ERIIU-1 C� DANGEROUS DOG I T NEED TO REGISTER DIRECTLY _QTYHALI� AT FAXED 01-05-23 BY A' 01/05/2023 16:05 4024260101 HOLSTEIN VET CLINIC PAGE 04/06 2023 PET LICENSE VERI"CATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR - 218 S, 16TH ST - BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, . BUT NO MORE THAN THREE (a) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT. ***PLEASE ROAD CAREFULLY*** r OF fIA131E ; V&WIMAXIML Y ARE R IRED 5 - n of City Ordinances 6,105 and carries a penalty of a fine up to $150.00 per pet. Failure to do so is a violation V�T ILI6ENS_EAENEW_AjS ARE D3/1�, The city shall recognize a microchip ID number as the license number, it shall be unlawful for any dog or cat to weer any license or other city ID other than that Issued by the City of Blair for such dog or cat. NEW,. . PET L)CENSING Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten NEW RtaLDENTS TO BLAIR Must register pets within 10 days of residency Owner Name Spouse ....................... Owner Address clity/state/zip Phone # Pet Names Sophie Age: ZY SOX; Spayed Female DOB: 09-03-20 Breed., Lab Micruchlp # 985141002843921 PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A REN RABIES VACCINATION DONE ON Rabies Description: 1 YEAR Shirley Stadler 750 Garfield Blair, NE 68008 402-426-4741 Tag #2959 Color: Lt Yellow 12-20-21 .Rabies Tag # 19683 AVAILABLE): # LICENSE FEE Intact Dog or Cat: $16.00 d D g oat: $11.00 Replacement Tag WOO Total $ � �'n PETS THAT ARE ON THE AC VEPoTENT LLYDA RV ___O_N E�RQU_10�� RE(51$TERDIRECTLY.A-T-C-I-T—YH—A—t�- DANGEROUS DUG LIST NVEIE5101 T11QJ _1L —It" 11 11 I'll - H 61 ste 'in Veterinary Clinic FAXED 01-06-23 Or,' Lisa $chrum D VM : Dr. Krlsta Holstein D VM BY 718 South .1911 Street Blair, NE 68008 -426-0101 Fax 402-426-7387 402 IL holsteinclinic@gmall-com k 10 A- PLCffle 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: Ciity of fflair o 218 S 16th St o Walk, HE 68008 you may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE.- March is, 2023 Owner Name: Owner Address: city/state/zip.. Blairy NE 68008 k Phone # LICENSE FEES: Dog or Cat: $16-00 ***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/ 5/2023. The City shall recognize a microchip Identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city Identification other than that issued by the City of Blair for such dog or cat. The City of Blair requires proof of rabies vaccination t be submitted with vour license application. Replacement Fee for Lost Tag: $5.00 1 OFN�--,, 1v c-7 t' eV9MS9rjT0rffrWL PET #1, Ut Dog E3 Cat Spayed/Neutered License Fee Pet Name lllv '.1 1 V Birthdate Sex Color Breed** Replacement $ Declared Dangerous or Potentially Dangerous Dog* El Y 'P N 1 0 MICROCHIP # (If applicable), SUBTOTAL: RABIES VACCINATION DATE L (3 yr) (I yr) - City Tag # 4L PET #2 El Dog 0 Cat LI Spayed/Neutered Pet Name Birthdate Sex Color Breed" Declared Dangerous or Potentially Dangerous Dog: D Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) — WE Replacement $ -** SUBTOTAL., $ City Tag # PET #3 El Dog El Cat Ll Spayed/Neutered License Fee $ Pet Name Birthdate Sex Replacement $ Color Breed** Declared Dangerous or Potentially Dangerous Dog: 0 Y El N MICROCHIP # .