W01/25/2023 17:18 4024260101 HOLSTEIN VET CLINIC PAGE 03/03
2023 PET LICENSE
VERIFICATION/APPLICA.TIOW MR 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. 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 ON DWELLING UNIT.
*OOPLEASE READ CAREFULLY***
YOU„ ARE REQUIREa BY LAW TCI LICENSE YQUR PETS THE CITY C1F 13LAIR REnUIRE PROOF OF EABIpS VACCINATION_
Failure to do so is a violation of City Ordinances 6.103 and carries a penalty of a fina up to $150-00 per pot,
PET LICENSE RENEWALS ARE DUE BY 3/1512023.
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 LICENSLUQ-Must be licensed Within 10 days of ownership (OR) at 6 months of ape if puppy or kitten
NEW RESIDENT GLAIR Must register pets within 10 days of residency
Owner Name Chris Wallace
Spouse Megan
Owner Address 1928 Colfax St
City/State/Zip Blair, NB 68008
Phone # ! 402-980-7211
Pet Name, Abbi
Tag #3284 _
Age: 10Y Sex: Spayed Female, Color: Grey and White
DOB: 04-13-12
Breed: Dmh
Microchip # � Rabies Tag #
PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): #
RABIES VACCINATION DONE O� �-25-23
Rabies [description: (1 1 YEAR )1 3 YEAR,
Holstein Veterinary Clinic
Dr. Lisa $ hrum DVM : Or. 10 sta Holstein VVM'
718 South 1911' Street Blair, N� 68008
402-426-7387 402-426-0101 Fax
holsteindini+c@gmail-COITI
LICENSETM
Intact
Dog or Cat: $16.00
/tared .
D or c
aK'$1 11.Qg
Q
RM
$5.00
Total M
PE75 TNA,TAR� ON THE ACTIVE PpTENTIALLY DANGEROUS OR
DANGEROW DQG L15T NEED T6 RfCvl$TER DIRECTLYAT C✓'LV HA1L•
FAXED 01-25-23
BY
01/25/2023 17:18 4024260101 HOLSTEIN VET CLINIC PAGE 02/03
2023 PET LICENSE
VERIFICATION/APPLICATION FOR CITY OF BLAIR
IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A LQG(S) AND /OR 6AT(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,
BLJT NO MORE THAN THREE (3) ADULT DOGS OR THREr. (3) ADULT CATS PER RESIDENTIAL OR DWELLING I)NIT.
—PLEASE READ CAREFULLY"*
YOU ARE _ff�_ WIAEDBYLA�Wl �ENSE�YQU _PETS. THE CI BLAIR RE QUIRESPROOF, OF RABIES VACCINATION,
Failure to do so is a violation of City Ordinances B.103 and carries A penalty of a fine urn to $150-00 Per pet.
PET LICENSERENEWALS
REME
The city shall recognize a nilcrochip 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 j_LICENSING MLISt))O 11censed within 10 days of owjjer�diip (OR) at 6 roonths of age if puppy or kitten
NEW RESIDENTS �TQBLA Must register pets within 10 days of rosidoncy
Owner Name
Spouse
Owner Address
City/State/Zip
Phone #
Pot Name: Dave
Age- 11Y
DOB: 04-13-11
Breed: DSH
Sex. Neutered Male
Microchip #
ITLFASE —INCLUDE CITY TAG NUMBER IF THIS IS A RJECE
RABIES VACCINATION DONE 01-25-23
Rabies -Description: tl YEAR
Chris Wallace
I IT, =.
1928 Colfax St
Blair, NE 68008
402-980-7211
Tag #3285
Color: Whi/Gray
Rabies Tag #
(IF AVAILABLE); #
3 YEAR
Ho . Istein Veterinary Clinic
,fir, Liss Schrum,014M : Dr. KrIsta Holstein 13VM
718 South 191h Street Blair, NE 68008
402-426-7387 402-426-0101 Fax
holsteinclinic@ 9mail-com -
UPQNWIE FEES
Intact
Dog or Cat: $16-00
red
Do rat' $11.00
)o 80P g
$5.00
Total $A—,
PETS7NATAREONTHEACTIV
DANGEROUS DOG LIST NEED TO_RE(31STERDIREI--74YATCITY NAIL,
FAXED 01 5-23
01
BY
01/25/2023 17:18 4024260101 HOLSTEIN VET CLINIC PAGE 01/03
2023 PET LICENS5
VERIFICATION/APPLICATION FOR CITY OF BLAIR
IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A OOG(S) AND /OR CAT(S),
COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO:
OITY OP BLAIR - 219 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"*
Failure to do so is a violation of City Ordinances 6,103 and oarrios a penalty of a fine up to $150,00 per pet,
PET LICEN ENE ARE int it; BY g/ia-/2923 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 PETLICENSINGMust be licensed within lo clays of owjjorship (OR) at 6 months of age if puppy or kitten
NEW RESIDENTS T EILM Must register pets within 10 days of residency
Owner Name
Chris Wallace
Spouse
owner Address
Megan
1928 Colfax St
cilty/stato/zlp
Blair, NE 68008
Phone#
402-980-7211
Pet Name: Jeff
Tag #3234
Age:, 6Y Sex: Neutered Male Color,
DOB, —01-05-17
Breed; Pit Bull
Microchip #
Rabies Tag 9 23041
PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE),#
RABWS VACCINATION DONE ON
01-25-23
Rabies Description: 1 YEAR 3;AR
Holstein Veterinar'y Clinic
Dr, .Lisa Schrum D VM : Dl', Krista Holstein D VM
718 South 19th Street Blair, NE 68008
402-426-7387 402-426-0101 Fax
h olstei nclinic @gma il.coni
LICENSE TEES
Intact,
Dog or Cat: $16.00
14 K-e—r�
Do or ' pat: $11,0
neplatM nt Tao
$5.00
Total $—A
TS THA TARE QN THEACTIVt POTENTIAL& 0AN ER005OR
0ANbLHUML11)0 15TNEED TOff 'r071'11AtL,-
?,�c=TEKD1Kdff0'A7'071'11AtL
FAXED
01-25-23
BY
—7 7, . .. ....
p.1
Jan 13 2311.22a
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 a Blair, NE 68008
You may legally own a combination of four (4) adult pets, but no more than three (3TbanwAplmal Hospital
or three (3) adult cats per residential or dwelling unit. (402) 426-3630
LICENSE RENEWALS ARE DUE: March 15, Z023,
Owner Name: s 4att 4
Owner Address: 2Z i otr o q& W.
city/state/zip: B'lrarir, NE 68008
Phone # 40c� ` 51 0 _ 0
LICENSE FEES: Dog or Cat: $16.00
Altered Dog or Cat: $11.00
S02 S my 30
air,
***PLEASE READ CAREFULLY***
YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS,
Failure to do so Is a violation of City ordinances 6.103 and carries
a penalty of a fine up to $150.00 per pet.
PET LICENSES RENEWALS ARE DUE BY 311512023. The City shal
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 rables vaccination to
be submitted with Your license application.
Replacement Fee far 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 Dpg ❑ CatiSpayed/Neutered License Fee $ 0
Pet Name Re..Im � d 61;- E Biate wmj 19 Sex 5 • F
Color 13Y-;ri dU2 Breed** rAec100dLo Replacement $ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N l 4
MICROCHIP # cl%102007-:71-1'61toLl (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: 01- i3' Z-,� (3 yr) X_ (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 Cl 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 $ At - 0
If you have questions, please contact Blair Police Department at (402) 426-4747
++++++++.+++*.+++++++++t+.+t++......++++.+.....+++++++++++.++++++++++++.+.t+.+
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee dale notapplrcab/e fnrnew peWnewfasidenlr)
Newly Aaguired Pets: New Residents to Blair:
■ Must be lbensed within 10 days of ownership ■ Must register pets within 10 days of
■ <OR> at 6 months of ages If puppy/kitten residency.
03/15/2023 17:26 4024260101 HOLSTEIN VET CLINIC PAGE 01/02
2023 PET LICENSE
VERIFICATION/APPLICATION FOR CITY OF BLAIR
IF YOU LIVE IN BLAIR CITY LIMITS AND 0VVN A DOG(S) AND /OR CAT(S),
COMPLETL THIS FORM AND RETURN WITH A CHECK PAYABLE TO;
CITY OF BLAIR - 218 S. 16' ST -y BLAIR, NE 68008
YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS,
BUT NO MORE THAN THREE 0 ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR [?WELLING UNIT.
***PLEAS'F READ CAREFULLY"°"°
YOU ARE REQUIRt"13 RY LAW TO L{CIfN$E YOUR PETS. SHE CITY OF BLAtR RE@UIRES RR+30F QF RABIES VACt~,INATiON.
Failure to do so is a Vidatiah Of City Ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet,
PET LICENS RENEWALS ARE,QLIE BY 3/15/2Q
The city shall recognize a micros hip ID number as the license number.
It shall be unlawful for any dopy Or cat to wear any license or other city ID other than that issued by the City of Blair for such dog or cat.
NEW PET LICEN$ING Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten
NEW RESlbENTS TO t LAIf3 Must register pets within 10 days of residency
Owner Name
Erich & Julia Warner
Spouse
Owner Address
1016 Flynn Dr.
-
City/State/Zip
Blair, NE 68008
Phone #
402-416-1710
I
Pet Name: Maya
Tag #914
Age: 11Y
DOB: 04-16-11
Sex: Spayed Female
Color: Black and White
Breed: German SH Pointer
Microchip.# 494C511814
Rabies Tag # 19284
PLFASE INCLUDE CITY TAG NUMBER IF Till$ IS A RENEWAL (IE AVAILABLE); #
RABIES VAICCENATION DONE ON
06-26-21
Babies Description: 1 YEAR
=3YEAR
Holstein Veterinary Clinic
Dr. Liss Schrum DVM ; Dr. Kr%ra Holstein 0V11
718 South 191" Street Blair, NE 68008
402-426-7387 402-426-0101 Fax
holsteinelinic@gmaii.com
I ICENSe FEES
Intact
Dog or Cat: $16.00
rag or cat: $11,QQ
keplaaement 'Tag
$5,00
Total $ 1 (
PETS THAT ARE ON THEp�TlVE POTENTIALLY j7ANGEROUS Oft
DANGEROUS DOG LIST n efQ TO REGISTER DIffCTLY AT GTY HALL.
