Veterinary Public Health Services

Application for New York City Dog License

Click here to download the PDF version of the Dog License Application.

After filling in the correct information, please use the print function on your computer to print a completed copy of this form and send it with the appropriate documentation and check or money order (payable to the NYC Department of Health & Mental Hygiene) to Veterinary Public Health Services, P.O. Box 4768, Church Street Station, New York, NY 10261-4768.

Your license certificate and dog tag will be mailed to you shortly. If you need help in completing this form, please call 311, Mon-Fri. 9AM-4:45PM, for assistance.

• Payment Information
• Applicant's Information
• Description of Dog
• Instruction in Spanish (Instrucciones En Espanol En La Pagina Siguiente)
• Affidavit for Spayed or Neutered Dog

Note: New York State Law requires that a surcharge of $3.00 be added to the licensing fee for all dogs not spayed or neutered. If your dog is spayed or neutered you must submit proof from your veterinarian with this application or complete and notarize the affidavit listed below.

Attencion: La ley del estado de Nueva York requiere que el precio de $3.00 sea anadido al precio de licensia para todo perro que no esta esterilizado. Si su perro esta esterilizado usted debe someter prueba certificada de su veterinario con esta solicitud o completar y notarizar el affidavit.

Payment Information

Check One Box Below and Submit Correct Payment (Remember, You Must Submit Proof of Spay/Neuter)
	Dog License Fee (Spay/Neuter)		$ 8.50
	Dog License Fee (Not Spay/Neuter)		$ 11.50
	Total Enclosed		$

Falsification of any statement made herein is an offense punishable by a fine or imprisonment or both (N.Y.C. ADMINISTRATIVE CODE 11519.0)

The Undersigned Makes The Following Statements In Accordance With Provisions of the NEW YORK CITY DOG LICENSE LAW

Applicant's Information

Name of Owner (Last Name)
(First Name)
Init.
Home Address
Apt. No.
City
State
Zip Code
Signature of Licensee	Sign Here >________________
Application Date	mm dd yyyy
Telephone

Description of Dog

Name of Dog
Sex	M F
Year of Birth
Spayed/Neutered	Yes No
Attack or Guard Trained	Yes No
Breed
Colors (see Color Selection Code below)	Dominant Secondary Third
Was Animal Vaccinated Against Rabies?	Yes No
Date Animal Vaccinated Against Rabies	mm dd yyyy
Total number of Dogs in Household

Note: If the permittee/licensee, or his employees or agents, refuse to answer questions in relation to this permit/license after being granted testimonial or use immuity, this permit/license may be revoked, or other appropriate action taken

Have Your Dog and Cat Vaccinated Against Rabies. It's the Law.

Color Selection Code

From the list of colors below, select the Dominant color of your dog and print that color in the first box. Next, select the Secondary color of your dog and print that in the second box. If your dog exhibits a Third color, print that color in the third box.

• Black
• Blond
• Blue
• Brindle
• Brown
• Gray
• Orange
• Rust
• Tan
• White

For example, a Dalmation dog would be listed as: Dominant color - White, Secondary color - Black. There would be no Third color. If your dog has only one color, print that color in the first box.

Instrucciones para Llenar la Solicitid de Registro para Perros

• Si necesita ayuda por favor llame al 311.
• La primera seccion de esta solicitud es para informacion sobre el dueno del perro que se va a registrar.
• Primera linea, escriba el apellido y el nombre del dueno del perro.
• Segunda linea, escriba la direccion y numero de apartmento del dueno.
• Tercerra linea, escriba la ciudad, el estado y el codigo de area del dueno.
• Cuarta linea, firme en la casilla indicada, escriba la fecha y su numero de telfono. 
• La segunda seccion de esta solicitud es para informacion acerca de su perro.
• Primera linea, escriba.
• Nombre, Sexo, Ano de nacimento de su perro.
• Marque "SI", si a su perro lo han esterilizado.
• Marque "SI", si su perro esta entrenado como perro de ataque o guardian.
• Segunda linea, escriba la raza de su perro.
• Tercera linea, escriba el color de su perro (se aceptan hasta tres colores). El primer color es el principal, luego el siguiente en importancia y el tercer color, si es necesario.
• Si su perro esta vacunado contra la rabia marque la casilla que dice "SI" y anote la feche en que lo vacunaron.
• Anote el numero total de perros que tiene actualmente en su casa.

Affidavit for Spayed or Neutered Dog

____________________________ being duly sworn, says: I reside at the address and am the owner of the dog indicated on the preceding pages of this dog license application. This dog was spayed/neutered or examined and found to be spayed/neutered by Dr.______________________, Veterinarian at (Street and Number, City, State, Zip) _______________________________ on ____________________, 20____. This affidavit is made to obtain a license for the dog referred to above.

Sworn to before me this
__________________ day of 20____.

________________________________
(Official Title)

________________________________
(Applicant)