Dog Sterilisation Registration Partial Refund Form

Print Blank Form

All fields are required except where indicated

Please note that this form may take up to 8 weeks to process.

Dog name:

Registration or tag number:

Primary breed:

Gender:

MaleFemale

Date of sterilisation:

Sterilisation certificate:

This field is mandatory to update your pets sterilisation status

Owner Details

Title (select from the drop box below - optional):

First name:

Surname:

Address:

Please enter the address where animal is to be usually kept. Note: street number and street name are needed for all addresses

Landline (e.g. 08 9500 1234 - optional):

Mobile (e.g. 0400 123 456):

Email:

Driver licence number:

Bank details:

Proof of address:

Attach a copy of a current driver's licence, utility bill showing current address or rates notice

Contact

Address

City of Cockburn
Whadjuk Boodja
9 Coleville Crescent,
Spearwood 6163

PO Box 1215, Bibra Lake DC,
Western Australia, 6965

Office opening hours:
8.30am to 4.30pm
Monday to Friday (excluding public holidays)

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