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TERRE HAUTE PET LICENSE APPLICATION
This form is for residents of the City of Terre Haute only. All dogs and cats over the age of three (3) months owned by residents of the City of Terre Haute must be registered per City Code Section 6-71
Complete the form and attach a photo of your dog or cat's current rabies vaccination form. Only one animal may be registered per form.
All fields marked with an asterisk (*) are required to be completed.
You will be contacted by telephone if there are any issues with your submission.
-------------------------------OWNER'S INFORMATION-------------------------------
Your name
*
First
MI
Last
Address
*
Street Address
City
State / Province / Region
Postal / Zip Code
No PO Box addresses
Phone
*
###
-
###
-
####
Email
*
Alternate Contact Name
First
MI
Last
Only complete if you wish to add an additional individual to be contacted. This individual will not be considered a registered owner of the dog or cat.
Alternate Phone
###
-
###
-
####
You may enter an alternative telephone number for yourself or if you listed an alternate contact, please list their telephone number.
Delivery method of approved license form
*
Please select
By Email
By US Mail
Please indicate whether you would like your pet license form to be emailed to you or sent by US Mail
------------------------------ANIMAL'S INFORMATION-------------------------------
Animal's name
*
Color/marking of animal
*
Examples would be white, brown, tan, black, tri-color black/white/brown, white with black markings, black with white markings.
Type of Animal
*
Please select
Cat
Dog
Animal Gender
*
Please select
Female
Male
Status of animal
*
Please select
Altered
Unaltered
Age of animal
*
Please select
Under 1 year old
1 year old
2 years old
3 years old
4 years old
5 years old
6 years old
7 years old
8 years old
9 years old
10 years old
11 -1 5 years old
16 years and older
Rabies Vaccination form from veterinarian
*
At this time we can only accept Jpg, Tif, Png, or PDF file
You may attach a photo of your pet
Any photo you attach of your pet would be used in case your pet becomes lost. Please limit file size to 2MB
At this time we can only accept Jpg, Tif, Png, or PDF file
Microchip information
If your animal is microchipped you may list the number here. It would be used if your animal becomes lost
Type of License
*
Please select
One Year License Altered Animal $15.00
Lifetime License Altered Animal $50.00
One Year License Unaltered Animal $75.00
Please select which license you are submitting an application for.
Payment required
Please visit www.TerreHauteCityCourtPayments.com for payment submission after submitting form - You will select CITATION/COSTS-FEES button - For Case/UTT number please enter PET LICENSE
