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Dogs – application to keep more than two dogs

Rangers Administration – application to keep more than two dogs at a property

Application Details
Name*
Title Given Name(s) Surname
Date of Birth (applicant must be over 18 years of age)*
DD slash MM slash YYYY
Residential Address*
Mobile Phone
Other Phone
Email*
Details of dogs subject to this application
Dog Details*
Name Age Breed Registered Y/N
How did you happen to obtain more than two dogs?*
How long have you had more than two dogs?*
Have you had, or are you currently in dispute with any of your neighbours?*
- Yes
- No
Comments*
Have you had any complaints from neighbours regarding your dogs? If yes, give reason :*
- Yes
- No
Reason*
Reason for request to keep more than two dogs :*
Payment Details
Please be advised Application Fee does not include dog registration.
Concession required (proof required)
- Yes
Pension Concession Proof*
Pensioner concessions can only be applied on proof of a current Pensioner Concession card, State Concession Card, Veteran’s Card or a Seniors Card together with a Commonwealth Seniors Health Card. You can attach a picture of the card(s) taken from your phone or camera.
IMPORTANT: Please ensure the image is large enough and legible. If an image is not suitable, we will need to request additional images.
Accepted file types: jpg, jpeg, png, gif, pdf, Max. file size: 10 MB.
Pensioner Application Fee*
(GST Inclusive)
Price:
Standard Application Fee*
(GST included)
Price:
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payment_process_mode
NOTE: THE PAYMENT PROCESSING CONTROLS ON THIS FORM ARE CURRENTLY SET FOR TEST MODE
(Use either 5555444433331111 or 4444333322221111 for the Credit Card No. with 111 as the CCV)
Payment Type Code
This field is hidden when viewing the form
Payment Type
Total (GST Inclusive)
$ 0.00
Credit Card*

MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Email
This field is for validation purposes and should be left unchanged.

Name	Age	Breed	Registered Y/N

Dogs – application to keep more than two dogs

Application Details

Details of dogs subject to this application

Payment Details