X, Y, Z�l ) U3s8�
..CITY OF BLAIR - 2021 PET LICENSE APPLICATION r V
If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to:
City of Blair • 218 S 16th St * Blair, NE 68008
You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs
or three (3) adult cats per residential or dwelling unit.
LICENSE RENEWALS ARE DUE: March 15, 2021
Owner Name: fi 4 h l /\/ )�q rd '-'5 q! 2
Owner Address: 3_� 3 A/ 2 1 s" /-
city/state/zip: Blair, NE 68008
Phone # �/0 .9_ , y5-1 ' b '� t' `/'
Drivers License # or Date of Birth 6 '/ - / 6 - / C/ Jr q
LICENSE FEES: Dog or Cat: $16.00
Altered Dog or Cat: $11.00
Replacement Fee for Lost Tag: $5.00
***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 3/1512021. 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.
Included is a Slate Fee of $1.25 being collected to fund the Nebraska Dog & Cat
PET # 1 0 Dog ❑ Cat ❑ Spayed/Neutered License Fee $ i l , U
Pet Name ` e M % Birthdate /Vo 1/ 2 o /ySex Mal, e-
Color 0 l Breed** ,� r� ti,o e_/v R e lh'we v e,^ Replacement $ * *
Declared angerous or Potentially Dangerous Dog: ❑ Y ;i" N
MICROCHIP # ? 9'5' // 2 6 ° 5' 3 ;2 z 9 i 5- (If applicable) SUBTOTAL: $ !6 0 0
RABIES VACCINATION DATE: (3 yr) _ (1 yr) City Tag # -�
ap,l
PET # 2 Dog ❑ Cat A' Spayed/Neutered License Fee $ k 0 0
Pet Name /) v c )lr r t ivw Birthdate 0 Sex Ma
Color w//�/ rC Breed** �e f e e Rep/acement$ **
Declared Dangerous or Potentially Dangero s Dog: ❑ ,Its N
MICROCHIP # (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: l a o A (3 yr) �� (1 yr) City Tag # a505*
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.)
VISA / MC #
Signature
Do Not Send Cash-byMail TOTAL ENCLOSE® $ 2 7, o P
Expires: Security Code:
If you have questions, please contact City Hall at (402) 426-4191 or by Fax: (402) 426-4195
+++++++++++a.....++++++.....++++++....+++++++++¢+++++++¢++++++++++++++++++++++
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March Mate fee date notapplicab/efornewpets/newresidents)
Newly Acquired Pets: New Residents to Blair:
n Must be licensed within 10 days of ownership a Must register pets within 10 days of
a <OR> at 6 months of age if puppy/kitten residency.
CITY OF BLAIR - 2023 PET LICENSE APPLICATION fi
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
j
Owner Name: � ��
Owner Address:`
City/state/zip: Blair, NE 68008
Phone #
LICENSE FEES: Dog or Cat: $16.00
Altered Dog or Cat: $11.00
***PLEASE READ CAREFULLY***
YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS.
Failure to do so is a violation of City ordinances 6.103 and carries
a penalty of a fine up to $150.00 per pet.
PET LICENSES RENEWALS ARE DUE BY 3/15/2023. The City shall
recognize a microchip Identification number as the license number. It
shall be unlawful for any dog or cat to wear any license or other city
Identification other than that Issued by the City of Blair for such dog or
cat. The Citv of Blair requires Droof of rabies vaccination to
be submitted with your license application.
Replacement Fee for Lost Tag: $5.00
Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program
PET # 1 ❑ Dog, Cat ❑ Spayed/Neutered License Fee $
Pet Name Birthdate '4 21 0, Sex
ColorBreed**Replacement$ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N
MICROCHIP # (If applicable) SUBTOTAL: $ _
RABIES VACCINATION DATE: 2, 11 I '. (3 yr) _K (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) _
XV
W
(1 yr)
(1 yr)
