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Please fill out all of the requested information. A separate application must be completed for each pet being registered. Applicants are required to submit proof of District of Columbia registration and proof of all legally required inoculations/vaccinations.
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| Name of Pet Owner: | * |
| Phone #: | * |
| Email Address: | * |
| Kind of Pet: | * |
| Breed: | * |
| Sex: | * |
| Name of Pet: | * |
| Color and Weight: | * |
| Age: | * |
| Is the pet in good health?: | * |
| Have there been any complaints about your pet? If so, have you paid for any damage caused by your pet? if yes, please explain.: | * |
| Does your pet have any behavioral problems? if yes, please explain.: | * |
| Has your pet ever Bitten a person or another animal? If so, please explain.: | * |
| Has your pet ever been declared 'dangerous' by a court of law or by the Washington Humane Society?: | * |
| Photo of Pet: | * |
| Copy of DC Registration: | * |
| Copy of Vaccination Certificate: | * |
| DC Pet License Number: | * |
| To prevent automated SPAM, please enter SZTL to submit your form (case sensitive): | * |
* indicates required field
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