Application Form New Dog Registration 1 Owner Details2 Dog Details3 Supporting 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 addressNo - Different postal addressPostal address* Street Address Town Post Code Dog DetailsDog’s breed*Dog’s gender*MaleFemaleDog’s name*Dog’s colour*Dog’s Date of Birth* Date Format: DD slash MM slash YYYY Is the dog microchipped?*YesNoMicrochip Number*Must be 15 digitsAnticipated date for microchipping* Date Format: DD slash MM slash YYYY Supporting Documents1. Do you hold a Pension Card?*YesNoUpload Proof of Pension Card*Accepted file types: jpg, jpeg, png, pdf, doc, docx.Is this the first dog registered to this household?*YesNo2. Is the dog Sterilised/Desexed?*YesNoUpload evidence/provide details*Accepted file types: jpg, jpeg, png, pdf, doc, docx.3. Are you transferring the dog from another Tasmanian Council during the same registration period?*YesNoUpload evidence/provide details*Accepted file types: jpg, jpeg, png, pdf, doc, docx.4. Is the dog obedience trained?*YesNoUpload Obedience Training Certificate*Accepted file types: jpg, jpeg, png, pdf, doc, docx.5. Is the dog declared dangerous?*YesNoUpload evidence/provide details*Accepted file types: jpg, jpeg, png, pdf, doc, docx.6. Is the dog a working/farm animal?*YesNo7. Is the dog a purebred owned by a registered breeder?*YesNoUpload evidence*Accepted file types: jpg, jpeg, png, pdf, doc, docx.Upload evidence of registration as a member with the Tasmanian Canine Association8. Is the dog used for hunting purposes?*YesNoUpload evidence*Accepted file types: jpg, jpeg, png, pdf, doc, docx.Upload evidence that the animal is used for hunting activities, e.g. farming9. Is the dog a Greyhound?*YesNoUpload evidence*Accepted file types: jpg, jpeg, png, pdf, doc, docx.Upload evidence of Greyhound Racing Tasmania registration10. Is the dog a Guide Dog / assistance / therapy dog?*YesNoUpload evidence of certification*Accepted file types: jpg, jpeg, png, pdf, doc, docx.11. Has the dog been impounded prior to registration?*YesNoPlease 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.
