Town of Pelham

Dog License Application

Owner Information:

Name:                                                                                                

Street Address:                                                                                 

Daytime Phone Number:                                                                  

Work Phone # or Cell #:                                                                   

Dog Information:

          New Dog               Renewal              Name of Dog:                                                                                             

          Male                      Female                Spayed/Neutered:            Yes            No

Color of Dog:                                     Breed:                                                     If mixed breed-list dominant breed name)

INSTRUCTIONS:

*  Please print this form

*  Mail to: Town Clerk, 6 Village Green, Pelham, NH 03076

*  Include the following:  

             √     Check payable to Town of Pelham for applicable fees

             √     Self – addressed stamped return envelope

             √     Copy of rabies certificate and spayed/neutered certificate

APPLICABLE FEES:

            Puppy                                                  $ 6.50 (4 to 7 months old)

            Adult Dog (spayed/neutered)            $ 6.50

            Adult Dog (not spayed/neutered)      $ 9.00

            Senior Citizen 65 & Over                  $ 2.00  (fee applies to 1^st dog only)

            Kennel License                                  $20.00 (5 or more dogs)

All dogs over 4 months of age must be licensed annually by April 30.  Per RSA 466:1

A $1.00 monthly fine is assessed starting June 1^st and each month thereafter until the dog is licensed.  Per RSA 466:7