APPENDIX D: DANGEROUS ANIMAL/ATTACK DOG PERMIT FORM

 

TOWN OF BREMEN, INDIANA DANGEROUS ANIMAL/ATTACK DOGS PERMIT        PERMIT No. ____________   Applicant’s Name: _____________________________________________   Address: _____________________________________ Phone: ______________________   Type of Dangerous Animal/Attack Dog(s) ________________________________________________________________   Number of Animals ____________        Fee $50.00 per animal: _______________     Photograph Submitted:            ______________________________   Proof of Liability Insurance:         ______________________________ (minimum $300,000)   Town of Bremen Registration Tag:      ______________________________     Applicant Signature ___________________________________________ Date _________     Approved by:                        ______________________________                               Clerk-Treasurer

 

(Prior Code, Ch. 71)