BREEDING AND SALE OF DOGS (WELFARE) ACT 1999
1. Name (BLOCK CAPITALS)
......................................................................………………….…
Cotswold District
Council
.................…………………………..………………………………..
2. Address
……………................................………….............……………….
Application for a licence to keep
a breeding establishment
3. Address of breeding establishment .................................................................………………….
(if different from 2 above)
.....................................................................…………………….
4. Are you disqualified from:
a) keeping a dog breeding establishment
b) keeping a pet shop
c) keeping a dog
d) having the custody of animals
e) keeping an animal boarding establishment
YES/NO
YES/NO
YES/NO
YES/NO
YES/NO
5. Please give the following information about the accommodation which the animals will occupy:
(a) construction
.......................................................................…………..……….
(b) size of quarters
..........................................................................………………….
(c) number of occupants
..........................................................................………………….
(d) exercising facilities
..........................................................................………………….
6. Number of bitches kept at premises…………………………………………………………………..
7. Number of bitches kept elsewhere …………………………………………………………………….
8. Number of bitches on breeding arrangement ………………………………………………………..
I agree to permit a person authorised by the council to inspect the premises before any licence is
granted.
I apply for a licence to keep a breeding establishment.
Signature......................................................…………….
Date.......................................…….
Please return this form and fee due to:
Environmental Services, Cotswold District Council, Trinity Road, Cirencester Glos GL7 1PX
The Name and Address of the License holder and Breeding Establishment address provided on this application will
be transferred to a Register held in Cotswold District Council Environmental Services.
I/We do/do not give consent to my/our name(s) and address, as a licensed premise, being given to members of the
public (delete as appropriate). Signed:………………………………………………………………. Date: …………………
All other information provided will be kept confidential subject to disclosure necessitated by any legal proceedings.
If an inspection of the premises is required, the information provided may be passed to a Veterinary Practitioner
(Mrs. B Patel, Data Protection Officer Tel: 01285 623000)