MDC Dog Registration - Change of details form

Changes to your dog's information

Use this form to let the Mackenzie District Council Animal Services (Regulatory and Compliance) team know if your dog has passed away, moved, had a change in ownership, or if you would like to update your or your dog's details.

Please note:

Changes to details can only be requested by the registered owner of a dog. After receiving a form this may be confirmed using the contact details currently on record.
The Dog Control Act 1996, section 19A(2) states that failure to supply information or willfully providing false particulars about a dog can result in an infringement of $750.

Details to update *

Change of ownershipChange of contact details or address (within the Mackenzie District)My dog and I have left Mackenzie DistrictMy dog and I have left New Zealand permanentlyUpdate microchip detailsUpdate desexing detailsMy dog has died

Your details (Current registered owner)

Privacy statement

Council collects the following personal information as required under the Dog Control Act (1996) so we can keep accurate records of dogs and their owners, and to communicate with you about your dog.

The owner's name
The owner's date of birth
The owner's address
The owner's contact details

For change of ownership requests we also collect

The new owner's name
The new owner's date of birth
The new owner's address
The new owner's contact details

This information will be shared with the National Dog Database operated by The Department of Internal Affairs. Your information will be stored in accordance with the Mackenzie District Council Privacy Policy.

First Name *

Last Name *

Mackenzie District Council ID Number (if known)

Date of birth *

Address

Your address details *

Street address *

Town *

Provence

Postcode *

Email Address

Phone number *

Your Dogs Details

Dog name *

Dog ID or Tag Number *

Microchip number

Change of ownership - New owner details

We may contact the current owner and/or new owner to confirm the change of ownership.

Does the new owner live in the Mackenzie District? *

YesNo

Reason for change of ownership *

Dog sold or rehomedPrevious owner passed away

First name

Last name

Address of the new owner *

Street address *

Town *

Postcode *

Email address

Phone number

Declaration

I hereby declare that the dog described above changed owner as shown above, on or about:

Change of address or contact within the Mackenzie District

Please update my: *

AddressPhone numberEmail

Updated street address *

Street address *

Town *

Postcode *

This is my new:

Postal addressPhysical location of my dog(s)Both

Do you currently have Responsible Dog Owner status

YesNo

Phone number

Email address

Change of address - outside of the Mackenzie District, within New Zealand

I declare that my dog no longer lives in the Mackenzie District *

Council my dog will now be registered with *

I have left or am leaving New Zealand with my dog

Date of departure from New Zealand

Please upload proof of export for your dog(s)

Browse

File formats accepted are jpeg, jpg, png, pdf or heic. 5mb maximum file size.

Was your dog registered this year? *

YesNo

You may qualify for a partial refund of your registration fees.

If you qualify your refund can be made:

To a bank account
to your Mackenzie District Council rates account

If I qualify for a refund please:

Refund to my bank accountRefund to my Mackenzie District Council rates account

We will be in touch to confirm your choice and request any information required to complete this process.

Update microchip information

Dog name *

New microchip number *

Update desexing information

Please upload your desexing certificate *

Browse

File formats accepted are jpeg, jpg, png, pdf or heic. 5mb maximum file size.

Please accept our sympathy for your loss

Thank you for filling out this form so we can be sure to update our records and not send you any unwanted correspondence.

Date of dog passing away *

Please attach a vet's certificate that shows the date of passing if available

Browse

File formats accepted are jpeg, jpg, png, pdf or heic. 5mb maximum file size.

Was your dog registered this year? *

YesNo

I understand that under section 19A(2) of the Dog Control Act, willfully providing false particulars about a dog can result in an infringement of $750. *

I declare that I am the legal owner of the above dog. *

I agree to be contacted if further confirmation is required before changes to my dog's records are made. *

I hereby certify that the information I have provided in this form is true and correct to the best of my knowledge. *

Signature *

Draw signature|Type signatureClear

Signature date

First name *

Last name *