(If applicable) SUBTOTAL:$ RABIES VACCINATION DATE: (3 yr) — (I yr) _ City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) K man TOTAL ENCLOSED $ j Do Not Send Cash by �L- If you have questions, please contact Blair Police Department at (402) 426-4747 .............................................................................. NEW PET/ NEW RESIDENT LICENSING REQUXREMIENTS (March 15 late fee date not applicable fornewpely1new residents) Newly Acaulred Pets: New Residents to Blair. W Must be Iloansed within 10 days of ownership M Must register pets within 10 days of Ea <OR> at 6 months of age If puppy/kitten residency. CERTIFICATE OF VACCINATION Date of Rabies Vaccination: 10/30/2023 Next Rabies Vaccination On: 10/29/2026 VETERINARY CLINIC Arlington Pet Hospital 225 N. 3rd St. Arlington, NE 68002 402-478-4141 ,00ertificate No: 0 n• OWNER OF ANIMAL Lora Stahl 1668 Nebraska St Blair, NE 68008 County: Washington This is to certify... THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW - Patient information... PATIENT: Penny TAG NO: 033100 SPECIES: Canine WEIGHT: 35.00 SEX: Spayed Female AGE: 4Y Color and markings: Brown Signed V" GRANT L-fTTLE, DVM License: 4022 L717114401t * =,$[ 10/30/2023 GL RABIES 3 YEAR, #033100 10/29/2026 10/30/2023 GL DHPP ADULT BOOSTER 2 YR 10/29/2025 10/30/2023 GL BORDETELLA ANNUAL BOOSTER 10/29/2024 8/3/2020 RABIES 1 YEAR Aabies Vaccine Information... .'InFG BY: NOBIV SER.NO: 66261'6 F OT EXP: 09/24/24 ADM: SQ 1 i CITY OF BLAIR ® 2023 PET LICENSE APPLICATIO(V If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair e 218 S 1th St @ Blair,, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2023 Owner Name: Owner Address:"' City/State/Zip: Blair, NE 68008 1 ,I Phone # t _ w LICENSE PEES: 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 i dli p PET # Dog ❑ Cat )Spayed/Neutered License Fee $ x. " Pet Name I "dild? Birthdate I 1 /2 I Sex ColorBreed** Replacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y LI'N MICROCHIP # - ` ,i (If applicable) SUBTOTAL: ; a RABIES VACCINATION DATE: q- � (3 yr) X- (1 yr) City Tag # j G 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) _ ■E License Fee $ Replacement $ ** SUBTOTAL: $ (1 yr) City Tag # ET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee Pet Name Birthdate Sex Color Breed** Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL LOSD $ If you have questions, please contact Blair Police Department at (402) 426-4747 ..........++++++++++++++.++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS(March 15late fee date not applicablefor newpets/new residents) Newly Acquired Pets: New Residents to Blair: ® Must be licensed within 10 days of ownership m Must register pets within 10 days of ® <OR> at 6 months of age if puppy/kitten residency. W 0 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: 04-30-22 at 12:42p FOR: Clara Stallings 5003 Woolworth Ave #12 Omaha, NE 68106 (603) 631-5542 Date For City Description Date: 04-30-22 Folder: 0 Invoice: 18005783 Net Price 04-30-22 Lillie 1 Canine DA2PP Vaccination, 1Y 27.00 04-30-22 1 Canine Rabies Vaccination, 3Y 27.00 04-30-22 1 Canine Bordetella Vaccination, 1Y 27.00 04-30-22 Visa payment -81.00 Old balance Charges Payments New balance 0.00 81.00 81.00 0.00 Reminders for: Lillie Last done 04/25 Canine Rabies Vaccination, 3 Y 04-30-22 04/23 Canine DA2PP, 1 Y 04-30-22 04/23 Canine Bordetella Vaccination 04-30-22 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 I r Omaha Animal Hospital 4908 L Street Omaha, NE 68117 (402) 734-5882 Is 0Wl07Kim 9 FOR: Clara Stallings 2467 Nebraska Street #4 Blair, NE 68008 (603) 631-5542 Date For Qty Description Printed: 06-01-22 at 2:22p Date: 05-10-22 Account: 11234 Invoice: 156944 Price Discount Price 05-10-22 Lillie 1 Spay > 6 months of age 149.00 05-10-22 1 Catheterization - Intravenous Surge 0.00 05-10-22 1 Endotracheallntubation 0.00 05-10-22 1 Heart Rate Monitoring 25.00 25.00 0.00 ** 05-10-22 1 Blood Pressure Monitoring 50.00 60.00 0.00 ** 05-10-22 1 Pulse Oximetry (Sp02) 35.00 36.00 0.00 ** 05-10-22 1 Isoflurane Maintenance Anesthesia 0.00 05-10-22 1 Induction Anesthesia 0.00 05-10-22 1 I.V. sedation, telazol 0.00 05-10-22 1 Presurgical Bloodwork/IV Catheter 0.00 05-10-22 1 DECLINED: CBC/Chemistry Presur 0.00 05-10-22 1 DECLINED: Chem 10 profile (IH) 0.00 05-10-22 1 DECLINED: Complete blood count 0.00 05-10-22 1 DECLINED: Catheterization - Intrav 0.00 05-10-22 1 Buster collar 25* 20.93 20.93 0.00 ** 05-10-22 1 Surgical Pain Management 0.00 05-10-22 4 Rimadyl 75 mg Chewable #23563 13.76 05-10-22 1 Micro chip insertion 44.50 05-10-22 1 Microchip Registration 19.99 Total charges, this invoice... 