FAXI-D 03-15 23
BY
03/15/2023 17:26 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. 16T" ST - BLAIR, NE 68008
YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS,
BUT NO MORE THAN THREE (?) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT.
***PLEASE READ CARIEFUILLY"It
YQU ARE REQUIRED BY LAW TO F OF RABIES VACCINATION,
Failure to do so is a violation of City OrdlriQricea 6103 and carries a penalty of a fine up to $150.00 per pet,
PET LICENSE RENEWALS ARE DUE BY 3/15/2023.
The city shall recognize a microchip ID number as the license number.
It shall be unlawftil for any dog or cat to wear any license or other city ID other than that issued by the City of Blair for such doo or cat.
NEW PET LICENSING Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten
NEW RESIDEN-F!5 TO BLAIR Must register pets within 10 days of residency
Owner Name
Erich & Julia Warner
spouse
Owner Address
1016 Flynn Dr.
city/state/zip
Blair, NE 68008
Phone#
402-416-1710
Pet Name: Rip
Tag #4052
Age: 13W
DOB: 12-10.22
$ex, Male
Color. Liver and White
Breed: German SHI Pointer
Microchip #
Rabies ag#231111
PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL or AVAILABLE): #
RABIES VACCINATION DONE ON
03-15-23
Rabies Description: rl YEAR
3 YEAR
..Holstein Veterinary Clinic
DA Lisa Schrum D VM -- Or Kl-&ta Holstein D V114
718 South I 9th Street Blair, NF 68008
402-426-7387 402-426-0101 Fax
holsteinclinic@gmail.corn
LICENSE FEES
or Cat: $16 00
Altered
Dog or cat: $11.00
Replacement Tq'Qr
$5.00
Total $
PM THAT ARE ON THE ACTIVE POTEN TIALLUANX;Ar _)vsok
DAN6ERou5 DOG LIST NEED TO REG1ST0,RLRFQ.YArCITY HALL,
FAXED 10.1-16-23
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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 fifth 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.
167,717-72 ►'' F 1=1 -
Owner Address:
City/State/Zip:
Phone #
1
go
Carol Weckmuller
_0
2026 Northridge Cir
Blair, NE 68008-4204
LICENSE FEES: Dog or Cat: $16.00
Al+'01-darill nn or r'nta 4k11 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.
Rteplacen-ment Fee for Lost Tag: $5.00
Included is a to Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program
0 0014
PET #1 Ll D o El Cat LISpayed Neutered License Fee $
Pet NaMe ek& - /6 e- _ Birthdate Sex Replacement $
Color Breed"
Declared Dangerous or Potentially Dangerous Dog: LJ Y /qN
MICROCHIP# 11C 1,6 E 3/1 7,S (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: (3 yr) — (1 yr) _ City Tag
PET #2 LJ Dog Ll Cat LJ Spayed/Neutered
Pet Name Birthdate Sex
Color Breed"
Declared Dangerous or Potentially Dangerous Dog: L3 Y
MICROCHIP # (If applicable)
RABIES VACCINATION DATE: (3 yr) —
mork
(I yr)
License Fee $ .
Replacement $
OTAL: $
— City Tag #
0 Dog LJ Cat Ll Spayed/Neutered License Fee $
Pet Name Birthdate Sex
Color Breed" Replacement $
Declared Dangerous or Potentially Dangerous Dog: J Y LJ 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 151ate fee date notapplIcable for newpelslnew residents)
Newly Acquired Pets: New Residents to Blair:
N Must be licensed within 10 days of ownership m Must register pets within 10 days of
E <OR> at 6 months of age if puppy/kitten residency.
A uICE
Holstein Vet Clinic
718 South 19th Street
Blair, NE 68008
402-426-7387
Check out our online store at www. HOLSTEI NVET,com for home delivery!
Printed: 02-04-22 at 11:41a
FOR: Carol Weckmuller Date: 02-04-22
2026 Northridge Drive Account: 1429
Blair, NE 68008 Invoice: 125420
(402) 278-0867
Date For Qty Description
02-04-22 Charlotte 1 Examination - Office Visit
02-04-22 1 Cytology/Slide - IN HOUSE
02-04-22 40 Cephalexin 500mg Capsule #17794
02-04-22 1 Depo-Medrol Inj > 1 CC < 2 CC
02-04-22 Visa payment
Old balance Charges Payments
0.00 109.80 109.80
/,- Reminders for: Charlotte (We-igi f 63.9Zs tOy-)---�-ast-carua,
04-30-23
Denfensor 3 (3 Year Rabies)
03-31---Canine
Influenza
03-31-22
Vangard Plus 5
03-31-22
Heartworm Test & Prevention
03-31-22
Bronchi Shield - Oral Bordetel
03-31-21
03-31-21
03-31-21
03-31-21
Thanks for choosing us to take care of your pet's health care needs!
Net Price
43.50
12.00
23.30
31.00
-109.80
New, balance
0.00
0
Holstein Vet Clinic
718 South 19th Street
Blair, NE 68008
402-426-7387
t
i I
��'�d Tare 4034�
Check out our online store at www.HOLSTEINVET.com for home deliveryl
Printed: 08-10-22 at 3:08p
FOR: Sonja Weiss P o' ; Date: 08-10-22
2714 Krejci Blvd r ;°`' Account: 10731
Blair, NE 68008 Invoice: 130531
(402) 708-9218
Date For Qty Description Net Price
08-10-22 Aurora 1 Exam - New Pet Exam 48.00
08-10-22 1 Vanguard® Feline RCP {Distemper) 29,00
08-10-22 1 Vanguard® Rabies 1 {1 YEAR) 29.25
08-10-22 3 Frontline GOLD Feline 52.50
08-10-22 Visa payment-158.75
Old balance Charges Payments New balance
0:00 158.75 158.75 0.00
Reminders for: Aurora Last done
08-10-23 Vanguard® Rabies 1 {1 YEAR) 08-10-22
08-10-23 Vanguard® Feline RCP {Distempe 08-10-22
Thanks for choosing us to take care of your pet's health care needs!
I
Date of Rabies Vaccination: 07-18-22 Certificate No: 3474
Next Rabies Vaccination On: 07-18-23 Previous Rabies Vaccination:
VETERINARY CLINIC OWNER OF ANIMAL
Thone Animal Hospital Friends of Blair Animal Shelter
902 S Hwy 30 P.O. Box 2330
Blair, NE 68008 Blair, NE 68098
402-426-3630 County:
This is to certify...
THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW.
Patient information...
PATIENT: Loki TAG NO: 008134
SPECIES: Feline WEIGHT: 8.00
SEX: N AGE: 24 months
Color and markings... GrTabby 1 -1
Signed
Dr. Donna Mertz License: 3630
Vaccinations done...
07-18-22 DM Rabies Vaccination (I Year), #008134
MFG BY: ZOETI SER.NO: 556836
LOT EXP: 04/25/23 ADM: SQ
13212 Cottner St,
Omaha, NE 68137
(402)334-5975
www.bestcarehospital.net
Rabies Certificate
7/17/2021
Client ID:
7141
Client Name:
Brian/Sonja Weiss
Address:
7-1.06-5-80th-St ,
ii 4 i
Lavi'sta;N
Telephone:
(402) 320-6996
Tag Number
Lot Number:
Producer:
K/MLV :
020901
464480
Merck
Killed Virus
Staff Name: Michael G. Siggers, DVM
License Number: NE #2672
Patient ID:
Name:
Species:
Breed:
Sex:
Color:
Markings:
Weight:
Birthdate:
Microchip:
Vaccination Date
Expiration Date:
Vaccine:
Dose:
1547
Milo
Canute
Spaniel, Eng. Spring
Neutered Male
White/Black
40
9/30/2013
985112005598070
7/17/2021
7/17/2024
Rabies Canine 3 yr Booster
1
i
a
EST
E
PET HOSPITAL
13212 Cottner St.
Omaha, NE 68137
(402) 334-5975
www.bestcarehospital.net
Rabies Certificate
6/26/2021
Client ID:
7141
Client Name:
Brian/Sonja Weiss
Address:
-7106 S.-80th-St
Lavista, _NE w f 68128
Telephone:
(402) 320-6996
Tag Number
Lot Number:
Producer:
K WILV:
020871
464480
Merck
Killed Virus
6
Staff Name: Michael G. Siggers, DVM
License Number: NE #2672
Patient ID:
Name:
Species:
Breed:
Sex:
Color:
Markings:
Weight:
Birthdate:
Microchip:
Vaccination Date
Expiration Date:
Vaccine:
Dose:
2758
Bear
Canine
Yorkshire, Mix
Neutered Male
Tan
8
1/14/2017
6/26/2021
6/26/2024
Rabies Canine 3 yr Booster
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 • 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 ,DU1E: March 15, 2023
Owner Name: -ar a- Wy5
Owner Address: S !:� 1 N a rf)-%1 2) YSd _
City/State/Zip: Blair, NE 68008
Phone # � 3(0� % b ® " O Cj
LICENSE FEES: Dog or Cat: $16.00
Altered Dog or Cat: $11.00
***PLEASE READ CAREFULLY***
YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS.
Failure to do so is a violation of City ordinances 6.103 and carries
a penalty of a fine up to $150.00 per pet.
PET LICENSES RENEWALS ARE DUE BY 3/15/2023. The City shall
recognize a microchip Identification number as the license number. It
shall be unlawful for any dog or cat to wear any license or other city
Identification other than that issued by the City of Blair for such dog or
cat. The Citv of Blair requires proof of rabies vaccination to
be submitted with your license application.
Replacement Fee for Lost Tag: $5.00
Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program
PET # 1 "--9 Dog ❑ Cat 'l Spayy d/ eutered License Fee $ 6
Pet Named Birthdate 6 I nniSex
Color Breed** k . cl 'e;77 Replacement$ **
Declared Dangerous or\1potentially Dangerous Dog: ❑ Y 12f N
MICROCHIP # (If applicable) SUBTOTAL: $ _
RABIES VACCINATION DATE: \,\_IIS ��Oa � (3 yr) � (1 yr) City Tag #Z5:�p
TT.
PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $
Pet Name Birthdate Sex
Color Breed** Replacement $ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N
MICROCHIP # (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag #
PET # 3 ❑ Dog ❑ Cat ❑ Spayed/Neutered
Pet Name Birthdate Sex
Color Breed**
Declared Dangerous or Potentially Dangerous Dog: ❑ Y
MICROCHIP # (If applicable)
RABIES VACCINATION DATE: (3 yr) _
M
(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 not applicable for new pets/new resident;)
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.
Blair Small Animal Clinic PC
David E. Johnson DVM
1734 Front Street
Blair, Nebraska, 68008
(402) 533-2722
Rabies Certificate
Patient ID:
9697
Client ID:
6206 -
Patient Name:
Smokey
Client Name:
Tara Wernke
551 North 23rd Street
Species:
-
Canine
mixed Breed
Address:
greed: _
Neutered MaleBlair,
NE 68008
Sex:_.,_
Dark Brown/Black & White
Color:
Phone:
(308)760-4309
Markings:
Birthday: 06/05/21017
pounds on 7116/2018
Weight:
982000410222627
Microchip ID:
Vaccination Date:
11/15/2021
Tag Number:
6639
Expiration Date:
11/1512024
Vaccine:
Imrab Rabies Vaccine
Lot Number:
18513
Producer:
Merial
Drug Expiration Date:
2/24/2023------
Brand:
Imrab 3 TF
J
Type:
Killed Virus
Manner of
Subcutaneously
nAminietrAtIon:
Staff Name: David E. Johnson DVM
License Number: 1893
Doctor Signature:
12/27/2022 18:00 4024260101 HOLSTEIN VET CLINIC PAGE 01/01
2023 PET LICENSE
VERnCATION/APPLICATION FOR CITY OF M O IR-
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 13LAIP.' 2i4 A&TH Vr — 0LA1F1� n1 ,000 i • v 0. � �r v � r+u � w
YOU MAY LEGALLY OWN A COMBINATIQN QF EOUR (4) ADULT PETS,
BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE 0) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT.
***PLEASE READ CAREFULLY***
Ytll„I ARE REQUIREb RY LAW Tt] LICENSE YOUR PETS THF,�ITY OF BLAIR REQUIRES PRQLIF f�F RABIE3 VACCINA71t�N
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 13E &MLS ARE UUE BY 3/15/2Q23.
The city shall recognize a miorochip 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 Moat ho lir•Pn.ged within to riayc nT nknlhiaral-hlin (nR) st R ninntht of c,u'a 14 puppy Qr kittom
NEW RESIDENTS TO BLAIB- Must register pets within 10 days of residency
Owner Neale,
v Larry West
Paula
Owner Address
2362 Hollow Rd
City/Stato2ip
Blair, NE 68006
[O—ho—ne #
402-
pet Name: Hobbes
Age: 3Y
DOB: 12.02-1 g
Sex: Neutered Male
Color: Rile Brrt
Breed: Dach Mix
Microchip # 981020041210051
Rabies Tag 9 20847
PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): #
RABIES VACCINATION DONE ON
12-27-22
LICENSE FEES
Intact
Dog or Cat; $16.00
Altered
or caf: $11.00
Replacement rag
$6.00
Total $ 1 [00
PETS T 4T RON 7 HC ACTIVE POTENTIALLY DANGEROUS OR
DANGEROI.I-U06 USY NEE0 TO RE615TER DIRECTLY AT CITY HALL.
,,-'Holstein Veterinary Clinic FAXED 92-27-22
n IIM , nr Krrcta llnlatpin !]I/M BY
71S SOLIth 19th 0,trggt Blair, nl(_ 6KOP
402-426-7337 402-426-0101 1=49x ;
-nail.aom
holsteinclinic gi
;.;
02/01/2023 15:05 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 DOGS) AND /OIL CAt'(S).
COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO:
CITY OF 9LAIR — 218 S. 16TH BT — 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 >a LIrvENSE YQkIR IPETS. THE CITY aF BLAIR REQUIRES PROOF OF RAVACCINATION.
Failure to do so Is a Violation of City Ordinances 6.103 and carries a penalty of a fine up to $150,00 per pet.
PET LIOEN_SE RENEWAL$ .ARE bUE BY 3/'15/2021-
The city shall recognize a microchip 1D number as the license number.
It shall be unlawful for any dog or cat to wear any license or other city IQ other than that issued by the City of Blair for such clog or cat:
NEW PET LICENSING Must be licensed within 10 days of ownership (01) at 6 months of age'if puppy or kitten
NEW RESIDENTS TO BLAIR Must register pets within 10 days of residency
Own6r'Name
Kris Wendt
Spouse
Ryan
Owner Address
_W 230 Baronage Circle
Pity/State/zip
Blair, NE 68008
Phone #
r
m 402.426.8997
Pet Name:! Beasley
Tag #3467
Age: 5Y
Sex: Spayed Female Dolor: Wh/Br/BI1k
DOB: 01 0g-19 ;•G
greed: En$ Setter
Mic�,uhip #
Rabies Tag # 20172
PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAI- (IF AVAILABLE):11
RABIES VACCINATION DONE ON
0:3-16-22
Rabie6 Description:
1 YEAR 3 YEAR
HPIstein -Veterinary'CI,inic
Di: Lisa Schrum DVM , Dr. KristR Holstein DVM
7118 South 19th Street Blair, NE 68008
402-426-7387 402-426-0101 Pax
i i 4c rn il.com
• l�lalsteil�cl n c .� a
• 9
LICENSE FEES
Intact
Dog or Cat: $16.00
/te o'
Do 6r cat: $11,00
Replacement Tag`
$5.00
Total $�
PETS THAT ARE ON THE ACTIVE PQT NVA LY pA1VGEROUS OR
DANGEROUS DOG LIST NEED TO REG/$TER DIRECTLYAT CITY HALL.
FAXED 02-01-23 .�-.�---
BY
02/01/2023 15:05 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 CAT(S),
COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO:
CITY OF BLAIR - 218 S. 16rHST - BLAIR, NE 68008
YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADUIT 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 T LICENSE HE CITY OF BLAIR ESPROOFOF F VACCINATION,
0 �00�FQ
Failure to do go is a Violation Of City orditlanCes 6-103 and carries a penalty of aline, up to $150,QQ pGr PUE.
PET LICENSE FINIEWALSAREDUEBY3tIV292-3. -
The GIW 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 f5jairfor such dog orcat,
NEW PET LICENSING Must be licensed within 10 days of ownership (OR) at B MbhthS Of age if puppy or kitten
NgZLRLSIDEBTS TO BLAIR Must register pets within 10 days of residency
Owner Name " I Kris Wendt
Spouse Ryan
Owner Address 230 Baronage Circle
city/stateaip — I I I 131air, NE 68008
Phone # .. 1 402-426-8997
Pet Name- Rocky
Tag #3479
Age: 9Y
DOB: 09-24-13
Sex, Neutered Male
Moir: Black and White
Breed:. Domestic Shorthair
Microchip #
Rabies Tag
PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILA13LE)- #
RABIES VACCINATION DONE ON
02-01-23
Rabies Description: 1: YEA.
3 YEAR
Holstein Veterinary Clinic
Or, 41sa Schrum D VM , Agr. KrIsta Holstein D VM
718 South 191h Street Blair, NE 68008
402-426-7387 402-426-0101 Fax
holsteinclinic@gmail-coal.
LICIINSE FEE
Intact
Dog or Cat'$16.00
ed
Dog( oat: ,D
Repface g
9
$5,00
Total $ --q-
PETS THAT ARC' ON rHE4.1-TIVEPOTENTIALLY I)AN66RoV:So—F?
DANGEROUS DOG LIST NEED TO REGISTER DIRECTLYAKPLKHAIL
FAXED 02-01-23
BY
L
PC '4 6
3)15Ia3 V-4- 35y o -4- l 04qSb
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 ®t Blair e 218 S 16th St 9 Blair, NE 6008
You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs
or three (3) adult cats per residential or dwelling unit.
LICENSE RENEWALS ARE DUE: NI rch 15 2023
Owner Name: 11�:_ 1 1
Owner Address: I I ��_� D �`N In
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 3/1512023. 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.
Replacement Fee for Lost Tag: $5.00
Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program
PET #1 ❑ Dog A Cat X Spayed/Neutered License Fee $ �• � �
Pet Name nyX _ Birt date �- g - JS Sex _
Color Breed** Replacement $ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y LJ N
MICROCHIP # (If applicable SUBTOTAL:
RABIES VACCINATION DATE: 3 lS a.3 (3 yr) (1 yr) City Tag #y 3 *
PET #2 Pog ❑ Cat 9 Spayed/Neutered License Fee U 0
Pet Name Birthdate (e)=i—=� 0 Sex
Color Breed** Via Im SX. nY k i _Replacement **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N
MICROCHIP # (If applicable) SUBTOTAL:
RABIES VACCINATION DATE: 3 — (3 yr) (1 yr) City Tag #,?
PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee
Pet Name Birthdate Sex
Color Breed** Rep/acement $ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N
MICROCHIP # (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag #
*PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL
** (This fee is due along with License Fee if requesting at the time of license renewal.)
Do Not Send Cash by Mail TOTAL ENCLOSED �� D �
If you have questions, please contact Blair Police Department at (402) 426-4747
+++++++++++++++++++++++++++++a.....+++++++.+++++++++++++++++++++++++++++++++++
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15late fee date not applicablefor newpets/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.
Blair Small Animal Clinic PC
David E. Johnson DVM
1734 Front Street
Blair, Nebraska, 68008
(402) 533-2722
Ellen Whitaker
1125 South Street
Blair, NE 68008
Page 1 / 1
Client ID: 1277
Invoice M 172453
Date: 3/15/2023
(402) 426-2073
Patient ID: 10817 Weight: 15.50 pounds
Patient Name: Samson Birthday: 03/08/2015
Species: Feline Sex: Neutered Male
Breed: Domestic Longhair
Description
3/15/2023 Examination -Wellness
Rhino-Calici-Flu-PanLeu-Annual
Rabies Vaccination - Feline 3 year
Cytology - Ear
Osurnia Otic Gel x tube
Staff Name Quantity
Total
David E. Johnson DVM 1.00
$30.00
1.00
$35.00
1.00
$30.00
1.00
$25.00
4.00
$77.36 T
Patient Subtotal:
$197.36
Instructions
Your cat has had the final dose in the series, and may be considered fully protected from Panleukopenia,
Rhinotracheitus, and calicivirus infection. We will notify you when it is time for booster vaccinations and other health
maintenance needs.
