Responsible Dog Owner Status Application

The Responsible Dog Owner Status is a special dog ownership status that recognizes good, responsible dog owners and entitles them to a reduced annual dog registration fee.

In order to hold Responsible Dog Owner Status, you must comply with the requirements of the Dog Control Act 1996 and the Mackenzie District Council Dog Control Policy and Dog Control Bylaw 2021.

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

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.

Before you start

If applicable, for this form you will need copies of your dog's:

Microchip number, if they have been microchipped
Certification, if they have been desexed
Certification by one of the organisations listed in the Dog Control Act, if you are registering a disability assist dog

Your Details

First Name *

Last Name *

Mackenzie District Council ID Number (if known)

Owner Date of birth *

Your date of birth is required to enable you to be distinguished from other persons with the same name. Certainty of identification is required in the enforcement of the provisions of the Dog Control Act 1996.

Address

Address where the dog/s will live *

Street address *

Town *

Postcode *

Email Address

Phone number *

Your dog/s must live in the Mackenzie District. If you live elsewhere, please complete a registration form with your local council.

Your Dogs Details

Total number of dogs that are living on your property now?

If you live in an urban area and you want to keep more than 2 dogs over the age of 3 months, along with this registration form you will also need a special licence and to pay a fee.

Would you like to add a secondary owner? *

YesNo

Secondary Owner

First name *

Last name *

Date of Birth

Secondary owner - Email address

Secondary owner - Contact number *

Please confirm you meet all of the criteria

I have been the registered owner of the dog(s) and have resided in the Mackenzie District for at least 12 months. *

YesNo

I have paid my dog registration fees on or before the 31 July for the last two years. *

YesNo

I have my dog(s) micro chipped in accordance with the Dog Control Act 1996 and have provided the microchip number to the Council *

YesNo

The property at which the dog(s) resides is suitably fenced and gated to contain the dog(s) and allows dog free access to the door of the dwelling. *

YesNo

The property at which the dog(s) resides provides for the welfare of the dog(s) including adequate warm housing, access to clean water and ample food and exercise area *

YesNo

I have not had a dog(s) that have been found at large, be uncontrolled, returned or impounded by Council Staff within the last two years. *

YesNo

I have not been issued with a warning notice or infringement notice for any dog related offence in the last two years. *

YesNo

I have not been prosecuted for any dog related offence in the last two years. *

YesNo

I do not have a dog that is classified as dangerous under the Dog Control Act 1996 *

YesNo

If you own more than two dogs, you hold a license issued by the Council to keep more than two dogs *

YesNo

Details about your dogs

Name *

Gender *

Breed *

Age (years)

Microchip number

Tag number

Classification *

Further information

Declaration

I agree to an inspection of my property to assess the suitability of the number and type of dogs applied for *

I agree to abide by any conditions imposed by the Council on the granting of responsible dog owner status. *

I agree to comply with the Dog Control Act 1996 and the Mackenzie District Council Dog Control Policy and Dog Control Bylaw 2021 and any subsequent amendments. *

I will pay the applicable fee *

In submitting this application to Mackenzie District Council, I declare that I, the person submitting the form, am the owner of, and responsible for, the dog/s described in this form and the information I have provided is true and correct. *

I agree to my obligations under the Dog Control Act. *

I understand that if my dog breaches any Council bylaws I will be liable for infringement fines. *

View Dogs and Animals fees and charges here

View the Mackenzie District Council Privacy Policy and Statement here

First name *

Last name *

Signature *

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Signature date