227.24 **Total discount included: 130.93 Your old balance... 0.00 Total payment(s) received... 227.24 05-10-22 Visa payment 227.24 Your new balance... 0.00 Your invoice total reflects our (unnamed) discount. Patient Total charges Lillie 227.24 Doctor's Instructions r (( ® y �` CITY OF BLAIR ®2023 PET LICENSE APPLICATION 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 1th St e Blair,, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS tEE DUE: Marcchr15, 2023 Owner Name: N l � ,iakti je - Owner Address: 1,77-0 1-f city/state/zip: Blair, NE 6008 Phone # C-Q Z7S ILIS� 0Y U92-DISF 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. Dog ❑ Cat P Spayed/Neutered License Fee $ Pet Name aur, Birthdate -Z -2o S x M Color �, Breed** R1k ae 'rC 7C.MA ► Ak Replacement $ * * Declared Dangerous or Potentially Dangerous Dog: ❑ Y L)Y N MICROCHIP # NO (If applicable) SU TOTAL: $ RABIES VACCINATION DATE: A - - (3 yr) (1 yr) City Tag # PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ 71V LOW (1 yr) (1 yr) License Fee $ Replacement $ SU TOTAL: $ City Tag # License Fee $ Replacement $ C,UBTOTAL: City Tag # *PLEASE INCLUDE THE CITYTAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED $ 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 new pets/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/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 @ Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2023 Owner Name: r Owner Address: � `1 G r ,v City/state/Zip: Blair, NE 68008 711 Phone # q 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. 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 Up Dog ❑ Cat ❑ Spayed/Ne tered License Fee $ Pet Name_ �� - _ Birthdate G l Sex M Color ?�(..� A Lih, L- Breed** 2" , Replacement $ ** Declared Danger ub s or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: 5 (3 yr) ' (1 yr) City Tag # PET # 2 ® Dog ❑ Cat ❑ Spayed/Neutered License Fee $ f °` Pet Name s :, Birthdate 'Q-;,,Sex Color (3, o Breed** _ :> 61jac-14-) 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 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 ENCLOSE® $ . If you have questions, please contact Blair Police Department at (402) 426-4747 ................................. o•..........++++++.....+++++++++++..++.++++¢ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15late fee date not applicable for new pets/new residents) Newly Acquired Pets: New Residents to Blair: • Must be lioensed within 10 days of ownership w Must register pets within 10 days of • <OR> at 6 months of age if puppy/Ivtten residency. Date of Rabies Vaccination: 08-17-22 Certificate No: 3525 Next Rabies Vaccination On: 08-17-23 Previous Rabies Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Thone Animal Hospital Troy Stanley 902 S Hwy 30 1871 Grant st Blair, NE 68008 Blair, NE 68008 402-426-3630 County: This is to certify... THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW. Patient information... PATIENT: June TAG NO: 008234 SPECIES: Canine WEIGHT: 0.00 SEX: F AGE: 17 weeks Color and markings... Chocolate Signed Dr.Kamala Freeman License: 3894 Vaccinations done... 08-17-22 KF Rabies Vaccination (1 Year), #008234 08-17-22 