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Animal Form
Animal Form
portaladmin
2020-02-10T10:00:42+10:00
Animal Admission Form
Merit ID
*
Officer Name
*
Date of Seizure
*
MM slash DD slash YYYY
Time of Seizure
*
:
Hours
Minutes
AM
PM
AM/PM
Animal Type
*
Dog
Cat
Livestock
Location of seizure
*
Street Address
Address Line 2
City
Reason Seized
*
At Large
Dog Attack
Trapped
Surrender
Shelter Gate
NTBR
Failure to register
Weather
Fire
Windy
Storms
Fireworks
Hot
Rainy
Sex
*
Male (desexed)
Male (entire)
Female (desexed)
Female (entire)
Unknown
Age
*
Puppy / Kitten
Adult
Breed
Colour
*
Microchip Number
*
Currently registered with the Shire or other Council?
*
Yes
No
Animal name
Was animal wearing a council tag?
*
Yes
No
Was a photo taken?
*
Yes
No
Animal photo / image
Drop files here or
Select files
Max. file size: 128 MB.
Disc No.
Animal License No.
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