Reminder
03/15/2024 Rhino-Calici-Flu-PanLeu-Annual
03/15/2026 Rabies Vaccination - Feline 3 year
Invoice Total:
default Tax Rate
Total:
Balance Due:
Previous Balance:
Balance Due:
Check Check # 3539:
Less Payment:
Balance Due:
$197.36 F
$5.42
$202.78
$202.78
$0.00
$202.78
($202.78)
($202.78)
$0.00
Order your pets supplies online now through our website www.blairsmalIanImalclInic.vetsfIrstchoice.com For questions contact
us at 402-533-2722.
Blair Small Animal Clinic PC
Client ID:
Client Name:
Address:
Phone
David E. Johnson DVM
1734 Front Street
Blair, Nebraska, 68008
(402) 533-2722
Rabies Certificate
1277
Patient ID:
10817
Ellen Whitaker
Patient Name:
Samson
1125 South Street
Species:
Feline
Blair, NE 68008
Breed:
Domestic Longhair
Sex:
Neutered Male
(402)426-2073
Color:
Markings:
Gray
Birthday:
03/08/2015
Weight:
15.50 pounds on 3/26/2022
Microchip ID:
Tag Number:
00000
Vaccine:
Imrab Rabies Vaccine
Producer:
Merial
Brand:
Imrab 3 TF
Type:
Killed Virus
M, .r of
Subcutaneously
Administration:
Staff Name: David E. Johnson DVM
License Number: 1893
Doctor Signature:
Vaccination Date: 3/15/2023
Expiration Date: 3/15/2026
Lot Number: 18562
Drug Expiration Date: 9/14/2024
I.
Blair Small Animal Clinic PC
David E. Johnson DVM
1734 Front Street
Blair, Nebraska, 68008
(402) 533-2722
Ellen Whitaker
1125 South Street
Blair, NE 68008
Page 1 / 1
Client ID: 1277
Invoice M 172347
Date: 3/8/2023
(402) 426-2073
Patient ID: 4814 Weight: 10.12 pounds
Patient Name: Boots Birthday: 06/01/2010
Species: Feline Sex: Spayed Female
Breed: Domestic Shorthair
Description Staff Name Quantity Total
3/8/2023 Examination -Wellness David E. Johnson DVM 1.00 $30.00
Rhino-Calici-Flu-PanLeu-Annual 1.00 $35,00
Patient Subtotal: $65.00
Instructions
Your cat has had the final dose in the series, and may be considered fully protected from Panleukopenia,
Rhinotracheitus, and calicivirus infection. We will notify you when it is time for booster vaccinations and other health
maintenance needs.
Reminder
03/08/2024 Rhino-Calici-Flu-PanLeu-Annual
0' 9/2024 Rabies Vaccination -Feline 3 year
Invoice Total:
Total:
Balance Due:
Previous Balance:
Balance Due:
Check Check # 3536:
Less Payment:
Balance Due:
Scheduled Appointments:
Appt. for Samson on 3/15/2023 at 11:00 am.
$65.00
$65.00
$65.00
$0.00
$65.00
($65.00)
($65.00)
$0.00
Order your pets supplies online now through our website www.blairsmallanimalclinic.vetsfirstchoice.com For questions contact
us at 402-533-2722.
Blair Smiall Animal Clinic PC 3/8/2023
David E. Johnson DVM Page 1 / 1
1734 Front Street
Blair, Nebraska, 68008
(402) 533-2722
Ellen Whitaker Client ID: 1277
1125 South Street Estimate ID: 5018
Blair, NE 68008 Expiration Date: 04/22/2023
(402) 426-2073
Patient ID: 4814
Patient Name: Boots
Species: Feline
Breed: Domestic Shorthalr
Weight: 10.12 pounds
Birthday: 06/01/2010
Sex: Spayed Female
Description Staff Name
Low Qty.
Low Amount
Hi h Qty.
High Amount
3/8/2023
Dentistry - Simple <20# David E. Johnson DVM
1.00
$0.00
1.00
$0.00
3/8/2023
Gas Anesthesia-Sevoflurane <20#
1.00
$71.00
1.00
$71.00
3/8/2023
Dentistry - Simple
1.00
$175.00
1.00
$175.00
3/8/2023
Dentistry-Rotosonic & Polish
1.00
$41.25
1.00
$41.25
3/8/2023
Hospitalized - For Surgery
1.00
$0.00
1.00
$0.00
3/8/2023
Pre -Anesthetic Injection
1.00
$0.00
1.00
$0.00
3/8/2023
Monitoring During Surgery
1.00
$0.00
1.00
$0.00
3/8/2023
Post -Op Antibiotic Injection
1.00
$0.00
1.00
$0.00
3/8/2023
Post -Op Observation
1.00
$O.00
1.00
$0.00
" 112023
Post -Op Follow Up Instructions
1.00
- $0.00
1.00
$0.00
2023
Blood - Pre Chem 15 - Geriatric
1.00
$175.00
1.00
$175.00
Low Subtotal:
$462.25
High Subtotal:
$462.25
Low Total:
$462.26
High Total:
$462.25
This estimate is good for 30 days and Includes only those items listed. Payment will be required when your pet is released from the hospital.
Authorization
a ))o0
CITY OF BLAIR - 2023 PET LICENSE APPLICATION ' - )' ). -,). 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 • 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: ) «e5 \Nl , e
Owner Address: �k�'r�
City/State/Zip: Blair, NE 68008
Phone# 41)�a),�0"cie' 2
LICENSE FEES: Dog or Cat: $16.00
Altered Dog or Cat: $11.00
***PLEASE READ CAREFULLY***
YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS.
Failure to do 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!6 Dog ❑ Cat J Spayed/Neutered License Fee $
Pet Name J'ti- Birthdate v- rev , ), Sex die
Color & c Breed** orv� c" tt,'� M%X Replacement$ **
Declared Dangerous or PFtenti lly Dan Brous Dog: ❑ Y N
MICROCHIP # I � 5 1 q I OP `� l� (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: (3 yr) (1 yr) /,) City Tag # lam*
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) _
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 not applicable fornewpets/new residents)
Newly Acquired Pets: New Residents to Blair:
■ Must be licensed within 10 days of ownership ■ Must register pets within 10 days of
■ <OR> at 6 months of age if puppy/kitten residency.
3�IS��3 CAs� � IOV�b�
.y , T
If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to:
City of Blair e 218 S 16th St @ Blair, NE 68008
You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs
or three (3) adult cats per residential or dwelling unit.
LICENSE RENEWALS ARE DUE: March 15, 2023
a ***PLEASE READ CAREFULLY***
Owner Name: --A- it V v 3 X m n Y \\ i t u ra- C. (-A
�)((x s° y YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS.
Owner Address: 1 sf Failure to do so is a violation of City ordinances 6.103 and carries
a penalty of a fine up to $150.00 per pet.
City/state/zip: Blair, NE 68008
PET LICENSES RENEWALS ARE DUE BY 3/15/2023. The City shall
Phone # 4�te i 3J ® LE 1 E2 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
' Do or Cat' 16.00 cat. The City of Blair requires proof of rabies vaccination to
LICENSE FEES
• 9 • $ be submitted with your license aDDlication.
Altered Dog or Cat: $11.00
Replacement Fee for Lost Tag: $5.00
Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program
PET #1 Dog ❑ Cat ❑ Spayed/Neutered License Fee $ 1 �o . 00
Pet Name ' ` x 7 Birthdate �o" Sex
Colorer ° , w Breed** Au Replacement$ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y JN
MICROCHIP # (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: 2-0-1 2 2 (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 #
T #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered
Pet Name Birthdate Sex
Color Breed**
Declared Dangerous or Potentially Dangerous Dog: ❑ Y
MICROCHIP # (If applicable)
RABIES VACCINATION DATE: (3 yr) _
IN
(1 yr)
License Fee $
Replacement $ **
*PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL
** (This fee is due along with License Fee if requesting at the time of license renewal.)
Do Not Send Cash by Mail TOTAL ENCLOSED $ Iry 00
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 newpefs/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.
CERTIFICATE OF VACCINATION
Date of Rabies Vaccination: 02-21-22 Certificate No: 0
Next Rabies Vaccination On: 02-20-25 Previous Rabies Vaccination:
VETERINARY CLINIC OWNER OF ANIMAL
Thone Animal Hospital Derek Hartford
902 S Hwy 30 8229 S st #32
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: Knockout TAG NO: 007542
SPECIES: Canine WEIGHT: 67.50
SEX: M AGE: 2 years
Color and markings...
Signed
Dr.Kamala Freeman
License: 3894
Vaccinations done...
02-21-22 KF Rabies Vaccination (3 Year), #007542
02-20-25
Rabies Vaccine Information...
MFG BY: ZOETI SER.NO: 542135
LOT EXP: 02-14-23 ADM: SQ
LtIt �174
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 o Blair, NE 6800
You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs
or three (3) adult cats per residential or dwelling unit.
LICENSE RENEWALS ARE DUE: March 15, 2023
Owner Name: chfis I Sgrm Whitwa
Owner Address: 1014Sfin tTrit t DY•
city/state/zip: Blair,. E6 008
Phone# ��4�10-3334
LICENSE FEES: Dog or Cat: $16.00
Altered Dog or Cat: $11 00
***PLEASE READ CAREFULLY***
YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS.
Failure to do so is a violation of City ordinances 6.103 and carries
a penalty of a fine up to $150.00 per pet.
PET LICENSES RENEWALS ARE DUE BY 3/15/2023. The City shall
recognize a microchip Identification number as the license number. It
shall be unlawful for any dog or cat to wear any license or other city
Identification other than that Issued by the City of Blair for such dog or
cat. The City of Blair requires proof of rabies vaccination to
be submitted with your license application.
