2022 Dog License Application*

Town of Wyoming, Iowa County Wisconsin

The cost of the annual license is $5.00 for a neutered/spayed dog and $10.00 for an un-neutered/unsprayed dog.

     If you have four or more dogs, a $40 “kennel” license may be purchased for twelve or fewer dogs. Contact Town Treasurer to purchase a kennel license.

     License will be subject to a $10 late fee if application is received after March 31,2022 or after the date a dog becomes five months of age. If you no longer own a previously licensed dog, please notify the Town Treasurer.

     Rabies vaccination information is required with this application. You can supply the information below OR include a copy of the dog’s rabies vaccination certificate from your veterinarian.

OWNER INFORMATION

Owner’s Name:____________________________________________________Date:____________                                                                                                                  

Email: ________________________________________________

Phone:________________________________________________

Street Address & City:_____________________________________________Zip________________

DOG INFORMATION

Dog’s Name:___________________________________________

Color:____________________ Breed:______________________

Circle One: Neutered Male ($5.00)   Un-Neutered Male ($10.00)      Spayed Female ($5.00)    Un-Spayed Female ($10.00)

Proof of vaccination must be included by completing below or providing a copy of rabies certificate

The above dog was vaccinated against rabies on: ____________________ Year: 20____

Vaccine Mfg. __________________    Serial Number: _________________

Expiration Date: ________________   Vet Clinic :______________________________________

DOG INFORMATION

Dog’s Name:___________________________________________

Color:____________________ Breed:______________________

Circle One: Neutered Male ($5.00)   Un-Neutered Male ($10.00)      Unspayed Female ($5.00)    Un-Spayed Female ($10.00)

Proof of vaccination must be included by completing below or providing a copy of rabies certificate

The above dog was vaccinated against rabies on:____________________ Year: 20____

Vaccine Mfg. __________________    Serial Number: _________________

Expiration Date: ________________   Vet Clinic :______________________________________

                 TOTAL AMOUNT included with this application: $_________________________

(Dog license payment must be separate from your tax payment)

Make check payable (one check for multiple applications OK) to the Town of Wyoming. Return payment, license application(s), and a self-addressed stamped envelope to Al Friedman, Treasurer, 6672 Lower Wyoming Rd, Spring Green, WI 53588. Please include a self-addressed stamped envelope to receive your dog tag(s).

Dog tags must be attached to the dog’s collar and worn at all times.

*Pet licensing and rabies vaccination certification subject to provisions of Chapters 95 and 174 of the Wisconsin State Statutes, which may change at any time.