Application for Dog Licence

Date

Part 1 - Applicant Information

Applicant Name:

Second Applicant Name: (if applicable)

Address: (Including City and Postal Code)

City

Province

Postal Code

Phone Number:

Cell:

Email Address:

New Resident to Port Coquitlam? *

Yes

No

If adding a dog to your account, please enter your account number.

Is this dog new to your family?

Yes

No

Move Date:

Date dog added to family

Requested by Bylaw Officer?

Yes

No

Part 2 - Dog Information

Dog Name:

Colour:

Sex:

Male

Male and Neutered

Female

Female and Spayed

Breed:

Dog Age:

Tattoo and or Microchip Identification

Tattoo Identification

Microchip Identification

Neither - no tattoo or microchip

Tattoo and or Micro-chip Number:

Part 3 - Fees

The cost of licensing your dog depends on whether or not it is spayed or neutered - a reduced licence fee is charged for spayed or neutered dogs. Further, a discount on licence fees is available if you submit an application before February 1st.

For applications submitted BEFORE February 1st only

Spayed or Neutered - $32 Unaltered

Unaltered - $80

For applications submitted AFTER February 1st only

Spayed or Neutered - $47

Unaltered - $95

For applications submitted after the due date, your fee will be reduced by $15.00 if: a) you have just recently acquired your dog, b) your puppy has reached 6 months of age, or c) you have moved into the City of Port Coquitlam in the last 30 days.

If any of the above conditions applies to your application, please provide details:

If you have chosen the Spayed or Neutered fee option, please provide a Spay or Neuter certificate. Please attach a copy of the spay/neuter certificate.

Maximum upload size: 209.72MB

Attach any other relevant documentation here.

Maximum upload size: 209.72MB

Eg: Service dog certification.

Once your application has been received, a representative of the City will contact you to confirm your licence fee. A new resident will be issued a licence without charge upon surrender of a current tag from another jurisdiction.

If your dog is lost, do we have your consent to give your name and phone number to the finder?

Yes

No

reCAPTCHA

Personal information collected on this form by the City of Port Coquitlam will only be used for the purposes for which it was collected under the authority of section 26(c) of the Freedom of Information and Protection of Privacy Act (FOIPPA). If you have any questions regarding the collection of this information, please contact the City’s Records and FOIPPA Administrator at 604-927-5250 or clerks@portcoquitlam.ca.