Replacement Fee for Lost Tag: $5.00
Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program
Dog ❑ Cat Spayed Neutered License Fee $
Pet Name AL 9,0564Birthdate 111110 Sex F
Color Briri IG Breed** t Rep/acement$ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y N
MICROCHIP # 91102.003330345 (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: 4120121 (3 yr) (1 yr) City Tag # 00
PET #2 ❑ D o g Cat )tSpayed/Neutered License Fee $_
Pet Name (h 1 fi t Birthdate Sex
Color TolhfiV Breed** fit( r{,aft-hairr Replacement $ **
Declared Dan erous or Potentially Dangerous Dog: ❑ Y 9 N
MICROCHIP # (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: (3 yr) (1 yr)_ City Tag # i5 3 0
❑ 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 $ 11 .00
If you have questions, please contact Blair Police bepartment at (402) 426-4747
++++++++++++++++++++++++++++++++++++.....•+++++++++++++++++...............++++
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March ISlate fee date notapplicable for newpets/newresidenis)
Newly Acquired Pets: New Residents to Blair:
Must be licensed within 10 days of ownership 0 Must register pets within 10 days of
<OR> at 6 months of age if puppy/kitten residency.
Holstein Vet Clinic
718 South 19th Street
Blair, NE 68008
402-426-7387
Printed: 01-16-23 at 2:58p
CLIENT INFORMATION
Name Chris Whitwer (10116)
Address 1024 Stone Creek Dr.
Blair, NE 68008
PATIENT INFORMATION
Name
Chloe
Sex
Female, Spayed
Birthday
10-01-05 (unknown)
ID
Color
Tabby
Reminded
(none)
Reminders for: Chloe
10-21-23 Vanguard® Rabies 1 {1 YEAR}
10-21-23 Felocell 4 { Feline Distemper
MEDICAL HISTORY - Vaccination View
Date By Code
11-09-20 LS 420002
10-21-21
10-21-22
4RAB1
KKH 420001
4RAB1
LS 420001
4RAB1
Description
Spouse Sara Whitwer
Species Feline
Breed DSH
Age 17y (unknown)
Rabies
Weight 13.90lbs
Codes
Last done
10-21-22
10-21-22
Felocell 4
Defensor 1 (1 Year Rabies)
Felocell 3 { Feline Distemper }
Defensor 1 { 1Y RABIES }
Vanguard® Feline RCP {Distemper}
Vanguard® Rabies 1 {1 YEAR)
Patient Chart
Qty (Variance) Photo
CERTIFICATE OF VACCINATION
Date of Rabies Vaccination: 04-20-21
Next Rabies Vaccination On: 04-19-24
VETERINARY CLINIC
Holstein Vet Clinic
718 South 19th Street
Blair, NE 68008
402-426-7387
This is to certify...
Certificate No: 0
Previous Rabies Vaccination:
OWNER OF ANIMAL
Chris Whitwer
1024 Stone Creek Dr.
Blair, NE 68008
County:
THAT 1 HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW.
Patient information...
PATIENT: Roxy TAG NO: 19087
SPECIES: Canine WEIGHT: 63.20
SEX: S AGE: 14 months
Color and markings... Brindl/Brn
Signed
Krista Holstein , DVM
Rabies Vaccine Information...
License: 3612
MFG BY: ZOETI SER.NO: 402242
LOT EXP: 07/20/21 ADM: SQ
Z (.
,,.. }
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 1h 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 RENEWALSARE DUE. March.15 2023
®Weer Name: 7 <'%?) 7 a';
r
Owner Address: L '
Y• r
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 CHN of Blair reouires i2roof 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 tr Spayed/Neutered License Fee $ ! '
Pet Nam pr °��) Birthdate ` _ '� r � Sex
Breed** i lo,lu rle ')e Replacement $ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y 0 N
MICROCHIP # (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: � ��.�'; '', (3 yr) °'` (1 yr) City Tag # `�='t •
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
IN
(1 yr)
License Fee $
Replacement $
CUBTOTAL:
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 E CL S
If you have questions, please contact Blair Police bepartment at (402) 426-4747
.....++++++++++++++++++++++++.....++++++++++++++¢+++++¢++++++++++++++++++¢++++
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Marchl5/ate fee date not applicablefornewpets/newresidenis)
Newly Acguired Pets: New Residents to Blair:
Must be lioensed within 10 days of ownership ® Must register pets within 10 days of
<OR> at 6 months of age if puppy/kitten residency.
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 1, 2023
Owner Name: Tb A " V_ 1-
Owner Address:.` i d.
City/state/zip: Blair,, NE 68008
Phone #
f 4`
LICENSE FEES: Dog y [1
• ,. • • 1'
Replacement• ti ,c 1'
***PLEASE READ CAREFULLY***
YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS.
Failure to do so is a violation of City ordinances 6,103 and carries
a penalty of a fine up to $150.00 per pet.
PET LICENSES RENEWALS ARE DUE BY 3115/2023. The City shall
recognize a microchip Identification number as the license number. It
shall be unlawful for any dog or cat to wear any license or other city
Identification other than that Issued by the City of Blair for such dog or
cat. The City of Blair renuires Proof of rabies vaccination to
be submitted with your license application.
Dog ❑ Cat "' Spayed/Neutered License Fee $
Pet Name "r �I 'L i Birthdate Sex
Color 7, / Breed** I; u A Replacement$ **
Declared Dangerous or Potentially Dangerous Dog: LJ Y N
MICROCHIP # (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: 0;.2 C (3 yr) (1 yr) City Tag
PET #2 ® Dog ❑ Cat ❑ Spayed/Neutered
Pet Name Birthdate Sex
Color Breed**
Declared Dangerous or Potentially Dangerous Dog: ❑ Y
MICROCHIP # (If applicable)
RABIES VACCINATION DATE: (3 yr) _
PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered
Pet Name Birthdate Sex
Color Breed**
Declared Dangerous or Potentially Dangerous Dog: ❑ Y
MICROCHIP # (If applicable)
RABIES VACCINATION DATE: (3 yr) _
License Fee $
Replacement $
❑N
SUBTOTAL: $
(1 yr) City Tag #
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 Sena cash by Main' TOT L CO
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 for newpets/newresldents)
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.
Feb 13 23 02:29p
p,1
CITY OF BLAIR - 2023 PET LICENSE APPLICATION
If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to:
City of Blair • 218 S 16th St a Blair, NE 68008
You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs
or three (3) adult cats per residential or dwelling unit.
LICENSE RENEWALS ARE DUE: March 15, 2023
Owner Name:
Owner Address:
city/state/zip: Blair, NE 68008
Phone # `'1(I L 5L4 - 9 G g I
LICENSE FEES: Dog or Cat: $16.00
Altered Dog or Cat: $11.00
***PLEASE Pf" CARMJLLY***
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 pew
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
he submitted with your license application.
Replacement Fee for Lost Tag. $5.00
Induded is a State Fee of $1.25 being .collected to fund the Nebraska Dog & Cat Operator Inspection Program
PET # 1 a Dag ❑ Cat Spayed/Neutered License Fee $
Pet Name "[U' 1 r-- Birthdate �,2-h- Sex -aQ� _
Color 4z�,�� Breed** i_Wo nrn%ik Repfacement $ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y tt N
MICROCHIP # (if applicable) SUBTOTAL:
RABIES VACCINATION DATE:4 �— (3 yr) )X (1 yr) City Tag # 2973
PET #2 a Dog ❑ Cat n Spayed/Neutered License Fee$
�G
Pet Name _ Birthdate :Z-�-0 Sex V
Color Z7,1XI Breed** L A 1Q Replacement $
Declared Dangerous or Potentially Dangerous Dog: ❑ Y QM od
MICROCHIP # (If applicable) SUBTOTAL: $ 11.
RABIES VACCINATION DATE: (3 yr) �X_ (I yr) City Tag # 2682
PET #3 J 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 Mot Send Cash by Mail TOTAL ENCLOSED $
If you have questions, please contact Blair Police Department at (402) 426-474T
.....+++++.+++.++++.++*.+++++++.+++...........++*.+...............+++++++*+++
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (MarrYr i51atefee di enotapplirab(efornewpeWnewrosidenls)
Newly Acquired Pets:NM Residents to Blair:
■ Must be licensed within 10 d* of uwes tip ■ Must register pets within 10 days of
■ <OR> at 6 months of age if pi ppy/Ititten residency,
CITY OF BLAIR ® 2023 PET LICENSE APPLIC o
If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made pale to:
City of Blair a 218 S 16th St e Blair, NE 68008
You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs
or three (3) adult cats per residential or dwelling unit.
LICENSE RENEWALS ARE DUE: March 15, 202
Owner Name:
Owner Address: x L7 L 11-1,e uJ AAE 21d ,
City/State/Zip: Blair, NE 68008
Phone # +t, -2) /Z( 9 '2 `t47
LICENSE FEES: Dog or Cat: $16.00
Altered Do or Cat• Atli 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.
Replacement Fee for Lost Tag: $5.00
Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program
PET #1 a Dog ❑ Cat 0 Sparred/Neutered License Fee $
Pet Name r,/ Bir-tl4date P 16 y,?s Sex /1).
Color 4 c E,? Breed** ; . y)o 6 Replacement $ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y Jul N
MICROCHIP # 7ss' iiz oo y ia) %1'c> (If applicable) SU TOTAL: $
RABIES VACCINATION DATE:/L-L- (3 yr) ,.t (1 yr) City Tag # ZZ212L
PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered
Pet Name Birthdate Sex
Color Breed**
Declared Dangerous or Potentially Dangerous Dog: ❑ Y
MICROCHIP # (If applicable)
RABIES VACCINATION DATE: (3 yr) _
(1 yr)
License Fee $
Replacement $
• L
City Tag
❑ 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 ; A d v
If you have questions, please contact Blair Police Department at (402) 426-4747
++++++....++++++++++++++++++.+++++++++++++++++.....++++++++++++..........+++++
NEW PET/ NEW RESIDENT LICENSING REQUIREMENTS (Marchl5/ate fee date not applicablefornewpety1newresidents)
Newly Acquired Pets: New Residents to Blair:
Must be lioensed within 10 days of ownership N Must register pets within 10 days of
<OR> at 6 months of age if puppy/kitten residency.
&A 4-- ? V, � �
CITY OF BLAIR ® 2023 PET LICENSE APPLICATIONt
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 e Blair,, NE 68008
You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs
or three (3) adult cats per residential or dwelling unit.
LICENSE RENEWALS ARE DUE: March 15, 202\3' i
Owner Name: 6;4k6, C 1 � .� ; 5" L( A � � v. -1ii .
