2022 N.J. Dog License Application Form - Township of Deerfield, Cumberland County
This form & Payment is due by March 31, 2022 or late fees will be imposed in the amounts described below.
Sign in to Google to save your progress. Learn more
This license to own, keep or harbor the dog described below is issued to: *
Name and Address:
Date: *
MM
/
DD
/
YYYY
Phone Number: *
Dog Description: *
Breed: *
Age: *
Color & Markings: *
Address where dog will be kept (if different from above): *
Date of Spay/Neutering:
MM
/
DD
/
YYYY
Date of Rabies Vaccination: *
MM
/
DD
/
YYYY
Vet Name, Address & Phone # who provided rabies vaccination: *
Rabies Expiration Date & Certificate #: *
This license will expire January 31, 2023. Please make sure this form is completed in full and then submitted with the appropriate fees as described. The information provided here will be transferred to a license form which will be provided to you by the Township Clerk or the Deputy/Secretary. You can submit this form electronically or print it and bring it with your fees to the Township Building at 736 Landis Avenue Rosenhayn, NJ 08352. If mailing, please use P.O. Box 350 Rosenhayn, NJ 08352.
Fees through March 31, 2022 are $8.20 for spayed/neutered pets. $11.20 if NOT neutered or NOT spayed. April 1st, those fees go up to $11.20 and $14.20 respectively. The Municipal Clerk can assist you by dialing 856-455-3200 or email kseifrit@deerfieldtownship.org.
Untitled Title
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report