License Fee $
Replacement $ * *
SUBTOTAL: $
City Tag # *
License Fee $
Replacement $
SUBTOTAL: $
City Tag #
*PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL
** (This fee is due along with License Fee if requesting at the time of license renewal.)
Do Not Send Cash by Mail TOTAL ENCLOSED $
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
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
Client ID:
5893
Patient ID:
5691
Client Name: '',, �,�as
Katie"& Matt Yeaton
Patient Name:
Binx
Address:
535 S 17th St
Species:
Feline
Breed:
Domestic Longhair
Blair, NE 68008
Sex:
Neutered Male
Color:
Beige Tiger
Phone:
(402)926-8988
Markings:
Birthday:
06121 /2011
Weight:
13.56 pounds on 12/21/2022
Microchip ID:
Tag Number:
00000
Vaccination Date:
3/15/2023
Vaccine:
Imrab Rabies Vaccine
Expiration Date:
31l512026
Producer:
Merial
Lot Number:
18562
Brand:
Imrab 3 TF
Drug Expiration Date:
9/14/2024
TNrpe:
Killed Virus
anner of
Subcutaneously
Administration:
Staff Name: David E. Johnson DVM
License Number: 1893
Doctor Signature:
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, 202
Owner Name: ,ywr ""` <✓� Y/` _ //
Owner Address:
city/state/zip: Blair, NE 6800
Phone #
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 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 & Cat Operator Inspection Program
PET #1 ❑ Dog Lam" C a t paye /Neutered License Fee $ 1)),
Pet Name Bi hdate 4
Color Breed** Replacement $
Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N
MICROCHIP # 11 ,i (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: = - (3 yr) (1 yr) City Tag # Vik,,
TTn
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 ❑ N
MICROCHIP # (If applicable)
RABIES VACCINATION DATE: (3 yr)
(1 yr)
License Fee $
Replacement $
SUBTOTAL:$
*PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL
** (This fee is due along with License Fee if requesting at the time of license renewal.)
Do Not Send Cash by Mail TOTAL ENCLOSED $
If you have questions, please contact Blair Police Department at (402) 426-4747
++.++++++++++++++++++++,....++++++++++++......++++++++++++++++++..........++++
NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date not applicable for'newpets/newre5idenLs)
Newly Acquired Pets: New Residents to Blair:
• Must be lioensed within 10 days of ownership a Must register pets within 10 days of
• <OR> at 6 months of age if puppy/kitten residency.
„ V tip
`` i
CITY OF BLAIR - 2023 PET LICENSE APPLICATION
If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to:
City of Blair e 218 S 16th St e Blair, NE 6008
You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs
or three (3) adult cats per residential or dwelling unit.
LICENSE RENEWALS ARE DUE: March 15, 2023
Owner Name:
Owner Address:
City/State/Zip: ,,I hair, E 68008 108
L
Phone # Lo 2 - � 7 , . mot' 3 is5
LICENSE FEES: Dog or Cat: $16.00
Altered Dog or Cat: $11.00
***PLEASE READ CAREFULLY***
YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS.
Failure to do so is a violation of City ordinances 6.103 and carries
a penalty of a fine up to $150.00 per pet.
PET LICENSES RENEWALS ARE DUE BY 3115/2023. The City shall
recognize a microchip Identification number as the license number. It
shall be unlawful for any dog or cat to wear any license or other city
Identification other than that Issued by the City of Blair for such dog or
cat. The City of Blair 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 #1 �+ Dog ❑ Cat 0-Spayed/Neutered License Fee $ 11, �
--> Pet Name C Uu-I- BirthdateCe1:7y12vi Sex k&fJ-e-
Color P2-d , Breed** l At11, Replacement$ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y U N
MICROCHIP # I I (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: Zoe I (3 yr) ✓ (1 yr) City Tag #
T #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $
Pet Name Birthdate Sex
Color Breed** Replacement **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N
MICROCHIP # (If applicable) SUBTOTAL:
RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag #
PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered
Pet Name Birthdate Sex
Color Breed**
Declared Dangerous or Potentially Dangerous Dog: ❑ Y
MICROCHIP # (If applicable)
RABIES VACCINATION DATE: (3 yr) _
W
(1 yr)
License Fee $
Replacement
SUBTOTAL:$
*PLEASE INCLUDE THE CIfYTAG NUMBER IF THIS IS A RENEWAL
** (This fee is due along with License Fee if requesting at the time of license renewal.)
po
Do Not Send Cash by Mail TOTAL ELO $ .®
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/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.
