Renewal of Kennel Licence

FORM 12 TASMANIA
DOG CONTROL ACT 2000
Applicants Name(Required)
Postal Address(Required)
Renewal of Licence to Keep:(Required)
Breed(s) or Kind(s)
Number of Dogs
Registration Number(s)
 
At my Premises:
Full address of kennel location
Licence holders should be aware that failure to comply with the conditions listed on the licence may result in the cancellation of non-renewal of the licence.
Clear Signature
DD slash MM slash YYYY