KF DA2PPV 08-17-23 08-01-22 DM Bordetella Oral 08-01-23 Rabies Vaccine Information... MFG BY: ZOETI SR.NO: 556836 LOT EXP: 04/25/23 ADM: SQ Date of Rabies Vaccination: 02-15-22 Next Rabies Vaccination On: 02-14-25 VETERINARY CLINIC Thone Animal Hospital 902 S Hwy 30 Blair, NE 68008 402-426-3630 This is to certify... Patient information... Certificate No: 2645 Previous Rabies Vaccination: OWNER OF ANIMAL Michelle Stanley 1871 Grant st Blair, NE 68008 County: PATIENT: Charlie TAG NO: 007513 SPECIES: Canine WEIGHT: 33.00 SEX: N AGE: 16 months Color and markings... BrownMhit Signed Dr. JoeDiMari License: 3258 Vaccinations done... 02-15-22 JRD Rabies Vaccination (3 Year), #007513 02-14-25 02-15-22 JRD DA2PPV+L 02-15-23 02-15-22 JRD Bordetella Oral 02-15-23 02-26-21 KF Rabies Vaccination (1 Year), #006465 12-21-20 JRD DA2PPV Rabies Vaccine Information... MFG BY: ZOETI SER.NO: 542135 LOT EXP: 02-14-23 ADM: SQ If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair @ 218 S 16th St 9 Blair, NE 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 D1 • I ste�� Ownerll-i Address: , I lu City/State/Zip: Blair, NE 11 ' • 10 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 fine a penalty of a 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: $6.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program 3 ! A PET #1 Dog ❑ Cat Spayed Neutered License Fee $ I Pet Name Birthdate 11 Sex Color Breed** Replacement$ ** Declared Dang ou or Potentially Dangerous Dog: ❑ Y N MICROCHIP # 9 $51 I � 0yR 6 fa 6c, S A (Tf applicable) SU TOTAL. $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # v} PET #2 Doq ❑ Cat Spayed/Neutered License Fee $ eld Pet Name Q Birthdate XZ)[&ex S Color Breed** Replacement$ ** Declared Dangerous g, ?otentiallyDangerous Dog: ❑ Y W N MTCROCHIP # $ 0'I j as C(If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: 2- 9 JQ i (3 yr) z (1 yr) City Tag #- I,,. l j PET #3 ❑ n n n Cat ❑ Spayed/Neutered Pet Name �_ - Birthdate Color _ Breed** Declare, pus or Potentially Dangerous Dog: ❑ Y P N MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) License Fee $ Replacement $ SUBTOTAL: (1 yr) City Tag *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) M Do Not Send Cash by Mail TOTAL ENCLOSED $ If you have questions, please contact Blair Police bepartment at (402) 426-4747 +.++++.........++++++++++++++++++........+++++-r+.+++++++++. ¢-r++++¢++++....... NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March I5/ate fee date notapplicable fornewpets/newresldents) Newly Acquired Pets: New Residents to Blair: • Must be licensed within 10 days of ownership a Must register pets within 10 days of • <OR> at 6 months of age if puppy/Idtten residency. Reminder Letter Report Sorted Client I Client ID Client Name Patient ID Patient Name -7 Steffen, Jamie Phone: (402) 218-0182 5949 Saida 8972 Punky Bacon 9820 Nishka Item ID/Description Type Date 176 Feline Leukemia Vac -Annual L 5/17/2015 100 Rhino-Calici-Flu-PanLeu-Annual L 1/31/2020 84 Rabies Vaccination - Feline 3 year L 1/31/2021 151 Heartworm Test - Snap RT L 12/10/2023 937 Leptosporosis Vaccination annual L 1/12/2024 INTRA Oral Bordetella/Parainfluenza L 1/12/2024 82 Rabies Vaccination - Canine 3yr L 2/2/2024 14153 Distemper/ Parvo DAPP-3 year L 1/12/2026 151 Heartworm Test - Snap RT L 12/10/2023 937 Leptosporosis Vaccination annual L 1/12/2024 INTRA Oral Bordetella/Parainfluenza L 5/19/2024 82 Rabies Vaccination - Canine 3yr L 6/6/2025 14153 Distemper/ Parvo DAPP-3 year L 1/12/2026 Blair Small Animal Clinic PC Page 1 of 1 Date: 8/11/2023 12/01/2022 17:49 4024260101 HOLSTEIN VET CLINIC PAGE 01/04 2023 PET LICENSE VERIFICATION/0PLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S), COMPLETE THIS FORM AND RTURN. WITH A CHECK PAYABLE TO: CITY OF BLAIR — 218 S. 16 TH ST — BLAIR. NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PF-M BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CAT . 