581-BEAMAN TAG 581 aFT.utp
,off --7, ' City of Yelm
a 105 Yelm Ave. W., Yelm, WA 98597
:_gPhone: (360)458-3244 Fax: (360) 458-4348
:� , ; www.ci.velm.wa.us
Application for Dog License
Fee Schedule:
Dog License: FREE
Replacement Tag: $2.00
Annual Registration for Dangerous Dog: $500.00 (Yelm Municipal Code—Chapter 6.08.070)
The City of Yelm requires all dogs to be registered annually and have current rabies inoculations.
Registrations cannot be issued unless proof of current rabies inoculation is provided with this
application. The dogs are required to wear the rabies tag issued by the veterinarian. (Yelm Municipal Code —
Chapter 6.12) r
Owner Name: Kti.../ (�i 1 (71'404 r y'aill VI Owner Phone#: b(-5---,;7(v ..3286:
Physical Address: 1 SSU jer4k.lr( 1}{ ,2raw/ E-mail Address: J Gfi4'ILi, altif4i,COA1-7
#of Dogs: / (Maximum of three allowed per YMC Chapter 6.08.030)
/Xl
1. Name of Dog: )(��' Male: _ Female:7\ Spayed or Neutered; Y.l N
_
L ti _
i
Breed: i_bil VIGt 'Ti Color: ,L1;.7)?, [./C
2. Name of Dog: Male: Female: Spayed or Neutered: Y/ N
Breed: Color:
3. Name of Dog. Male: Female: Spayed or Neutered: Y/ N
Breed: Color:
Completed applications (including proof of rabies inoculations) may be mailed or delivered to Yelm City Hall,
105 Yelm Ave. W., Yelm, WA 98597. Incomplete applications will be returned. Applications may be obtained at
City Hall, Monday through Friday 8:00 am to 5:00 pm or by visiting our website at www.ci.yelm.wa.us. Tags are
issued at City Hall. You may receive the tag by mail if requested.
To report a lost dog or if you have an animal complaint please call our
Public Works Department at (360) 458-8406.
For office use only c�(
Date license(s)issued: Tag Numbers: 1. J u ( 2. 3.
Replacement Tag: Y/N (If replacement tag, then enter original tag number here: )
Proof of rabies enclosed: Yes No(please explain)
Date Information entered into database: By Whom:_0\-\ L�K `'---
Revised 05/05/10 sjd