New Dog License Application

Owner's Name

First Last

Owner's Address

The mailing address for the owner of the dog(s).

Street Address City State ZIP Code

Owner's Phone

Alternate Telephone

Owner's Email

Dog Name

Home Address

Same as Owner's Address

Street Address City State ZIP Code

Breed

Color of Dog

Rabies Tag#*

This should be on the rabies Immunization certificate. A copy of this must be submitted with all new license applications and is required to be updated with immunization.

Date of Vaccination*

Date of Birth

Spayed or Neutered?

Yes
No

Proof that dog is spayed/neutered is required to receive the discount

Please submit proof of Spay or Neuter

Drop files here or

To qualify for the spay or neuter renewal fee you must submit proof of the surgery with each new dog application.

Micro Chip# (if applicable)

If your dog has a microchip number, please include it

Micro Chip Type (if known)

Please upload a scanned copy or photo of the rabies immunization certificate, signed by a licensed veterinarian

Drop files here or

If preferred, you may email a copy or photo of the rabies immunization certificate to doglicense@sjc.utah.gov

Do you have an additional dog you need to register?

Yes
No

Additional Dog Information

Dog Name

Home Address

Same as Owner's Address

Street Address City State ZIP Code

Breed

Color of Dog

Rabies Tag#*

This should be on the rabies Immunization certificate. A copy of this must be submitted with all new license applications and is required to be updated with immunization.

Date of Vaccination*

Date of Birth

Spayed or Neutered?

Yes
No

Proof that dog is spayed/neutered is required to receive the discount

Please submit proof of Spay or Neuter

Drop files here or

To qualify for the spay or neuter renewal fee you must submit proof of the surgery with each new dog application.

Micro Chip# (if applicable)

If your dog has a microchip number, please include it

Micro Chip Type (if known)

Please upload a scanned copy or photo of the rabies immunization certificate, signed by a licensed veterinarian

Drop files here or

If preferred, you may email a copy or photo of the rabies immunization certificate to doglicense@sjc.utah.gov

New License Fee $10.00 per Dog.
Renewals will be mailed yearly. Renewal Pricing - Spayed/Neutered $5.00 Non-spayed/Unneutered $20.00

Certification

The City of South Jordan's Municipal Code:

1.	Any dog required to be licensed shall be covered by homeowners, renter, or other insurance.
2.	No personal shall own or harbor more than two (2) household pets per species over the age of four (4) months per dwelling.
3.	The City shall issue a license for a dog located in the city upon satisfaction of the following conditions:
a.	Owner of the dog completes an approved application.
b.	Owner of the dog pays the required fee (fee set by resolution of the City Council)
c.	Proof of updated rabies vaccination or a notarized letter from a veterinarian is provided stating a dog cannot be vaccinated due to health reasons.
4.	Owner of a dog shall at all times cause the dog to wear the license tag.
5.	Please refer to City Code Chapter 6 for all ordinances and requirements for licensing/owning a dog in the City of South Jordan.

Please read the following statement before signing below:

I certify that I have read the instructions and all information contained on this form is true to the best of my knowledge.

The City of South Jordan's Municipal Code:

Any dog required to be licensed shall be covered by homeowners, renter, or other insurance.
No personal shall own or harbor more than two (2) household pets per species over the age of four (4) months per dwelling.
The City shall issue a license for a dog located in the city upon satisfaction of the following conditions:

Owner of the dog completes an approved application.
Owner of the dog pays the required fee (fee set by resolution of the City Council)
Proof of updated rabies vaccination or a notarized letter from a veterinarian is provided stating a dog cannot be vaccinated due to health reasons.

Owner of a dog shall at all times cause the dog to wear the license tag.
Please refer to City Code Chapter 6 for all ordinances and requirements for licensing/owning a dog in the City of South Jordan.

Please read the following statement before signing below:
I certify that I have read the instructions and all information contained on this form is true to the best of my knowledge.

Owner Signature*

Use your mouse or on a touch screen use your finger or stylus to sign

Please type your name as signed above*

Signature Date*

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New Dog License Application