Death of dog form : Christchurch City Council

Dog owner to complete this form to enable the Council to update its dog register and to enable a refund, where appropriate.

First name

Full name, no abbreviations please

Middle name

Enter NA if you don't have a middle name

Last name

Mailing address

Contact phone number

A refund of a portion of the registration may be refunded to the registered owner only.

The Council prefers to pay refunds to a bank account. Please provide details below. (a cheque may be sent if a bank account is not available)

Owners Bank account name

Owners Bank account number

Dogs name

Registration tag number or Animal ID

Additional details

Please email me a copy of this form

Spam protection - not visible to user

Note: It is an offence to make a false statement relating to dog registration.

The information is being collected to enable the Council to maintain its dog register and records
The intended user of the information is the Council's Environmental Services Unit
You have the right of access to and correction of any personal information held about you by the Council
This information is held on the Council's dog register
Supply of information from the dog register is strictly limited by Section 35 of the Dog Control Act 1996.

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