TOWN OF SMITHS FALLS
77 Beckwith St. N., Smiths Falls, Ontario K7A 4T6
(613) 283-4124 Fax (613) 283-4764
DOG TAG APPLICATION - BYLAW 8126-2008
Name of Owner
Address
P/C
Phone Number
Date:
Cell Phone
E-Mail
TAG 1
Dog Name
 Male
 Neutered
Breed
Colour
Age
 Female  Spayed
PIT BULL TYPE DOGS ARE RESTRICTED - DOLA
Rest. or Vic.
Rabies Tag
 $50.00
Designated Restricted (R) or Vicious (V)  Yes  No
Shot Type
Rabies Date
 1yr  3 yr
Fees prior April 1
□ Spay/Neutered $15.  Chip $5
#
 NOT Spay/Neutered $30.  Chip $20
#
Fees post April 1
□ Spay/Neutered $30.  Chip $10
#
 NOT Spay/Neutered $60.  Chip $40
#
TAG 2
Dog Name
 Male
 Neutered
Breed
Colour
Age
 Female  Spayed
PET CARE IS NOT FREE – BE RESPONSIBLE
Rest. or Vic.
Rabies Tag
 $50.00
Designated Restricted (R) or Vicious (V)  Yes  No
Shot Type
Rabies Date
 1yr  3 yr
Fees prior April 1
 Spay/Neutered $15.  Chip $5
#
 NOT Spay/Neutered $30.  Chip $20
#
Fees post April 1
 Spay/Neutered $30.  Chip $10
#
 NOT Spay/Neutered $60.  Chip $40
#
Total Fees Due
DOG 1
Recd By:
$
 Cash  Cheq.  Debit
DOG 2
Total $
$
VETERINARY SERVICE
PH
FX
I hereby give permission to the Town of Smiths Falls to contact my Veterinary Service provider named above to verify rabies
vaccination date/expiry, spay/neuter date and Micro Chip information for the above named dogs.
Signature:
FAILURE TO COMPLY WITH THE RESPONSIBLE ANIMAL OWNERSHIP BYLAW WILL RESULT IN FINES
MAXIMUM ANIMALS HOUSEHOLD - 4
LEASH MAXIMUM 2 M
POOP & SCOOP ~ OR FINES
MAXIMUM ANIMALS OF ONE TYPE - 3
RABIES VACINATION REQUIRED
DOLA = DOG OWNERS LIABILITY ACT
TAGS ON ANIMAL OR FINES
RUNNING AT LARGE
DOG OWNER LIABILITY ACT
VICIOUS OR RESTRICTED DOGS SHALL BE MUZZLED WHEN ON A LEASH OR KEPT IN A 6 SIDED ENCLOSURE
The information of this licence is collected under the authority of the Municipal Act, S.O. 2001, C.25. as amended and will be
used for the dog licensing and animal control records of the Municipality. See reverse for Schedule A to By-law No: 8126-2008
for Licence Fees. Providing false statements is an offence under the Provincial Offences Act and may result in Fines. Rev. 2011