NSW CompanionAnimals Register

CHANGE OF OWNERPROCESSED BYAPPROVED ANIMALWELFARE ORGANISATIONOR COUNCIL POUNDFORM C3B

This form is to be used by:

Council pounds.

The completed yellow copy must be sentwithin 14 days of the change of owner toany local council.

How to use this formYellow data entry copyThe completed yellow copy of the form maybe sent to any local council. Please put theform in a sealed envelope marked‘Confidential’ and ‘For the attention of theAnimal Registration Officer.’ If you are unsureof the address of the local council, you willfind it on our website atwww.dlg.nsw.gov.au.

Pink owner’s copyThis must be given to the new owner asevidence of ownership.

White file copyThis must be kept confidentially for at least2 years.

Please call Salmat on 02 9311 9899 to order more pads of this form. The form

at www.dlg.nsw.gov.aucan also be downloaded from our website

approved animal welfare organisations oran organisation approved under clause 16(d) of the Companion Animals Regulation2008, or

This form is only to be used by:

under clause 16(d) of the Companion Animals Regulation 2008, orApproved animal welfare organisations or an organisation approved

council pounds where an already microchipped animal is being soldor re-homed. Use form P1A if the animal is being mirochipped.

There is no fee to change ownership.

The organisation re-homing the animal is responsible for notifying theCompanion Animals Register of the change of owner of the animal.

The details marked # are optional. All other informationis required under the Companion Animals Act 1998 and Regulation 2008and will be entered onto the NSW Companion Animals Register.

Note: This form does not Lifetime Register the animal. You need tocheck with your council to find out if the animal needs to be lifetimeregistered.

NSW Companion Animals RegisterChange of Owner

Processed by Animal Welfare Organisation or Council Pound C3B

New Owner detailsThe owner must be a person 18 years or over. If the animal is a dog theowner must not be disqualified from owning a dog.12. Name of organisation – if applicable. Please also provide the name of the

person responsible for the care of the animal at questions 13 to 15 below

I verify that the information provided on this form is correct.

23. Date

Tick whichever of the following applies: A signed surrender form has been obtained from the previous owner or

person authorised in writing by the previous owner. The animal was awarded to the animal welfare organisation by an order

of a court. The animal was re-homed under s31A of the Prevention of Cruelty to

Animals Act 1979. The animal was purchased from a council pound. Other – please explain

24. This is to certify that this animal was surrendered by its previous owner(or a person authorised in writing by the previous owner) to the

Name of animal welfare organisationaccording toorganisation policy.

Name of location

branch of

15. First name

20. Home address - if different to question 10

18. Mobile phone number

19. E-mail address

16. Home phone number

13. Title:14. Family name

21. Postal address - if different to question 10

17. Work phone number

25. Name of officer 26. Position

28. Date

27. Signature

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22. Signature of person nominatedat questions 14 to 15

Postcode

Postcode

4. Is the animal desexed?

yes no

Note: When claiming a reduced registration fee you must provideproof of desexing.

Animal details

2. Species: dog cat

5#. Animal’s name

3. Gender: male female

Microchipping detailsmust be completed by the organisation re-homing the animal 1. Microchip number

11#. Secondary address for animal eg holiday house or boarding kennel

8. Colour

9. Identifying marks / features

10. New address where animal is to be usually kept note: streetnumber and street name are needed for all addresses — property name onlyis not sufficient

OR

7. Animal’s date of birth Approximate year of birth

6. Breed

Postcode

Postcode

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What happens nowThe organisation from which you have just purchased thisanimal should give you the pink copy of this form. Theorganisation must enter the information on the NSW CompanionAnimals Register within 7 days or send the yellow copy of thisform to any local council within 3 days. Once the informationhas been entered on the Register you should receive aCertificate recording your details as the new owner.

Only authorised people, such as council staff and police, canaccess the information on the NSW Companion Animals Registerand only to enforce the Companion Animals Act 1998.

If you are concerned that disclosure of your information couldjeopardise the safety of you or your family, you may request thatthese details be suppressed. If this is the case, we recommendthat you do not list your animal on any private databases. Pleasecontact any NSW local council for more information.

What to do if there are errors on the CertificateYou can correct or update the information on your animal’sCertificate by contacting any local council. You may need toprovide written proof before council can amend your record.

Council will provide you with a new Certificate once the changeshave been processed.

What to do if circumstances changeIf circumstances change, you need to notify any local council toupdate your animal’s record within a certain period of time. Youmay need to take a copy of your Certificate or a copy of this formto the council.

Some examples of changed circumstances are:

change of ownership, either sold or given away - the ‘old’owner must notify a council within 14 days

change of address - within 14 days

change of any other of the animal’s details eg. desexed -within 14 days

a court declaration that a dog is dangerous is made orrevoked - within 7 days

the animal dies - within 28 days

the animal is missing for more than 72 hours - within 96hours after the animal went missing

If you don’t notify any of these changes or you give false ormisleading information, you may be fined up to $550 or up to$2,200 for a dangerous or restricted dog.

What to do if you sell or give away this animalBefore selling or giving away your animal, you should get acopy of the ‘Change of Owner/Details C3A’ form from any localcouncil. The form is also available on our website atwww.dlg.nsw.gov.au. Both you and the new owner will have tocomplete and sign the form.

As the ‘old’ owner you have the responsibility of sending thecompleted form to any local council within 14 days. You willneed to attach a copy of this form or your Certificate to the‘Change of Owner Details’ form.

This information is collected on behalf of the Division of Local Government, Department of Premier and Cabinet (Locked Bag 3030, Nowra NSW 2541), and is held on the NSW Companion Animals Register.

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