5 PFR RESIDENTIAL OR DWELLING UNIT. —PLEASE READ CAREFULLY*** YOU . ARE REQUIIJED 13Y LAW TQ_jjfENSE YOUH I PETS. THE CITY OF BLAIR FIEOUIRES PRO RABIES VACCINATION. Failure to'do so is a Violation of City Ordinances 6,103 and carries a penalty of 8 fine up 10 $1b0,00 per pet. PET LICENS j3ENEWALSAR92UE_0Y311V2Q2_3, The city sh'all recognize"a microchip ID number as the license number. at ' It shall be unlawful for any dog or cat to wear any license or other city ID other than that issued by the City of Blair for such dog or c NEW'PET L!QE_N,9LNG_Must be licensed within 10 days of ownership (OR) i R) at 6 months of ago f puppy or kitten NEW RESIDENT_$.TQ _BLAIR Must register pets within 10 days of residency Owner Name Spouse. Qwner Address City/state/zip - "bone* Pet Name; DUt0hCSS Aue, _3Y Sex: Spayed Female .DOB: 08-21-19, greed:,. Spaniel, Springer Roger Steinbough 816 WASHINGTON Blair, NE 68008 402-426-4550 Color: lover and White Miq.rv'ChIp# 985141001672656 1,Rabies Tag # 18432 PLEASEIN .. C . LUIDE CITY TAG NUMBF-11 IF THIS IS A RENEWAL (IF AVAILABLE): # RABIES VACCINATION DOW ON 12.12-20 Rabies Doseeiption! 1 YEAR 3 YEAR .Holstein Veterinary Clinic - ,or, Lisa. Schrum DVM :,or. Kfista Holstein D VAII 710' South 191h Street Blair, NE 68008 ":402-426r7387 402-426-0101 fax holsteincli nic@ g mail com LKMff_F E 1- 9 111fact Do.g or Cat: $16.00 Replacement Tag $5-00 Total $ PET,` THAT ARE ON THE ACTIVEPOTeNPALLYDANGER0110R DANGEROUS gQLLLST NEED T REGISTE�QJR•ECTLYAT effHALL. FAXED 12-01-22. BY ------------ if Acl�_4 icy 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 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:�'1 s_ Owner Address: city/state/zip: Blair,, NE 6/8008 ��":..) .fir%•% �� !r- "r Phone # LICENSE FEES: Dog or Cat: $16.00 Altered Doc* 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 $ ll1 4Y, Pet Name_--, 1'"l Birthdate 14 Sex /4 Color �firl�,_ Breed**Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y Q N MICROCHIP # f/rd�� (If applicable) SUBTOTAL: $imf J � RABIES VACCINATION DATE: 3 -8- 20 (3 yr) (1 yr) City Tag # E 2 Dog ❑ Cat ' Spayed/Neutered License Fee $ -- Pet Name V Birthdate Sex ki Color �i,,711jA 5424-r � f Breed** � " /7 Replacement $ Declared Dangerous or Potentially Dangerous Dog: ❑ Y 4 N MICROCHIP # ) :� P 0 6 R /1 (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE. V (3 yr) i✓' (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 fornewpets/newresidenis) Newly Acquired Pets: New Residents to Blair: Must be licensed within 10 days of ownership ® Must register pets within 10 days of <OR> at 6 months of age if puppy/kitten residency. CITY OF BLAIR ® 2023 PET LICENSE 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: " 'j Owner Address: city/state/zip: Blair,, NE 68008 Phone # LICENSE FEES: Dog or Cat: $16.00 Altered Do or Cat• $11 00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 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 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 Dog ❑ Cat A Spayed/Neutered License Fee $ l Pet Name G Birthdate q z 24 Sex Color Breed** Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y JQ N MICROCHIP # 1 (If applicable) SUBTOTAL: $ _ RABIES VACCINATION DATE: 1 tl (3 yr) X (1 yr) City Tag # ET #2 ❑ Dog 0 Cat 0 Spaye eutered License Fee -CO Pet Name t Birthdate Sex Color Breed** Rep/acement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # _(If applicable) SU TOTAL: $ RABIES VACCINATIOON DATE:�tl4 J&t z(3 yr) (1 yr) City Tag # PET #3 ❑ Dog Cat LZ Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color ' eed** Rep/acement$ ** Declared Dangerous & Pote tially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION E: (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 CL $ If you have questions, please contact Blair Police Department at (402) 426-4747 ..........