Year

Month

M/F

Color

Hair

Breed

Fees

Penalty

Tag No.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Age

Sex

Certificate for the registration of dog for the year ________

The undersigned says that the facts indicated above ARE TRUE.

Signature of Applicant ______________________

Telephone No.  ________________  Date ____________________

Name: _____________________

Address:_____________________

City/State/Zip____________________

Please print and complete the form below and mail to our office with a check for $16.00 for each dog.

Please enclosed a self-addressed stamped envelope.

A penalty shall be assessed if Dog License is not secured on or before January 31, or within 30 days after the dog becomes 3 months of age, or is brought from outside the state R.C. Sec. 955.01.05

Blue Bar

Michael T. Bacon
Hardin County Auditor
One Courthouse Square, Suite 250
Kenton, Ohio 43326-2389
(419) 674-2239     Fax: (419) 674-4023

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