King County pet license application

Is your animal a [ ] Dog or a [ ] Cat?
Is your animal [ ] Male or [ ] Female?

Breed: ____________________________  Color: _____________________

Name: _______________________________________________________

Is your pet altered: [ ] Yes [ ] No
Microchip number (if any): _________________________________

Type of License Applying for: (Check one)
[ ] Juvenile (under 6 months--6 month expiration) $5.00
[ ] Altered (proof required) $20.00
[ ] Unaltered $60.00 (Coupon for $25 savings on a spay/neuter included w/ purchase)
[ ] Sr. Citizen (proof altered--proof 65/older) Dog $20.00/Cat $12.00
[ ] Service Animal - No fee
[ ] Buddy License $5.00 - See below for more information. To be eligible, this must be accompanied by another application for a full price pet license.

INFORMATION ABOUT YOU:

Your name: ______________________________________________________

Physical Address: ________________________________Unit #:_________

City: ____________________________ State:_________Zip:_______________

P.O. Address (if different):

P.O. Box:_________________________________________________________

City: ____________________________ State:_________Zip:_______________

Home Phone: (____)_____- ________  Alternate Phone: (____)_____- ________

SPECIAL OFFERS:

You may choose a special offer with the purchase of a new pet license. NEW license includes the following: $20 altered, $60 unaltered and $20 or $12 senior dog or cat licenses. Promotional offers do not apply to $5 juvenile licenses, renewals, reissues and transfers. You may check ONE special offer:

       [ ]  Free microchip implant with purchase of a new pet license. (We will mail you a voucher, upon request, with your new pet license that you can redeem for the microchip.)

      [ ]  $5.00 Buddy License. With the purchase of one full price license, you may obtain a second pet license of equal or lesser value for only $5.00. Be sure to send us two of these application forms, one for each pet you are licensing.

MAILING INSTRUCTIONS:

Complete a separate form for each pet and mail along with check payable to King County Pet License to:
King County Pet License
King County Administration Building
500 4th Avenue, Room 403
Seattle, WA 98104-3277.

If you have any questions, please contact us at (206) 296-2712.