++++++++++++++++++.....+++++++.+++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date notapplicable fornewpets/newresidents) Newly Acquired Pets: New Residents to Blair: Must be lioansed 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 Date of Rabies Vaccination: 07-11-22. Certificate No: 2878 Next Rabies Vaccination On: 07-10-25 Previous Rabies Vaccination: VETERINARY CLINIC = OWNER OF ANIMAL Thone Animal Hospital Cheryl Stevens 902 S Hwy 30 647 N 12th St Nair, NE 68008 Blair, NE 68008 402-426-3630 County: This is to certify... THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW. Patient Information... PATIENT: Carl Bosco SPECIES: Canine SEX: NJ TRIG NO: 008076 WEIGHT: 0.00 AGE: =15 months Color and markings..: Tan Signed Dr. Joe DiMari License: 3268 Vaccinations done... 07-11-22 JRD Rabies Vaccination (3 Year), 9008076 07-1(}-2b 07-11-22 JRD DA2PPV Syr 07-10-25 07-11-22 JRD Bardetella Oral 07-11-23 07-28-21 DM Rabies Vaocinaticn (1 Year), #006966 07-28-21 DM DA2PPV Rabies Vaccine Information... MFO BY: ZOETI SER.NO: 556836 LOT EXP: 04125/23 ADM: SO r tCERTIFICATE OF VACCINATION Late of Rabies Vaccination: 11-04-22 Next Rabies Vaccination On: 11-03-25 VETERINARY CLINIC Thane Animal Hospital 902 S Hwy 30 Blair, NE 68008 402-426-3630 Certificate No: 0 Previous Rabies Vaccination: 005273 MINER OF ANIMAL Cheryl Stevens 647 N 12th St Blair, NE 68008 County: AGAINSTThis is to certify... THAT I HAVE VACCINATED RABIES BELOW. Patient information... PATIENT: Callie SPECIES., Feline SEA[: S TAG Nth; 008457 WEIGHT:18,50 AGE: 7 years Color and markings... Dk Tiger Signed F. Joe DiMari License:3258 Vaccinabons dame... 11-04-22 JRD Rabies Vaccination (3 Fear), #009457 11--03-26 11-11-19 JRD Fe 4Way (Rh ino/Cali/PanVChla) 11-10-20 Rabies Vaccine Information... c i +' LOT EXP: r i Date of Rabies Vaccination: 11-0422 Next Rabies Vaccination On: 11-03-25 VETERINARY CLINIC Thane Animal Hospital 902 8 Hwy 30 Blair, NE 68008 402-426-3630 This is to certify... Gertif cute No: 4 Previous Rables Vaccination: 005272 OWNER OF ANIMAL Cheryl Stevens 647 N' 2th St Blair, NE 68008 County: a , - . �, r: Patient information... PATIENT: Binx TAG NO: 008456' SPECIES: Feline WEIGHT:13.90 SEX: N AGE: 7 years Color and markings... Slack -4 License: 3258 Vaccinations one... 114M-22 JRD Rabies Vaccinatim (3 Year), #000456 1 1-03-25 11-11-19 JRD Fe 4Way (RhinofCali/PanUChla) 11 -1 D-20 $ *,583359 LOT EXP: • O 03/15/2023 15:10 4024260101 HOLSTEIN VET CLINIC PAGE 01/01 2023 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLF TO; CITY OF BLAIR - 218 S.16 TH ST - BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION or FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (2) ADLJ4T DOGS OR THREE M ADULT CATS PER RESIDENTIAL OR DWELLING UNIT. *"PLEASE READ CAREFULLY— E CITY OF Failure to dr) so is a Violation of City Ordinanoes 6,103 and carries a penalty of a fine up to $150.00 per pat. PET LIOI=NSE, gNgW&La_ARE t]� �Y 3/15/202� The city shall recognize a microchip 10 number as the license number. It shall be unlawful for any clog or cat to wear any license or other City ID other than that 'issued by the City of Blair for such dog or cat. hLEY,V PET LICENSING Must be licensed within 10 days of ownership (OR) at 6 months of ago if puppy or kitten NEW Must