Type Full Name :

Sign With Hand

If "Other," specify

Fee Description	Fee
Spayed/Neutered 1 Year Dog	$12.00
Non Spayed/Neutered 1 Year Dog	$16.00
Spayed/Neutered 3 Year Dog	$30.00
Non Spayed/Neutered 3 Year Dog	$40.00

License Fee

Is a service dog?

Dog Owner/Guardian Information

Sex

Is the dog exempt from rabies vaccination?

Color and Markings

{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]}
{[AWEBSITE]}

Dog License

Application Type

Phone #

Address

Age

Important Information

Applicant Signature

Name

Expiration Date of Vaccination

{[CNAME]}

Name

PLEASE ONLY UPLOAD YOUR RABIES CERTIFICATE & PROOF OF ID - PLEASE DO NOT INCLUDE OTHER MEDICAL RECORDS OR ANY OTHER DOCUMENTS.

The following documents must be filed with this appliction:

Valid Proof of Identification *
Such as a State-issued driver's license/ID card, US Passport, military ID card, etc.

Rabies Vaccination Certificate *
If the dog is exempt then provide original exemption letter or NJ VPH-28 "CERTIFICATE OF EXEMPTION FROM RABIES VACCINATION FORM" form.

Service Dog Registration Cerificate
If the dog is a service dog then provide a valid Service Dog Registration Certificate.

If applicable, provide the details of another owner that resides at the same address.

Veterinarian Information

In order to acquire a 2022 dog license your rabies vaccination must be valid as follows:

1-Year license - 5/1/2022 thru 4/30/2023.
3-Year license - 5/1/2022 thru 4/30/2025.

Name

I acknowledge that all statements made herein are accurate and that this application will not be accepted as submitted until all required documents are filed and all applicable fees are paid. I acknowledge that if no payment is made within seventy-two (72) hours of this application, it will be deemed null and void, and I will be required to make a new application.

Phone #

Is spayed or neutered?

Required Documents

Hair Length

Pursuant to N.J.S.A. 4: 19-152A, all dogs must be properly inoculated against rabies. This vaccination must be administered by a licensed veterinarian and must be current for the full licensing period. State law also requires that you provide documentary proof. (Kindly attach a photocopy)

Select the period of Licensure desired

Licensing & Fees

Date of Vaccination

All licenses are renewable yearly in May. A $25.00 late charge will be applied to any license not renewed by May 31 of the current year.

Address

Dog Information

Name

Certification

Breed

Primary Phone #

NOTICE TO ALL HOBOKEN DOG OWNERS: Pursuant to Hoboken Municipal Code 93-2, all dogs in the City of Hoboken must possess a dog license annually - failure to comply will result in a summons issued with a mandatory court appearance.

Specify the Address where BOTH Dog and Owner/Guardian reside