County Option Dog Tax Application

State Form 52694 (R / 1-15)
Prescribed by the Department of Local Government Finance

Instructions (See also Indiana Code 6-9-39)

1. Who Must File: Any person who harbors or keeps a taxable dog in or near a person’s premises, regardless of who owns the dog. A person who harbors or keeps a taxable dog is liable for the tax.

2. What is a “taxable” dog: Any dog six (6) months of age or older. The maximum tax is $5.00 per dog; however, the fiscal body of a county may adopt a lesser amount. List each taxable dog separately unless applying for a Kennel License. A Kennel License is available for persons breeding, boarding, training, or selling dogs. See below for fees.

3. Where the Taxes Go: A seventy-five cent fee may be retained by the designated tax collector. The remainder is divided with 20% for canine research and education at Purdue University and 80% may be used by the county for the support of animal care facilities; animal control, including dead animal disposal; reimbursement to farmers for livestock kills; and reimbursement to people who have undergone treatment for post-exposure rabies.

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Name*
Address*
Emergency Contact
List Dogs That you own, harbor or keep.*
List the dogs six (6) months of age and older, that you own, harbor or keep. Add additional rows for multiple dog listings.
Breed
Major / Minor Color
Spayed / Neutered
Sex
Age
Name
Tag #
 
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