Application Form New Dog Registration 1Owner Details2Dog Details3Supporting Documents Owner DetailsRegistered address, where dog is kept* Street Address Town Post Code Name of Dog Owner* First Last Primary phone number*Mobile numberHome phoneWork phoneEmail address* Residential address* Street Address Town Post Code Postal address* Yes - Same as registered address No - Different postal address Postal address* Street Address Town Post Code Dog DetailsDog’s breed*Dog’s gender* Male Female Dog’s name*Dog’s colour*Dog’s Date of Birth* DD slash MM slash YYYY Is the dog microchipped?* Yes No Microchip Number*Must be 15 digitsAnticipated date for microchipping* DD slash MM slash YYYY Supporting Documents1. Do you hold a Pension Card?* Yes No Upload Proof of Pension Card*Accepted file types: jpg, jpeg, png, pdf, doc, docx, Max. file size: 2 MB. Is this the first dog registered to this household?* Yes No 2. Is the dog Sterilised/Desexed?* Yes No Upload evidence/provide details*Accepted file types: jpg, jpeg, png, pdf, doc, docx, Max. file size: 2 MB. 3. Are you transferring the dog from another Tasmanian Council during the same registration period?* Yes No Upload evidence/provide details*Accepted file types: jpg, jpeg, png, pdf, doc, docx, Max. file size: 2 MB. 4. Is the dog obedience trained?* Yes No Upload Obedience Training Certificate*Accepted file types: jpg, jpeg, png, pdf, doc, docx, Max. file size: 2 MB. 5. Is the dog declared dangerous?* Yes No Upload evidence/provide details*Accepted file types: jpg, jpeg, png, pdf, doc, docx, Max. file size: 2 MB. 6. Is the dog a working/farm animal?* Yes No 7. Is the dog a purebred owned by a registered breeder?* Yes No Upload evidence*Accepted file types: jpg, jpeg, png, pdf, doc, docx, Max. file size: 2 MB. Upload evidence of registration as a member with the Tasmanian Canine Association8. Is the dog used for hunting purposes?* Yes No Upload evidence*Accepted file types: jpg, jpeg, png, pdf, doc, docx, Max. file size: 2 MB. Upload evidence that the animal is used for hunting activities, e.g. farming9. Is the dog a Greyhound?* Yes No Upload evidence*Accepted file types: jpg, jpeg, png, pdf, doc, docx, Max. file size: 2 MB. Upload evidence of Greyhound Racing Tasmania registration10. Is the dog a Guide Dog / assistance / therapy dog?* Yes No Upload evidence of certification*Accepted file types: jpg, jpeg, png, pdf, doc, docx, Max. file size: 2 MB. 11. Has the dog been impounded prior to registration?* Yes No Please contact the Council’s Customer Service Officers on 6429 8900 as other fees will apply.Consent* I agree to Central Coast Council's Privacy Policy & all information provided is truthful.
