here - Tablelands Regional Council

Tablelands Regional Council
PO Box 573,
ATHERTON QLD 4883
Telephone: 1300 362 242
Email:
Web:
info@trc.qld.gov.au
www.trc.qld.gov.au
Application for Registration of Cats and Dogs 2013/2014
Animal Management (Cats and Dogs) Act 2008
Payment of the registration fee/s MUST be submitted with this application.
Section 1 - Applicant details (Please complete all details in full using BLOCK LETTERS)
Applicant
(Animal Owner)
Postal Address
(if different from above)
Contact
Telephone
Numbers
Email
Title:
Given Names:
Surname:
Residential Address:
Suburb:
Home: Mobile: Work:
Postcode:
Property Address
where animal/s to
Address:
be kept
If same as residential
address write 'as above' Suburb: Postcode:
Section 2 - Concessions - (Please tick if applicable). If no concession please go to Section 3
Copies of concession must be provided where applicable
De-sexing
Proof must be
supplied
Sterilisation Certificate/letter
from Vet
Dog 1
Cat 1
Dog 2
Cat 2
Pensioner
Full aged pensioner or
equivalent.
Copy of concession
card/Pensioner Centrelink
Authorisation Form
Association
Memberships
Must be a current member
and proof of membership
supplied
Association
Memberships
Proof of membership must be
supplied
Name of Card holder: Pension No:
Kennel Club or Canine Assoc Expiry Date:
Assistance Dog
(Guide/Hearing/Assistance)
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Section 3 - Animal Details
Dogs
1) Dog Name: 2) Dog Name:
Sex: Male/Female
Desexed: Yes/No
(if yes, proof required)
Sex: Male/Female
Date of Birth: Month Year Date of Birth: Month Year
Desexed: Yes/No
(if yes, proof required)
Primary breed:
Cross breed:
Colour and makings:
Permanent Identification Number (PID)/Microchip
No Yes - Certificate of Identification supplied
Permanent Identification Number (PID) / Microchip
Primary breed:
Cross breed:
Colour and makings:
Permanent Identification Number (PID)/Microchip
No Yes - Certificate of Identification supplied
Permanent Identification Number (PID) / Microchip
Cats
1) Cat Name: 2) Cat Name:
Sex: Male/Female
Desexed: Yes/No
(if yes, proof required)
Sex: Male/Female
Date of Birth: Month Year Date of Birth: Month Year
Desexed: Yes/No
(if yes, proof required)
Primary breed:
Cross breed:
Colour and makings:
Permanent Identification Number (PID)/Microchip
No Yes - Certificate of Identification supplied
Permanent Identification Number (PID) / Microchip
Primary breed:
Cross breed:
Colour and makings:
Permanent Identification Number (PID)/Microchip
No Yes - Certificate of Identification supplied
Permanent Identification Number (PID) / Microchip
Section 4 - Declaration of applicant
I hereby apply for registration of the animals(s) described and declare that the details are correct to the best of my knowledge.
1. Where the pensioner's concession has been applied for, I authorise the Department of Centrelink or Veteran Affairs is
divulge to the Council of the Tablelands Regional Council as much of the information contained in my records as is
necessary to determine my eligibility for such concession and for no other purpose.
2. I am aware that the number of animals kept at this property is in accordance with the allowable number of cats/dogs to be
kept on a property as stated in Council's Local Law Keeping and Control of Animals.
3. If applicant is under the age of 18 years, the parent or guardian is deemed to be the keeper of the animal.
4. I have a suitable enclosure or adequate fencing to prevent my animal/s from escaping.
Applicant Signature:___________________________________________Date:____/____/____
Privacy Note: Tablelands Regional Council is collecting your personal information in accordance with the Animal Management (Cats and Dogs)
Act 2008, for the purpose of processing your animal’s registration. The information will only be accessed by authorised council employees of
Tablelands Regional Council. Some of this information may be given to the Department of Infrastructure and Planning should your dog be
declared a regulated dog. Your information will not be given to any other person or agency unless you have given us permission or we are
required by law.
Office Use Only
Property No. Tag Number Animal No. Date Paid Fee Paid Receipt No. Cashier
Dog 1
Dog 2
Cat 1
Cat 2
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BE A RESPONSIBLE ANIMAL OWNER
REMEMBER
ALL cats and dogs must be registered with Council from 12 weeks of age.
Cats and Dogs born after 8 September 2010 must be microchipped.
If you are found to be keeping an unregistered cat or dog on your property, you will be in breach of the
Animal Management (Cats and Dogs) Act 2008 and a Penalty Infringement Notice may be issued.
An effective enclosure must be maintained to ensure your cat/dog does not stray from the property.
CAT AND DOG REGISTRATION FEES 2012/2013
Type of Registration Proof Required Fee
Entire Cat/Dog N/A $68.00
Desexed Cat/Dog * Sterilisation Certificate/letter from Vet $13.00
Entire Dog owned by a Member of a
Kennel Club or Canine Assoc *
Entire Cat/Dog owned by a
Pensioner *
Documentation/membership card indicating current
membership
Full aged pensioner or equivalent. Copy of concession
card/Pensioner Centrelink Authorisation Form
$24.00
$35.00
Assistance Dog * Documentation indicating Guide/Hearing/Assistance Dog FREE
Working Dog *
Documentation indicating applicant is engaged in
Primary Production
FREE
Puppy/Kitten (under 12 weeks old) N/A FREE
Declared Regulated Dog
(Restricted, Dangerous, Menacing)
As per conditions $245.00
* Supporting documentation must be provided with this application when making payment.
Payments can be made in person during business hours at any of the following Council
Service Centres/Agencies.
Service Centres/Agencies
Atherton Service Centre - 45 Mabel Street, Atherton
Herberton Service Centre - 40 Grace Street, Herberton
Malanda Service Centre - 31 James Street, Malanda
Mareeba Service Centre - 65 Rankin Street, Mareeba
Kuranda Library - 4-12 Thooree Street, Kuranda
Ravenshoe Library - 24 Moore Street, Ravenshoe
Call 1300 362 242 or visit www.trc.qld.gov.au for opening hours
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