Type Full Name :
Sign With Hand
Last Name
If Other Breed, specify
Required Documents
Vaccination Information
Owner Information
Sex *
Age *
Phone # *
Color *
Phone # *
1. New Registrations
All new applicants must include a valid Rabies Certificate and Spayed/Neutered Certificate before a license can be issued.
The Rabies Certificate must be valid through December 31st of the licensing year.

2. Renewals
Renewals must include a valid Rabies Certificate.
The Rabies Certificate must be valid through December 31st of the licensing year.

3. Service Dogs
All applications for Service Dogs must include a valid Service Dog Registration Certificate.

Address *
50 Winfield Scott Plaza
Elizabeth, NJ 07201
(908) 820-4178
elizabethnj.org
Hair Length *
Rabies Tag #
Address of Vaccination *
Applicant Signature *

If Service Dog please atttach the official certificates here

Dog License Application
First Name *
Renewal Email
Expiration Date *
City of
Elizabeth
First Name
Is Valid?
If applicable, provide details of another owner for this dog that resides at the same address.
Veterinarian Information
Last Name *
Vaccination Information
Dog Name *
I acknowledge that all statements made herein are accurate and that this application will not be accepted as submitted until all required documents are remitted, and all applicable fees are paid. I acknowledge that if no payment is made within seventy two (72) hours of this application, it will be deemed null and void, and I will be required to make a new application.
Pick-up or Mail Dog Tag?
Phone #
Spayed/Neutered? *
Once you submit your application or complete your payment, the application process is complete. Please avoid submitting more than one application for the same pet. Thank you!

Note that payment must be received in full before a Dog License and Registration Tags can be issued and fees are non-refundable.

License Fee
Vaccination Date *
Email *
Full Address *
Dog Information
Name *
Certification
Breed *
Address 2
Service Dog? *
Pet Size *
Email
Previous License Number (if known)
Specify Address where BOTH Dog and Owner reside *