Dog - Deceased Refund Application

Current Owner Detail

Dog Details

I understand that making a false statement in this application may make me liable on conviction to a fine not exceeding $3,000 under section 41A of the Dog Control Act 1996.

Your Bank Details

Please supply your account details below to enable direct credit payment to be made to nominated account.

By submitting my application, I accept the terms & conditions and that the information I have provided is correct.