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West Valley City 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
27. Contact Preference*

    1. Phone
    2. Email
29. Driver's License Number*

30. State*

31. Date of Birth*
    Date of Birth

35. Pet Information

37. Pet Type*

    1. Dog

    1. Cat

    1. Ferret

    1. Pot-Bellied Pig

39. Pet's Name*

40. Pet's Age*

42. Check which applies:*

    1. Female

    1. Spayed

    1. Male

    1. Neutered

44. Breed*

    Please indicate a specific breed type, even if the animal is a mixed breed.

45. Color(s)*

47. Is your pet microchipped?*

    1. Yes
    2. No

49. Microchip #

50. Other

54. Rabies Vaccination Information

56. Vaccination Date*

57. Expiration Date*

59. Rabies Tag #*

60. Veterinarian*

61. Rabies Certificate*

    Please upload a copy of your rabies certificate.

63. License Fee*

    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.

65. After submission, you can call 801-965-5800 to make the license payment. 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.

Leave This Blank:


71. 1. Receive an email copy of this form.
72. Email address

    This field is not part of the form submission.

73. Submit

* indicates a required field