TNAWB

1. Name and address of the applicant (breeder) – Current Details

2. Name and address of the establishment

3. Telephone number (Mobile/Landline with STD code)

4. Details of accommodation provided for dogs

5. Working hours and weekly off day

6. Arrangements for ventilation, illumination, temperature control, food storage, water, cleanliness and waste disposal

7. Details of dogs (and other animals if any) presently kept for breeding

#	Species	Breed	Male	Female	Total	Action
1

8. Name and address of Veterinary Doctor providing service

9. Whether ambulance/tractor available (Give details)

#	Type	Reg. No.	Driver Name	Driver Mobile	Action

10. Number of staff employed and their experience

11. Arrangement made for disposal of dead animals/caracasses

12. Particulars of dogs proposed to be used for breeding

13. Qualification and experience of the applicant in breeding/maintaining dogs

14. Details of fee remitted (₹5000 for Renewal)

The prescribed fee shall be paid through Demand Draft (DD) drawn in favour of "Tamil Nadu Animal Welfare Board", payable at Chennai.
The Demand Draft must be sent through Tapal (Registered Post / Speed Post) to the Board’s official address.

DD/Cheque No.

Bank Name & Branch

DD/Cheque Date

Upload DD/Cheque Image / Payment Proof

15. Details of breeding bitches/dogs acquired during the year

#	Microchip	Date Acquired	Date Mated	Mated With (Microchip)	Pups Born (Microchips)	Action

16. Details of deaths of dogs/pups during the year

#	Microchip	Date of Death	Cause / Postmortem Report	Action

17. Details of sale of pups/dogs during the year

#	Microchip	Age	Date of Sale	Price ₹	Buyer Address					Phone	Action
#	Microchip	Age	Date of Sale	Price ₹	Address Line 1	Address Line 2	City	District	PIN Code	Phone	Action

18. Number of unsold pups and arrangements made for their upkeep

19. Existing Registration Number *

I hereby declare that the above particulars are true and correct to the best of my knowledge and belief.

Signature of Applicant