register pots within 10 days of residency Owner Name I .... Jane & LeRoy Gramke-Stevens Spouse Owner Address 1 575 South 16 St. Gity/stateaip I Blair, NF. 68008 Phone # 402-278-2652 r 1mvrev M Pet Name: Dawson Age: 12Y Sex: Neutared Male Color, White 00R: —01.01-11 Breed,, Mix Microchip # — Fk abies Tag # 23160 PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABL0, # RABIES VACCINATION DONE ON 03-15-23 Rabies Description: 1 YEAR. �PEAR Holstein Veterinary Clinic Or. Lisa 5chrLjn7 DV114 :Cyr. Krism Holstein DVM 718 South 19th Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteinclinic@gmail.corn W,ENBLE FEES IntaGt Dog or Cat: $16.00 -SO 141 vup Or UC itIficame'"t )ray $5.00 Total PETS THAT ARE ON THE ACT(VEPOTEq-TLAtLY DANGEROUS OR oA1VG-ERQV5 OOGUST NEED TO REGISTER Q1RF(,-ftY AT WY HALL, FAXED 03-15-23 BY d k k i l � INS/®ICE Omaha Pet Vaccination Clinic 2911 S. 120th St. Omaha, NE 68144 402-443-2006 Affordable Pet Vaccination Clinics with NO OFFICE CALLS OR EXAM FEES Printed: 02-17-23 at 11:16a FOR: Angela Stutznegger Date: 02-17-23 1805 Park St Folder: 0 Blair, NE 68008 Invoice: 243918 (402)917-3871 Date For Qty Description Net Price 02-17-23 Olaf 1 Canine DA2PP Vaccination, 1Y 29.00 02-17-23 1 Canine Lepto Vaccination, 1Y 29.00 02-17-23 1 Canine Bordetella Vaccination, 1Y 29.00 02-17-23 1 Tri-Heart Plus Chew Tabs 51-100 Ibs 6 pk 56.00 02-17-23 Wynne 1 Canine DA2PP Vaccination, 1Y 29.00 02-17-23 1 Canine Lepto Vaccination, 1Y 29.00 02-17-23 1 Canine Bordetella Vaccination, 1Y 29.00 02-17-23 1 Anal Sac Expression 22.00 02-17-23 1 Tri-Heart Plus Chew Tabs up to 25 Ibs 6p 36.00 02-17-23 4 Bravecto 10 22'Ibs 248.00 02-17-23 Visa payment-536.00 Old balance Charges Payments New balance 0.00 536.00 536.00 0.00 Reminders for: Wynne (Weight: 18.4 Ibs - 8y) 02/24 Canine DA2PP, 1 Y 02/24 Canine Bordetella Vaccination 02/24 Canine Leptospirosis Vaccinati 10/23 Canine Rabies Vaccination, 3 Y Reminders for: Olaf (Weight: 58.2 Ibs - 8y) 02/24 Canine DA2PP, 1 Y 02/24 Canine Bordetella Vaccination 02/24 Canine Leptospirosis Vaccinati 10/23 Canine Rabies Vaccination, 3 Y Thank you for your business! www.DRDOBESH.com Last done 02-17-23 02-17-23 02-17-23 10-30-20 Last done 02-17-23 02-17-23 02-17-23 10-30-20 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 o 218S 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 DUE: March 15, 2023 Owner Name: Owner Address: T c' city/state/zip: Blair, NE 68008 Phone # _ t 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 3115/2023. The City shall recognize a microchip Identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city Identification other than that Issued by the City of Blair for such dog or cat. The Citv of Blair_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 ❑ o g ❑ Cat qP Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color 7Breed** Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: t Y W N 1 &r$- te, r- MICROCHIP # (If applicable) SUBTOTAL: $ / RABIES VACCINATION DATE: �� / Z, , (3 yr) (1 yr) City Tag # * PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ W W (1 yr) (1 yr) License Fee $ Replacement SUBTOTAL: $ City Tag # License Fee $ Replacement $ SUBTOTAL:$ *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED If you have questions, please contact Blair Police Department at (402) 426-4747 .....++++++...............++++++++++++++++++.....+++++++¢+++++++++++++¢.+++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March Mate fee date not applicable I&newpe&lnewresidents) Newly Acquired Pets: New Residents to Blair: Must be licensed within 10 days of ownership ■ Must register pets within 10 days of <OR> at 6 months of age if puppy/Idtten residency.