APPLICATION FOR GRANT OF LICENCE TO KEEP
A DOG BREEDING ESTABLISHMENT
Licensing, Town Hall, Feethams, Darlington. DL1 5QT
Web site: http://www.darlington.gov.uk
Telephone: 01325 405888 Fax: (01325) 405983
BREEDING OF DOGS ACT 1973
I/We hereby make an application for the GRANT to keep a breeding establishment for dogs at the
premises described below in pursuance of Section 1 of the Breeding of Dogs Act 1973.
Full Name of Applicant
Mr
Mrs
Miss
Ms
Other
Surname
First Name (s)
Have you ever been
known by another name
Date of Birth
19
Home Address of
Applicant
E-Mail Address
(If applicable)
Name of Breeding
Establishment
Address of Breeding
Establishment (If
different from above)
Home
Telephone
Business
Telephone
Is the establishment operative throughout the year
Fax
Number
Yes
No
Yes
No
If No, please state the period
when normally operative
Who will have direct control or
management of the establishment
Is a responsible person living at the establishment
ELMs 11 19.9.12
If No, what arrangements are in
place in case of an emergency
Are you or any person who will have control or management of the establishment at any time:Disqualified from Keeping a Breeding Establishment
Yes
No
Disqualified from Keeping a Boarding Establishment for Animals
Yes
No
Disqualified from Keeping a Pet Shop
Yes
No
Disqualified from Keeping a Dog
Yes
No
Disqualified from Having Custody of Animals
Yes
No
Type of accommodation to be used:
Wholly indoors
Wholly outdoors
Combination of indoors and outdoors
Breeds of dogs to bred at
the establishment
Number of bitches kept
Ages of
bitches kept
Material used in
construction of outside
kennels, if any
Materials used in
construction of indoor
kennels in any
Heating arrangements, if
any
Lighting arrangements, if
any
Ventilation if applicable
Food storage facilities
ELMs 11 19.9.12
Arrangement for disposal
of excreta
Water supply
Fire Alarms
Prevention/Control of
Infection
Please give name and
address of your usual
veterinary surgeon or
practitioner
Please read statements below carefully before signing the application.
I/We are aware of the provisions of the Breeding of Animals Act 1973 and 1991, and The Breeding
and Sale of Dogs Act (Welfare) Act 1999 and apply for a licence to keep a Breeding Establishment.
I understand that if there are any additional veterinary charges incurred with this application, then I
shall be liable to pay them promptly.
I enclose with this application – please  where applicable
a) The full licence application fee
I/We declare that the answers and information i/we have given are correct in every respect.
HOW WE COLLECT AND USE INFORMATION
The information collected, on this form and from supporting evidence, by Darlington Borough Council will be used t o
process your application. The information may be passed to the Department of Social Security, Employment Service and
Inland Revenue as permitted by law.
We may check information provided by you, or information about you provided by a third party, with other information held
by us. We may also get information from certain third parties, or give information to them to check the accuracy of
information, to prevent or detect crime, or to protect public funds in other ways, as permitted by law. These third parties
include Government Departments and local authorities.
We will not disclose information about you to anyone outside Darlington Borough Council nor use information about you
for other purposes unless the law permits us to. Darlington Borough Council is the Data Controller for the purposes of the
Data Protection Act 1998. If you want to know more about what information we have about you, or the way we use your
information, you can ask at; Licensing Unit, Town Hall, Feethams, Darlington. DL1 5QT Tel: 01325 388562 Fax:
(01325) 388555 Web site: http://www.darlington.gov.uk
Email: licensing@darlington.gov.uk
Signature
Date
If signing on behalf of a body
corporate please state appointment
held
ELMs 11 19.9.12
ELMs 11 19.9.12