Online Form - Change of Details of an Existing Cat or Dog Registration

Type of Change

Depending on the type of change, you will be required to fill out specific sections.

Change of address (within Shire of Chittering) - Sections 1, 2, 3 & 6
Change of owner - Sections 1, 2, 4 & 6
Sterilised / Deceased / Transferred out / Microchipped - Sections 1, 2, 5 & 6

Choose Type of Change*

Change of address (within Shire of Chittering)
Change of owner
Sterilised / Deceased / Transferred out / Microchipped

SECTION 1 – Current Owner Details

Full Name*

Residential address*

Postal address (if different from above)

Date of birth*

Home phone

Work phone

Mobile phone*

Email address*

SECTION 2 – Dog / Cat Details

Animal 1

Animal 1 - Registration Number*

Animal 1 - Type*

CatDog

Animal 1 - Name*

Animal 1 - Microchip number*

Animal 2

Animal 2 - Registration Number

Animal 2 - Type

CatDog

Animal 2 - Name

Animal 2 - Microchip number

Animal 3

Animal 3 - Registration Number

Animal 3 - Type

CatDog

Animal 3 - Name

Animal 3 - Microchip number

SECTION 3 – Change of address (within Shire of Chittering)

Address where the animal(s) are normally kept

Number of dog(s)/cat(s) to be located at these premises

Will the dog(s) be effectively confined in or at the premises identified above?

YesNo

SECTION 4 – Change of Owner & Alternative Contact

New Owner

Given Name(s)

Surname

Date of Birth

Residential Address

Postal address (if different from above)

Home phone

Work phone

Mobile phone

Email address

New Delegate/Alternative Contact

Given Name(s)

Surname

Date of birth

Residential address

Postal address (if different from above)

Home phone

Work phone

Mobile phone

Email address

Do you have any convictions for offences against the Dog Act 1976, Cat Act 2011 or Animal Welfare Act 2002 in past 3 years?

YesNo

Are you currently banned, or have you ever been banned, from owning or keeping a dog under an order under the Dog Act 1976 section 46A(2) either permanently or for a period specified in the order?

YesNo

SECTION 5 – Sterilisation / Microchip / Deceased / Transferred out

Options ( Match with corresponding follow-up question below)

Animal now sterilised
Animal now deceased
Animal transferred to different Council
Animal now microchipped

If Sterilised - Certificate must be attached to this form

Max File Size: 10.00 MB
Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx

If Deceased - Provide date deceased

If Transferred - Provide name of new Local Government

If Microchipped - Provide microchip number

SECTION 6 - Declaration

The local government may refuse an application if any or all of the required information is not provided within the time period specified in the legislation.

Declaration Acknoledgement

I declare that the information I have provided is true and correct. I am aware that it is an offence to provide false and misleading information