I N V 0 1 C E
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: 12-30-21 at 2:48p
FOR: Lisa Yost Date: 12-30-21
2242 Colfax St. Account: 8205
Blair, NE 68008 Invoice: 124586
(402) 426-4817
Date For Qty Description Net Price
12-30-21 Scout 1 Bravecto Oral Tabs 45-88 LBS EACH 52.00
12-30-21 1 Rabies Tag Replacement 5.00
12-30-21 1 City Tag/2022 Altered 11.00
12-30-21 Visa payment -68.00
Old balance Charges Payments New balance
0.00 68.00 68.00 0.00
Reminders for: Scout (Weight: 74.0 Ibs - 7y) Last done
08-31-24 Denfensor 3 (3 Year Rabies) 09-01-21
09-01-22 Vangard Plus 5 L4 09-01-21
09-01-22 Bronchi Shield - Oral Bordetel 09-01-21
Doctor's Instructions
Bravecto Oral Tabs 45-88 LBS EACH
REBATE AVAILABLE FOR YOUR PURCHASE OF BRAVECTO!
BUY 2 GET $10.00
BUY 4 GET $25.00
COUPON CODE: BRAV2021
VISIT https://rewards.mypet.com/#/ TO SUBMIT YOUR REBATE.
Thanks for choosing us to take care of your pet's health care needs!
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 ®f Blair @ 218 S 16tht @ 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:,- fr
Owner Address:
City/State/Zip:
Phone #
Blair, NE .11:',
LICENSE FEES: Dog or Cat: $16.00
Altered Dog or Cat: $11.00
***PLEASE READ CAREFULLY***
YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS.
Failure to do so is a violation of City ordinances 6.103 and carries
a penalty of a fine up to $150.00 per pet.
PET LICENSES RENEWALS ARE DUE BY 3/15/2023. The City shall
recognize a microchip Identification number as the license number. It
shall be unlawful for any dog or cat to wear any license or other city
Identification other than that Issued by the City of Blair for such dog or
cat. The City of Blair requires Proof of rabies vaccination to
be submitted with your license application.
Replacement Fee for Lost Tag: $5.00
Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program
PET # 1 ❑ Dog p'-' Cat ,U, Spayed/Neutered License Fee $
Pet Name ""i Birthdate Sex I �
Color Breed** - 7 "Cif Replacement $ **
Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N
MICROCHIP # (If applicable) SUBTOTAL: $
RABIES VACCINATION DATE: :; ? 3 - ./, .�L (3 yr) (1 yr) City Tag # �
PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered
Pet Name Birthdate Sex
Color Breed**
Declared Dangerous or Potentially Dangerous Dog: ❑ Y
MICROCHIP # (If applicable)
RABIES VACCINATION DATE: (3 yr) _
M
(1 yr)
License Fee $
Replacement $ **
•
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 NCLOSED $
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 fornewpet-s/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.
CITY OF BLAIR ® 2023 PET LICENSE APPLICATION 3 -7, 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 e 218 S 16th St e Blair, NE 68008
You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs
or three (3) adult cats per residential or dwelling unit.
LICENSE RENEWAI c ARE DUES March 15 2023
Owner Name:
Owner Address: > C)
city/state/zip: Blair,, ME 6008 /
Phone # I q 6 '� :I
LICENSE FEES: FEES: Dog or Cat: $16.00
Alt d D or Cat• $11 00
***PLEASE 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.
ere og .
Relal Im ��t Fee for Lost Tag: $ a.00
Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program
PET #1 16 Dog ❑ Cat( Spayed Ne tered License Fee $
Pet Name Z �I Bilthdate 1 IL26Sex fi **
Color 1 Breed** Replacement $
Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N
MICROCHIP # (If applicable) SUBTOTAL:
RABIES VACCINATION DATE: (3 yr) (1 yr) Ci 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) _
License Fee $
Rep/acement $
❑N
SUBTOTAL:
(1 yr) City Tag #
PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee
Pet Name Birthdate Sex
Color Breed** Replacement
Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N
MICROCHIP # (If applicable) SUBTOTAL:
RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag #
*PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL
** (This fee is due along with License Fee if requesting at the time of license renewal.)
Do Not Send Cash by 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/newre5identy)
Newly Acquired Pets: New Residents to Blair:
Must be lioensed within 10 days of ownership ■ Must register pets within 10 days of
■ <OR> at 6 months of age if puppy/kitten residency.