Owner Address: W ra �1��v�r, �►�E
City/State/Zip: Blair,, NE 68008/ tt
Phone#��_��,�li��l�a
LICENSE FEES: Dog 1
***PLEASE READ CAREFULLY***
YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS.
Failure to do so is a violation of City ordinances 6.103 and carries
a penalty of a fine up to $150.00 per pet.
PET LICENSES RENEWALS ARE DUE BY 3/15/2023. The City shall
recognize a microchip identification number as the license number. It
shall be unlawful for any dog or cat to wear any license or other city
Identification other than that Issued by the City of Blair for such dog or
cat. The City of Blair renuires proof of rabies vaccination to
be submitted with your license application.
Replacement Fee for Lost T ag: $5.00
Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program
PET #1 Dog ❑ Cat Spayed/Neutered— License Fee $
Pet Name "P f, Birthdate I Sex
Color IK t_ ► Breed** LA,1,A- C,?vo� Rep/acement $ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y
MICROCHIP # (If applicable) SUBTOTAL: $ 11,00
RABIES VACCINATION DATE: 4-j qj-a a (3 yr) \� (1 yr) City Tag # Loly
PET #2 GI"'D o g ❑ Cat Spayed Neutered � License Fee $ F (�
Pet Nalme. Birthdate 3- -1c Sex ,\1F-
Color tYBreed \,J15 Cor,,; Rep/acement$ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y
MICROCHIP # (If applicable) SUBTOTAL: $ • r
RABIES VACCINATION DATE: (3 yr) (1 yr) \z"� City Tag # *
F
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 TOTALE ., 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 fornewpets/new residents)
Newly Acquired Pets: New Residents to Blair:
Must be licensed within 10 days of ownership ■ Must register pets within 10 days of
<OR> at 6 months of age if puppy/aten residency.
Le L J
CITY OF BLAIR ® 2023 PET LICENSE APPLICATION
If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to:
City of Blair e 218 S 16th St 9 Blair, NE 68008
You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs
or three (3) adult cats per residential or dwelling unit.
LICENSE RENEWALS ARE DUE; March 15 2023
Owner Name: i is J I `` it �'1 ', t. a i > pt ►
Owner Address:
city/state/zip: Blair, NE 68008
r
Phone #A.
l
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 auDlication.
l�eplacernent 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
-, ❑ p o g Cat Spayed/Neutered / License Fee $`
P� et Name / Bi date I Sex
Color i,; Breed" Replacement$ **
Declared Dangerous or Potentially Dangerous Dog: 0 Y N t
MICROCHIP # (If applicable) SUBTOTAL: $ !
RABIES VACCINATION DATE:,-/�` 1._ . 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) SU TOTAL: $
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) _
(1 yr)
License Fee $
Replacement $
S T TAL: $
City Tag #
*PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL
** (This fee is due along with License Fee if requesting at the time of license renewal.)
Do Not Send Cash by Mail TOTAL ENCLOSED $ d 06
If you have questions, please contact Blair Police Department at (402) 426-4747
++++++....++++¢+..........++++++++++++++++++....+++++++++++¢++++.....+++++++++
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March I5/ate fee date notapplicable fornewpets/newresldents)
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.
CITY OF BLAIR - 2023 PET LICENSE APPLICATION
t }
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 AREDUE: Larch 15, 2023
Owner Name: tii a)(,
Owner Address: Vj`"�
city/state/zip: Blair, NE 6800
Phone # W?) Z-78 _004-7
--ICENSE FEES: Dog , 0►
a 4
***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 W Dog ❑ Cat 0 Spaye /Neutered License Fee $
Pet Name B15Cu1-1- Birthdate 17-1 zko j2p Sex erno,IC
Color wh`i-tc w) B3 o-c"1L cars Breed** Matsu ( WI-Kcscl Stnrt-yta) Replacement$ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y U4 N
MICROCHIP # cl b6 D 1 CIE) UM (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: JV c� I (3 yr) �i (1 yr) IO zw 2c, Ci -fag # ��3�1�1
PEA' #2 1A Dog ❑ Cat ❑ Spayed/Neutered License Fee $
Pet Name —MO -fin Birthdate q 5 2e1 z Sex Fe
Color white gown C�rcLv Breed** MuIGh'i (motte-sc Is It Zu Replacement $ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y W N
MICROCHIP # (If applicable) SU 'TOTAL: $
RABIES VACCINATION DATE: 1 l 1-", (3 yr) (1 yr) 11 1W 46 City Tag # '7('9
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.)
Do Not send cash by Mail TOTAL
If you have questions, please contact Blair Police bepartment at (402) 426-4747
++++++++++++++++++++++.+++++++++++++++++++++++++++++++++++++++++++++++++++++++
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15late fee date notapplicable fornewpets/new residents)
Newly Acquired Pets: New Residents to Blair:
Must be lioansed within 10 days of ownership E Must register pets within 10 days of
<OR> at 6 months of age if puppy/kitten residency.
CITY OF BLAIR ® 2023 PET LICENSE APPLICATION 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 16thlair, 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
1 SUE: March 15, 2023
Owner Name: (Iyv�
Owner Address: I W
city/state/zip: Blair,, NE 6y80
Phone # In, - Qoct; - VAN
LICENSE : Dog or Cat: $16.00
Replacement Fee for • r Iiil
***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.
PET #1 XI Dog ❑ Cat ❑ Spayed/Neutered License Fee $
Pet Name Birthdate -)ols Sex IVl
Color Breed** �; I �Qb tj �)r Replacement $ **
Declared Dangerous or Potentially Dangerous Don: ❑ Y ❑ N
MICROCHIP # Kir (If applicable) SUBTOTAL: $ I Ca
RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # q . _*
PET #2 3 Dog ❑ Cat ❑ Spayed/Neutered License Fee $ ,
Pet Namec 7 4 1-1
Birthdate I10-' 0 Sex t'
Colol-Tw Breed** Q L)ii')tact Replacement$ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N
MICROCHIP # (If applicable) SUBTOTAL: $ 110aty
RABIES VACCINATION DATE: t= ) (3 yr) (1 yr) City Tag #naI4*
PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $
Pet Name Birthdate Sex
Color Breed** Replacement$ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N
MICROCHIP # (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag #
*PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL
** (This fee is due along with License Fee if requesting at the time of license renewal.)
Do Not Send Cash by Mail TOTAL ENCLOSED
If you have questions, please contact Blair Police Department at (402) 426-4747
+a-+++...............r++,r+++++++++.++++.+++++++++++++++++++++++++++++++++++++++
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date not applicable fornewpets/new residents)
Newly Agrguired Pets: New Residents to Blair:
Must be licensed within 10 days of ownership 0 Must register pets within 10 days of
"`E <OR> at 6 months of age if puppy/ldtten residency.
Client ID: 9394
Client Name: Jane Williams
Address: 850 N 14th St
Blair, NE 68008
Phone: (402)208-1914
Tag Number:
7598
Vaccine:
Imrab Rabies Vaccine
Producer:
Merial
Brand:
Imrab 3 TF
T"",�:
Killed Virus
N, .er of
Subcutaneously
Administration:
Staff Name: David E. Johnson DVM
License Number: 1893
Doctor Signature:
Blair Small Animal Clinic PC
David E. Johnson DVM
1734 Front Street
Blair, Nebraska, 68008
. (402) 533-2722
Patient ID:
14250
Patient Name:
Sweetpea
Species:
Canine
Breed:
Chihuahua
Sex:
Female
Color:
Tan and White
Markings:
Birthday:
03/08/2020
Weight:
Microchip ID:
Vaccination Date:
3/20/2023
Expiration Date:
3/20/2026
Lot Number:
18562
Drug Expiration Date: 9/14/2024
J.
CITY OF BLAIR - 2023 PET LICENSE APPLICATION
If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to:
City of Blair 9 218 S 16th St e Blair, NE 68008
You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs
or three (3) adult cats per residential or dwelling unit.
LICENSE RENEWALS ARE DUE: March 15. 2023
Owner Name: (iCv i n 0 /`111 S
owner Address: Jd66 .5. (3:' A-V r
city/state/zip: Blair, NE 6008
Phone # ci o a• a 7 S-- r g s s'
LICENSE FEES: Dog or Cat: $16.00
Altered Dog or Cat: $11 00
***PLEASE READ FULLY***
YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS.
Failure to do so is a violation of City ordinances 6.103 and carries
a penalty of a fine up to $150.00 per pet.
PET LICENSES RENEWALS ARE DUE BY 3/15/2023. The City shall
recognize a microchip Identification number as the license number. It
shall be unlawful for any dog or cat to wear any license or other city
Identification other than that Issued by the City of Blair for such dog or
cat. The City of Blair requires Proof of rabies vaccination to
be submitted with your license application.
epiacemeni Fee for Lost Tag: $5.00
Included is a State Fee of $1.25 being collected to fund the Nebraska Cat Operator Inspection Program
T #1 Dog ❑ Cat Spayed/Neutered License Fee $
Pet Name Birthdate Sex M'I to -
color v ith�, Breed** A#-oliereT Replacement $ _**
Declared Dangerous or Potentially Dangerous Dog: ❑ Y WN
MICROCHIP # 0 // o? (If applicable) SUBTOTAL: $ A0 , ec7
RABIES VACCINATION DATE: //(3 yr) (1 yr) City Tag # 1
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
WE
(1 yr)
(1 yr)
License Fee $
Replacement $
SUBTOTAL:$
License Fee $
Replacement $
SUBTOTAL:$
— City ..
*PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL
** (This fee is due along with License Fee if requesting at the time of license renewal.)
Do Not Send cash by Mail TOTAL ENCLOSED $
If you have questions, please contact Blair Police Department at (402) 426-4747
++++++.....++++++++++++++++++++++++++++++++++++++++++.....++++++++++++++++++++
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date not applicable fornewpets/new residents)
Newly Acquired Pets: New Residents to Blair:
Must be lioensed within 10 days of ownership m Must register pets within 10 days of
<OR> at 6 months of age if puppy/Idtten residency.
