B ob Benroth

Robert L. Benroth
 Putnam County Auditor
245 E. Main Street,  Suite 201
Ottawa,  Ohio  45875
(419) 523-6686     Fax:  (419) 523-6390

Office Hours
Dog Application
Tax Rates

Age

Please print and complete the form below and mail to our office with a check for $18.00 for each dog.

Please enclose a self-addressed stamped envelope.

Sex

Certificate for the registration of dog for the year 20___

Year

Month

M/F

Color

Hair

Breed

Fees

Penalty

Tag No.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A penalty shall be assessed if Dog License is not secured on or before January 31, or within 30 days after the dog becomes 3 months of age, or is brought from outside the state R.C. Sec. 955.01.05

The undersigned says that the facts indicated above ARE TRUE.

Name: _____________________

Address:_____________________

City/State/Zip____________________

Signature of Applicant ______________________

Telephone No.  ________________  Date ____________________