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Animal Services Pet License Application

2. A staff member will contact you within 48 hours of submission in order to collect license payment. License is not issued or valid until payment has been received.
4. Application Type*

   1. New License

   1. License Renewal
8. Owner Information
10. First Name*
11. Last Name*
13. Address1*
15. Address2
16. Apartment #
18. City*
19. State*
20. Zip*
22. Phone Number*
23. Alternate Phone Number
24. Email
26. Best Contact Time to Get Payment Information*

    1. Morning
    2. Afternoon
    3. Evening
28. Owner's Date of Birth*
    Owner's Date of Birth
29. Please attach a photo of your government issued ID or Driver's License*
33. Pet Information
35. Pet Type*

    1. Dog

    1. Cat

    1. Ferret

    1. Pot-Bellied Pig
37. Pet's Name*
38. Pet's Age*
40. Check which applies:*

    1. Female

    1. Spayed

    1. Male

    1. Neutered
42. Breed*
    Please indicate a specific breed type, even if the animal is a mixed breed.
43. Color(s)*
45. Is your pet microchipped?*

    1. Yes
    2. No
47. Microchip #
48. Other
52. Rabies Vaccination Information
54. Vaccination Date*
55. Expiration Date*
57. Rabies Tag #*
58. Veterinarian*
59. Rabies Certificate*
    Please upload a copy of your rabies certificate.
61. Do you live in West Valley City or Taylorsville City?*

    1. West Valley City
    2. Taylorsville City
63. License Fee- West Valley City Resident *

    1. $1 (Senior License - Sterilized)
    2. $1 (Senior License - Unsterilized)
    3. $5 (Dog & Cat - Sterilized & Microchipped)
    4. $10 (Cat - Sterilized, No Microchip)

    1. $12 (Dog - Sterilized, No Microchip)
    2. $35 (Dog & Cat - Unsterilized)
    3. $0 (Service Dog - Proof Required)

    If the license is expired or 30 days past due, a $25 late fee will be assessed. *Must be 59 years of age or older to qualify for Senior License.
65. License Fee- Taylorsville City Resident*

    1. $25 (Dog & Cat- Unsterilized)
    2. $5 (Dog & Cat- Sterilized)
    3. $15 (Senior* License- New)
    4. $0 (Senior* License- Renewal)
    5. $0 (Service Dog- Proof Required)

    If the license is expired or 30 days past due, a $25 late fee will be assessed. *Must be 59 years of age or older to qualify for Senior License.
67. You can call 801-965-5800, 48hrs after submission to make the license payment, this allows our staff time to enter your information in our system. Payments can also be mailed or brought into the shelter at 4522 W 3500 S. West Valley City, UT 84120. LICENSE IS NOT VALID UNTIL PAYMENT HAS BEEN MADE.
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73. 1. Receive an email copy of this form.
74. Email address

    This field is not part of the form submission.

75. Submit

* indicates a required field