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Jersey City
Pet Partnership Days
Featuring FREE Rabies Shots for Jersey City Cats and Dogs.
Dogs must be licensed or obtain license on site.*
Saturday, April 25, 10am-3pm, Pershing Field
Saturday, May 16, 10am-3pm, Audubon Park
Sunday, May 31, 10am-3pm, City Hall
*Vaccinations are free. Dog licensing ranges in price from $8 to $50.
Please visit www.jerseycitynj.gov/animalcontrol for rates and details
In Partnership With:
PRESENTED BY: MAYOR STEVEN M. FULOP, THE JERSEY CITY MUNICIPAL COUNCIL AND
THE DEPARTMENT OF HEALTH & HUMAN SERVICES
For more information, call (201) 547-6800
or visit jerseycitynj.gov
City of Jersey City Official Government Page
JC_GOV
CITY OF JERSEY CITY
DEPARTMENT OF HEALTH & HUMAN SERVICES
H.H.S. | 199 SUMMIT AVENUE| JERSEY CITY, NJ 07304
P: 201 547 6800 | F: 201 547 5168
STEVEN M. FULOP
STACEY L. FLANAGAN
MAYOR OF JERSEY CITY
DIRECTOR
2015 DOG LICENSE APPLICATION
*** New license rates effective May 1 ***
Licenses may be purchased for a period of 12 Months (1 Year) or 36 Months (3 Years).
Please complete the form below and return it with your check/money order made payable to:
JERSEY CITY DIVISION OF HEALTH and mail to:
ANIMAL CONTROL, 199 SUMMIT AVE, JERSEY CITY, NJ 07304
DOG OWNER/GUARDIAN INFORMATION [Please print clearly]
First name:
__________________________
Last name:
_________________________________________
Street address:
_____________________________________________
Preferred phone:
_____________________________
Email address:
___________________________________________________________________________________
Apt # _______
Zip code:
____________
Alternate phone: _____________________________
(We will not share your email address)
DOG INFORMATION [Please print clearly]
Dog’s name:
Dog’s age: _________
______________________________________
Sex:
M
or
F
(circle one)
Breed:
________________________
Spay/ neuter:
YES
or
NO
Hair: SHORT
(proof required)
Color & markings:
____________________________________
MEDIUM
LONG
(circle one)
Microchip #:
____________________________
All licenses effective May 1, 2015; all fees non-refundable. RENEW EARLY - fees go up May 1.
1 Year License (expires 4/30/16) - Rabies shots must be up to date until 3/1/16
Through April 30, 2015
Neutered dogs $8
Unneutered dogs $12
May 1 or later
Neutered dogs
$10
Unneutered dogs $20
3 Year License (expires 4/30/18) - Rabies shots must be up to date until 3/1/18
Through April 30, 2015
Neutered dogs
$20
Unneutered dogs $30
May 1 or later
Neutered dogs
$25
Unneutered dogs $50
Proof of Rabies Vaccination or Exemption Letter
All applications require a copy of the rabies vaccination certificate showing it to be valid through the license period and
attached to the application when filed. Dogs incapable of being inoculated are exempted when certified in writing by a duly
licensed veterinarian (original exemption letter or NJ VPH-28 “CERTIFICATE OF EXEMPTION” form is required).
$5 late fee for licenses not renewed by May 31, 2015. (Does not apply to new applicants.)
WWW.JERSEYCITYNJ.GOV
CITY OF JERSEY CITY
DEPARTMENT OF HEALTH & HUMAN SERVICES
H.H.S. | 199 SUMMIT AVENUE| JERSEY CITY, NJ 07304
P: 201 547 6800 | F: 201 547 5168
STEVEN M. FULOP
STACEY L. FLANAGAN
MAYOR OF JERSEY CITY
DIRECTOR
SOLICITUD DE LICENCIA DE PERRO 2015
*** Nuevas tarifas de licencia eficaces 01 de Mayo ***
Las licencias pueden ser adquiridas por un período de 12 meses (1 año) o 36 meses (3 años). Favor completar el
siguiente formulario y incluir un cheque o giro postal a nombre: JERSEY CITY DIVISION OF HEALTH y
enviar a:
ANIMAL CONTROL, 199 SUMMIT AVE, JERSEY CITY, NJ 07304
PROPIETARIO DE PERRO / INFORMACIÓN DE TUTORES [Por favor, escriba claramente]
Primer nombre:
__________________________
Dirección:
_____________________________________________
Preferido telefono:
Dirección de
la email:
Apellido:
_____________________________
_________________________________________
Apt # ______
Código postal:
____________
Suplente telefono: _____________________________
____________________________________________________________________________________
(No compartiremos su dirección de correo electrónico)
PERRO INFORMACIÓN [Por favor, escriba claramente]
Nombre del
__________________________________________ Edad: _________ Sexo:
M or F
perro:
(encierre en un círculo)
Raza:
Castrado / no
Pelo: CORTO MEDIO LARGO
________________________
SI o NO
castrado: (prueba que se exige)
(encierre en un círculo)
Color y marcas:
____________________________________
Microchip #:
_____________________________
Todas las licencias efectivas Mayo 1, 2015; todas las tarifas son no reembolsable.
RENOVAR TEMPRANA - tasas suben Mayo 1.
Licencia de 1 Año (expira 4/30/16) - Vacunas contra la rabia deben estar al día hasta Marzo 1, 2016
Al April 30, 2015
Neutered dogs $8
Unneutered dogs $12
May 1 o temprano
Perros castrados
$10
Perros no castrados $20
Licencia de 3 Años (expira 4/30/18) - Vacunas contra la rabia deben estar al día hasta Marzo 1, 2018
Al April 30, 2015
Perros castrados
$12
Perros no castrados $30
May 1 o temprano
Perros castrados
$25
Perros no castrados $50
Prueba de vacunación antirrábica o exención Carta
Todas las aplicaciones requieren una copia del certificado de vacunación contra la rabia mostrando que sea válido durante el
período de licencia y junto con la solicitud cuando fue presentada. Perros incapaces de ser inoculados están exentos cuando
sea certificado por escrito por un veterinario debidamente autorizado (carta de exención original o NJ VPH-28 "certificado de
exención" se requiere formulario).
$5 cargo por demora por licencias no renovadas en Mayo 31, 2015. (No se aplica a los nuevos solicitantes.)
WWW.JERSEYCITYNJ.GOV