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CITY OF BLAIR - 2023 PET LICENSE APPLICATION - . -u
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: 1(, m loz-
Owner Address: 30;w G o (IGA4 iD r
4.04
City/State/Zip: Blair, NE 68008
Phone # �Ll()� (9L3��
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 29 Dog ❑ Cat 2( Spayed/Neutered License Fee $ It C
Pet Name � Birthdate Sex YW
Color Wh '-, pl+�, Breed** �� 0a Replacement$ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y 4 1
MICROCHIP # (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: 34o 0 (3 yr) (1 yr) City Tag # 377
PET # 2 V Dog ❑ Cat W Spayed/Neutered License Fee $ (Q%
Pet Name raoq Birthdate Sex _
Color In Breed** C.hccn,�W—� Replacement $ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y AN
MICROCHIP # If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: Oo (3 yr) (1 yr) �). City Tag # 3337
PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered
Pet Name Birthdate Sex
Color Breed**
Declared Dangerous or Potentially Dangerous Dog: ❑ Y
MICROCHIP # (If applicable)
RABIES VACCINATION DATE: (3 yr)
❑N
(1 yr)
License Fee $
Replacement $
SUBTOTAL: $
City Tag #
*PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL
** (This fee is due along with License Fee if requesting at the time of license renewal.)
00
Do Not Send Cash by Mail TOTAL ENCLOSED $
If you have questions, please contact Blair Police Department at (402) 426-4747
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15late fee date not applicable fornewpets/new residents)
Newly Acquired Pets: New Residents to Blair:
■ Must be licensed within 10 days of ownership ■ Must register pets within 10 days of
■ <OR> at 6 months of age if puppy/kitten residency.
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 lair e 218 S 1th St e Blair, NE 68008
You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs
or three (3) adult cats per residential or dwelling unit.
LICENSE RENEWALS ARE DUE: March 15, 2023
A
Owner Name: I�1.t IT �9 c�� p L,LL'0 _
Owner Address: T 17 S+
City/State/Zip: Blair, NE 68008
Phone # 2,? ` 2� % X - 17
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 reauires proof of rabies vaccination to
be submitted with your license application.
Replacement Fee for Lost Tag: $5.00
Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program
PET # [ f„ D o � ❑ � Cat Spayed/Neutered M�+I License Fee $ `
Pet Name r -) ire � Birthdate ` zu Sex fly.
Color %'� ' �� � �� � Breed** &I Rep/acement $ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y A N
MICROCHIP # (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: .j -7 - ->1_ (3 yr) (1 yr) City Tag # J *
PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered
Pet Name Birthdate Sex
Color Breed**
Declared Dangerous or Potentially Dangerous Dog: ❑ Y
MICROCHIP # (If applicable)
RABIES VACCINATION DATE: (3 yr) _
PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered
Pet Name Birthdate Sex
Color Breed**
Declared Dangerous or Potentially Dangerous Dog: ❑ Y
MICROCHIP # (If applicable)
RABIES VACCINATION DATE: (3 yr) _
m
(1 yr)
(1 yr)
License Fee $
Replacement $
SUBTOTAL: $
City Tag #
License Fee $
Replacement
SUBTOTAL:
City Tag #
*PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL
** (This fee is due along with License Fee if requesting at the time of license renewal.)
Do Not Send Cash by Mail TOTAL ENCLOSED
If you have questions, please contact Blair Police Department at (402) 426-4747
++++++.....++++++++++++...........++++++++++++++++++++++++++++++++++++++++++++
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date not applicable fornewpets/new residents)
Newly Acquired Pets: New Residents to Blair:
• Must be 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 .. ► _
If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to:
City of Blair a 218 S 16th Ste Blair, NE 68008
You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs Al
or three (3) adult cats per residential or dwelling unit. - V y
�i
LICENSE RENEWALS ARE DUE: March 15. 2023
� Owner Name: \,�fi�r�-! ,�y%U/�'%74 �,�i/�S�L �(//, � 1.i�----
***PLEASE READ CAREFULLY***
YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS.
Owner Address:` �� Failure to do so is a violation of City ordinances 6.103 and carries
a penalty of a fine up to $150.00 per pet.
city/state/zip: Blair, NE 68008
/ Z ,2 7 PET LICENSES RENEWALS ARE DUE BY3/1512023. The City shall
Phone # ( T ! 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
or Cat' 16.00 cat. The City of Blair requires proof of rabies vaccination to
LICENSE FEES: Dog : $ be submitted with your license application.
Altered Dog or Cat: $11.00
Replacement Fee for Lost Tag: $5.00
Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program
PET #1 2f Dog ❑ Cat Spayed/Neutered License Fee
Pet Name A Birthdate Sex A**
Color _ Breed** Do, u c nn, j X. Replacement $
Declared Dangerous or Potentially Dangerous Dog: ❑ Y 'iN c� ,
MICROCHIP # i (If applicable SUBTOTAL: $
RABIES VACCINATION DATE: ';� 2' --(3 yr) (1 yr) City Tag #
PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered
Pet Name Birthdate Sex
Color Breed**
Declared Dangerous or Potentially Dangerous Dog: ❑ Y
MICROCHIP # (If applicable)
RABIES VACCINATION DATE: (3 yr) _
W
License Fee $
Replacement $ * *
SUBTOTAL: $
(1 yr) City Tag #
PET #3 , ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $
Pet Name Birthdate Sex
Color Breed** Replacement$ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N
MICROCHIP # (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag #
*PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL
** (This fee is due along with License Fee if requesting at the time of license renewal.)
t%
TOTAL ENCLO ED $
Do Not Send Cash by Mail
If you have questions, please contact Blair Police Department at (402) 426-4747
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date notapplicable for newpetslnewresidents)
Newly Acquired Pets: New Residents to Blair:
■ Must be licensed within 10 days of ownership ■ Must register pets within 10 days of
■ <OR> at 6 months of age if puppy/kitten residency.
03/.21/2023 14:11 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(G) AND /OR CAT(S),
WMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO;
CITY OF BLAIR - 218 8.16TH ST - BLAIR, NE 68008
YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS,
BUT NO M095, THAN THREE M ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT.
"""PLEASE RlEAD CAREFULLY***
Failure to do so is a violation of City Ordinances 6.103 and carries a penalty of a fine Up to $160.00 per pEft.
PET LIGE�I, R�ENEW
The city shall recognize a micrachip-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 LKEI-LICENSING -Must be licensed within 10 days of ownership (()R) at 6 months of age if puppy or kitten
Must register pets within 10 days of residency
OvOner Name
Leslie Wolfe
Spouse
Dustin
Owner Address
1927 (;restridge Dr
City/state/Zip
Blair, NE 68008
Pet Name: JiRX
Tag #3231
Age: 2V
DOB; 0449-20
Sax. Neutered Male
Color: White
Bree Westie
Microchip # 985141002843990
Rabies Tag # 19365
PLEASE INCLUDE CITY TAG NUMBER IV THIS
IS A RENEWAL 01F AVAILABLE). #
RABIES VACCINATION DONE ON
08-07-21
Rabies Description, 1 YEAR
3 YE
�7
Holstein Veterinary Clinic
Di. Llsa,50),,um DVM ! Di-. Kristo Holsheln,01A/14
718 South 191h Street Blair, NF 68008
402-426-7387 402-426-0101 Fax
liolsteiticlinic@grnail.com
PETS THATAPEONTHEACTIV
DANGEROUSVQ
LICEN En6 s_
fntm�jt
Dog or Cat., $116.00
�ered )i
I)OW r cat; $11-0)
floplacej7jent'rag
$6,00
Tota I $
03-21-2 FAXED 03-21-2
BY
i.TY . HAL 402-420.4i
U 02 4204195--
CERTIFICATE OF VACCINATION
Date of Rabies Vaccination: 03-04-22
Next Rabies Vaccination On: 03-03-25
VETERINARY CLINIC
Thone Animal Hospital
902 S Hwy 30
Blair, NE 68008
402-426-3630
This is to certify...
I I q)
�*609V
t- /0 NIS-
Certificate No: 0
Previous Rabies Vaccination: 004773
OWNER OF ANIMAL
Betty Wolsmann
805 N 22nd St #3H
Blair, NE 68008
County:
THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW.
Patient information...
PATIENT: Toby
SPECIES: Canine
SEX: N
Color and markings... TanMht/Bl
Signed
Dr. Donna Mertz
Vaccinations done...
TAG NO: 007578 Q0
WEIGHT: 31.70
AGE: 15 years
License: 3630
03-04-22
DM
Rabies Vaccination (3 Year), #007578
03-03-25
03-04-22
DM
DA2PPV+L
03-04-23
03-04-22
DM
Bordetella Oral
03-04-23
04-15-19
KF
Bordetella, P13 (Intra-trac 3)
03-04-23
04-15-19
KF
Check up, DA2PPV+L
03-04-23
04-18-16
LL
Annual Checkup, DA2PPV
03-04-23
Rabies Vaccine Information...
MFG BY: ZOETI SER.NO: 542135
LOT EXP: 02-14-23 ADM: SQ
CITY OF BLAIR - 2023 PET LICENSE APPLICATION
If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to:
City of Blair e 218 S 16h St e Blair,, INE 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 IRE DUE: March 15 023
Owner Name:' `-�' c > C
Owner Address:
City/State/Zip: Blair, NE 6 7,').
6Phone #(> � t t
LICENSE S: Dog or Cat: $16.00
Altered Do or Cat° $1 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_115/2023. 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
Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program
PET # Dog 14, Cat -' Spa ed tered License Fee $ , '10
Pet Name ( Birthdate r Sex
Color 7 Breed** 41"1 1 Replacement$ **
Declared Danger us or Potentially Dangerous Dog: ❑ Y ❑ N
MICROCHIP # (If applicable) SU T 'TAL: $
RABIES VACCINATION DATE: (3 yr) (1 yr) ,_ City Tag #
'I #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) _
"f #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 $
PUBTOTAL:
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 n
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 fornewpely1newresidents)
Newly Acquired Pets: New Residents to Blair:
Must be licensed within 10 days of ownership 0 Must register pets within 10 days of
<OR> at 6 months of age if puppy/kitten residency.
Holstein Vet Clinic
718 South 19th Street
Blair, NE 68008
402-426-7387
Check out our online store at www.HOLSTEINVET.com for home delivery!
