2008 N.J. DOG LICENSE
TOWNSHIP OF WASHINGTON 

PRINT THE BLANK FORM  AND COMPLETE 

ANIMAL NAME ________________________________________________________________

BREED  _______________________________________________   AGE _____________

COLOR(S) & MARKINGS ________________________________________________________

HAIR (long / short) (circle one)         SEX (M / F) (circle one)

SPAYED/NEUTERED & DATE _______/_______/_______ 

DATE RABIES VACCINATION EXPIRES   ______/______/______  

OWNERS NAME _______________________________________________________________

TELEPHONE NUMBER (908) __________________________________________

STREET ADDRESS ____________________________________________________________

CITY ________________________________________________________________

STATE  NJ   ZIP CODE _______________

AMOUNT SUBMITTED: ___________ CHECK # ___________  DATE ______/______/______

You must include a copy of your dog’s rabies vaccination certificate, veterinarian spay/neuter
certification (if applicable) and a self addressed stamped envelope with this application.

Mail this application with your check, certificates and self addressed stamped envelope to:

Township of Washington
Dog License Renewal
350 Route 57 West
Washington, NJ 07882

For Official Use Only:

License Number: ________________________                     Date Issued:  ______/______/______