2. Please fill out and submit information below, if you do not plan on making your payment through the front desk at City Hall.
4. First Name*
5. Last Name*
7. Mailing Address:
9. Street Number
10. Street Name
11. Street Direction
12. Apt #
14. Box #:
16. City*
17. Province*
18. Postal Code*
20. Reply Email Address:
22. Telephone No:*
24. Type of Dog:
26. Dog Licence Pricing – Select one (1) option below based on dog being spayed or neutered and based on your date of payment. There is a $5.00 discount if paid between November 1 and February 15 at 4:00pm. Fill out a separate form if you have more than one (1) dog.
28. Paid between November 1 and February 15 at 4:00pm:

    1. $30.00 - Unspayed or Unneutered
    2. $12.00 - Spayed or Neutered
    3. $130.00 – Four (4) dogs or more at one location (special zoning required)
29. Paid after February 15 at 4:00pm:

    1. $35.00 - Renewal - Unspayed or Unneutered
    2. $17.00 - Renewal - Spayed or Neutered
    3. $135.00 – Four (4) dogs or more at one location (special zoning required)

31.  

32. For new dogs licensed after July 31^st, pay 50% of the fees above

34. Sex:

    1. Male
    2. Female
35. Has paid the following sum:
37. For the following dog:
39. Name of Dog:*
41. Breed:*
42. Colour:*
44. Expected Date of Payment:
    Expected Date of Payment:
46. Method of Payment:

    1. City Hall Drop Box
    2. Mailed Cheque
    3. Online Banking Payment (see next to complete banking information below and read instructions)
48. (payments must be received by February 15 at 4:00pm, in order to receive the $5.00 discount. Post-marks and drop box payments received after the deadline will not be accepted for discount)
50. Name of Financial Institution
51. Name of Payee on account
53. If paying through online banking, please make your payment to the following account: • Payee – “Salmon Arm (City of) Property Taxes” • Account Number – 99999999 (Do NOT make your payment to your property tax account)
55. Delivery Method

    1. Pickup at City Hall
    2. Mail
Leave This Blank:


57. 1. Receive an email copy of this form.
58. Email address

    This field is not part of the form submission.

59. Submit

* indicates a required field