BREEDING OF DOGS ACT 1973 (AS AMENDED)
APPLICATION FOR A LICENCE TO KEEP 
A BREEDING ESTABLISHMENT FOR DOGS

APPLICANT’S DETAILS	

Title:
	
First name(s):	
Surname:	

Postal Address:

	

Post Town:
	
Post Code:	

Phone (Home):	
Phone (Mobile):

e-mail address:

Date of Birth:
	
NI number:	

DETAILS OF PREMISES TO BE USED AS A BREEDING ESTABLISHMENT FOR DOGS	

Trading Name:

	

Address of premises:

	

DETAILS OF DOGS BEING BRED	

Breed	
Number of Breeding Bitches Kept	
Age of Breeding Bitches

	

			

			

			

			

			

			

			

			

Name and address of private veterinary surgeon:

	

Please give the following information about the accommodation that the dogs will occupy:	

Construction:

	

Number and size of the quarters in which the animals are / will be accommodated:

	

Heating arrangements:

	

Method of ventilation:

	

Exercising facilities:

	

Lighting arrangements:

	

Water supply:

	

Arrangements for storage of food:

	

Arrangements for the disposal of excreta:

	

Description of isolation facilities for the control of infectious diseases:

	
DISQUALIFICATIONS	

Are you, or have you ever been disqualified from:
	
Keeping an animal boarding establishment?
	YES	NO	
Keeping a dog?
	YES	NO	
Having the custody of animals?
	YES	NO	
Keeping a pet shop?
	YES	NO	
Keeping any dangerous wild animals?
	YES	NO	
Keeping a riding establishment?
	YES	NO
	
Keeping a dog breeding establishment?
	YES	NO	

DECLARATIONS	

I agree to allow an officer, veterinary surgeon or veterinary practitioner authorised by the Council to inspect the premises, which are the subject of this application before any licence, is granted.  I agree to pay the costs of this inspection.  

I understand that the Authority is under a duty to protect the public funds it administers, and to this end may use the information I have provided on this form for the prevention and detection of fraud.  I understand that it may also share this information with other bodies responsible for auditing or administering public funds for these purposes.

I declare that the information given above is true to the best of my knowledge and that I have not wilfully omitted any necessary material. I understand that if there are any wilful omissions, or incorrect statements made, my application may be refused without further consideration or, if a licence has been issued, it may be liable to immediate suspension or revocation.
 
I understand that the Authority is collecting my data for the purposes described on this form and will not be used for any other purpose, or passed on to any other body, except as required by law, without my consent. 

Signature:

Print Name:

Date:

Please return this form with all relevant documents and the appropriate fee to:

Redditch Borough Council, Town Hall, Walter Stranz Square, Redditch, Worcestershire, B98 8AH