Printed: 10-12-22 at 3:35p
FOR: Debbie Woodard
Date: 10-12-22
1355 Lincoln
Account: 1131
Blair, NE 68008
Invoice: 132179
(402) 427-5712
Date For
Oty Description
Net Price
10-12-22 Jax
I Exam - Annual Physical Exam
20.00
10-12-22
1 Vanguard@ Feline RCP {Distemper}
29.00
10-12-22
1 Vanguard@ Rabies 1 (1 YEAR)
29.25
10-12-22
Mastercard payment
-78.25
Old balance Charges
Payments
New balance
0.00 78.25
78.25
0.00
P-Irniq,d: rs for: Jax (Weight: 14.8
lbs - 7y) Last done
10-12-23 Vanguard@ Rabies 1 (1 YEAR) 10-12-22
10-12-23 Vanguard@ Feline
RCP {Distempe 10-12-22
Thanks for choosing us to take rare of your pet's health care needs!
V —4
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 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 1, 2023 I ***PLEASE READ CAREFULLY***
Owner Name: 4 XYD MI \IV t ]c K xy CA K�I_J — ' ►—
° YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS,
Owner Address: 1tl .l1 k Failure to do so is a violation of City ordinances 6.103 and carries
a penalty of a fine up to $150.00 per pet.
City/State/Zip: Blair, NE 6008
��nn � PET LICENSES RENEWALS ARE DUE BY 3/15/2023. The City shall
Phone # d �a-1 I ��%l� iIV `t ('��—�"l�' uo� 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
FEES: D® ®r Cat: 1fi.®0 cat, The City of Blair requires proof of rabies vaccination to
LICENSE
9 : $ be submitted with your license application.
Altered Dog or Cat: $11.00
Replaceri'�nei t Free for Lost T ag: $5.00
Included is a State Fee of $1.25 being collected to fund the Nebraska & Cat Operator Inspection Program
Dog ❑ Cat ❑ Spayed/ eutered License Fee $
Pet Na Birthdate I I _ Sex-
Color Breed** � Rep/acement $ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y A N
MICROCHIP # (If applicable), SUBTOTAL: $
RABIES VACCINATION DATE: `� '! (3 yr) (1 yr) City Tag #sw%
T #2 Dog ❑ Cat ❑ Spa ed/Neu ered License Fee $
Pet Name Birthdate — I Sex
Color Breed*, Rep/acement$ **
Declared D ngerous or Potentially Dangerous Dog: ❑ N
SUBTOTAL: $
MICROCHIP # (If applicable)
RABIES VACCINATION DATE: - - (3 yr) (1 yr) City Tag '`' "
PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $
Pet Name Birthdate Sex
Color Breed** Rep/acement$ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N
MICROCHIP # (If applicable) SUBT TAL: $
RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag
*PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL
** (This fee is due along with License Fee if requesting at the time of license renewal.)
Do Not send Cash by Mail TOTAL ENCLOSED
If you have questions, please contact Blair Police Department at (402) 426-4747
++++++++++++++++++++++++++++++++++-r++++++.....+++++++¢++++++++++++++++++++++++
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date notapplicablefornewpets/newre5idents)
Newly Acquired Pets: New Residents to Blair:
Must be lioensed whin 10 days of ownership m Must register pets within 10 days of
<OR> at 6 months of age if puppy/kitten residency.
03/22/2023 12:45 4024260101 HOLSTEIN VET CLINIC;
2023 PET LICENSE
HAUL U11U4
VERIFICATION/APPLICATION FOR CITY OF BLAIR
IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A D000 AND /OR CAT(Sh
COMPLETF THIS FORM AND RETURN WITH A CHECK PAYABLE TO:
CITY OF MAR - 218 S. 16r" ST T BLAIR, NE 68008
YOU MAY LEGALLY OWN A COMBINATION OF POUR (4) ADULT PETS,
13UT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT.
*OOPLEASB READ CAREFULLY***
j(ODU ARE REdU)RETi BY LAW LO LICEN56 YtJUR PETS THE CITY CIF I3LAIFt REQUItt�S PR1]tlF dF RABIES VACCINAT
Failure to do so is a violetmn of City Ordinances 6,1Q3 and carries a penalty of a fine up to $150.00 per pet.
PT LICENSE RENEWALS ARFQUE BY 3115/Z923.
The clty shall recognize a microchip ID number as the license number,
it shall be unlawful for any clog or cat to weer any license or other city 1D other than that i"ued by the City of Blair for such dog or eat.
NEW PET LIMSING Must be licensed within 10 days of Qwnership (OR) at 6 months of age if puppy or kitten
NEW510ENTS Tt�.81A�1} Must register jets within 10 days of residency
Owner Name
Liz Worsfold
- - -
Spouse
Curt
Owner Address
123 S 23rd St
City/State/Zip
Blair, NE 68008
Phone #
402-427-3091
Pet Nome: Lexi
#2434
Age: 5Y
DOB: 09-04-17
sex: Spared Female
Color: Blk'fan
Breed: Cavalier Mix
Microchip # 986112009207209
Rabies Tag # 20276
PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): #
RABIES VACCINATION DONE ON 04-21-22
Rabies Description: 7 YEAR 3 YEAR
Holstein Veterinary Clinic
Dr. LIsA Schnim OVM : Or. Krim Holstain DVM
718 South 191" Str0et Blair, NE 68008
402-426-7387 402-426-0101 Fax
holsteinclinic@gmail.com
LICENSE FEES
/nfact
Dog or Cat: $10,00
Lrc'-ea
og$11.00
Replacement Tag
$5.00
Total $--[L--
P�'T5 THAT AkE ON THEAGTIVE FOT�'NTIALLY PANGEROU$ OR
DAf ER0U5 L)OGLIST NtTD TO RElaISTER OIRECTLYAT CITYHALL.
FAXED 03-22-23
BY
CITY HALL @ 402-426-4195
03/22/2023 12:45 4024260101 HOLSTEIN VET CLINIC PAGE 02/02
2023 FEET LICENSE
VERIFICATIONIAPPLICATION FOR CITY OF SLAIN
Ik YOU LIVE IN BLAIR CITY LIMITS AND OWN A D000 AN[) /OR CAT(S),
COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO:
CITY OF BLAIR — 216 S. 16TH ST — BLAIR, NE 68008
YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS,
BUT NO MORL THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT.
���P1,EA5E READ CA,REFULLY°�**
YOU E REC! ED BY W Tt� LICENSE YOUR i' i��F CITY l7F BI.AI OUI RRU OF R R VAC ATIO
Failure to do so is a vioiaiion of City Ordinances 5,703 and Carries a penalty of a fins up Ct7 $750.00 per pQt.
PET LICENSE �{ENEWALS ARl� [SUE BY 3/15/2Q23
Th®city shall reobgnize a micr4olllp ID number as the license number•
It shall be unlawful for any dog or cat to wear any license or other city Id atherthan that issued by the City of Blair for such dog or cat.
NEW EL LICENSING Must 6e licensed within 1Q days of ownership (OR) at 6 months of age if puppy or kitton
Ell W RE (DENT TO (LAIR Must register pets within 10 days of residency
Owner Name
Spouse
Owner Address
City/State/Zip
Phone #Iz
Met Name: Lillie
A) qe: 8Y
GOB: 01-01-15
Breed: Cav KC Spanlel
Microchip #
PLEASE INCLUDE CITY TAG
Ta
Sex: Spayed Female
RABIES VACCINATION DONE ON
IF THIS IS A RENE
07-29-22
Rabies Description: 1 YEAR � 3
Holstein Veterinary Clinic
Or. Lisa Schrum DVM ; Dr. Krista Holstein DVA4
718 South 19"1 Street Blair, NE 0$008
402-426-7387 402-426-0101 Fax
holsteinclinic@gmail.com
Liz Worsfold
Curt
123 S 23rd St
Blair, NE 68008
402-427-3091
Color: White/Brn
Rabies Tag # 20540
(IF AVAIL.ABLE): #
Uf
1.10ENSIr FEES
Intact
Dog or Cat: $16.00
A/tared
og or eat: $11.00
$5.00
Total $
—]�--
PETS TMATARE ON 7MEACTlVF POTENTIAl,(,Y pANGERpUS OR
DA EROUS Qn 1lST NEED 70 REGISTER Lyl RECTLY AT CITY HALL
FAXED 03-22-23
BY
—7r!5—
CITY HALL @ 402425-4195
Jan 13 23 11;29a P.1
CITY OF BLAIR - 2023 PET LICENSE APPLICATION
If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to:
City of Blair o 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:
IT
Citylstatelvp:
NE68�008
Blair,(�%Q
4.0 2 - — � 4: 7-1
Phone #
19 V --
LICENSE FEES: Dog or Cat: $16.00
Altered Dog or Cat: $11.00
***PLEASE READ CARERJLLY***
YOU ARE REQUIRED BY LAW To LICENSE YOUR PETS.
Failure to do so Is a violation or City ordinances 6.103 and carries
a penalty of a fine up to $150.00 per pet
PET LICENSES RENEWALS ARE DUE 0y 31is(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_iraccination ba
be subMitbed with your license application,
Replacement Fee for Lost Tag: $5.00
Included is a State Fee of $125 being cfllleched to fund the Nebraska Dag & Cat Operator Inspection Program
PET # 1 V Dog ❑ Cat Wspayer ered License Fee $ 11
Pet Name Birthdate 4
Color Breed** Replacement$ ** i
Declared Dangerous or Potentially Dangerous Dog: ❑ ❑ N
MICROCHIP # i j fIf applicable) SUBTOTAL: $
RABIES VACCINATION DATE: 3 ' (3 yr) _� (1 yr) City Tag #
rrra
PET #2 ❑ Dog ❑ Cat
❑ Spayed/Neutered
License Fee $
Pet Name
Birthdate Sex
Color
Breed**
Replacement $ **
Dedared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N
l
MICROCHIP #
(If applicable)
SUBTOTAL: $
RABIES VACCINATION DATE:
(3 yr) (1 yr)
City Tag # *
PET #3 ❑ Dog LJ 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.)
DoAlotSend Cash by Maff TOTAL ENCLOSED $
If you have questions, please contact Blair Police Department at (402) 426-4747
++++++++++++.....+*+**t....+t.....++++++++++++...................... F+++++....
NEW PE 'INEW RESIDENT LICENSING REQUIREMENTS (Mdah 151atefee dalermtapp(cWefornewpely1newresidents)
Newly Aoauired Pets: New Residents to Blair:
a Must be imised within 10 days of wmeiship ■ Must register pets within 10 days of
■ <oR> at 6 months of age If puppyll(Itten teWen y.