Permit Director

Please complete the information below and upload a valid rabies certificate.

Applicant Information:

Last Name: ^{(official ID)}

First Name:

Middle Name:

Suffix: ^{(jr, sr, etc.)}

Current/Previous Dog License Info: ^{enter your existing permit # and the issuing county}

Dog Tag #:

Telephone Number: ^{(###-###-####)}

^Primary:

^Work:

^{Mobile Phone:}

^Fax:

Updates via text message?

Yes No

Email:

^Address:

^Confirm:

Please Create A Password: ^{(you can use this to track progress, and we may need to contact you during the process)}

Password:

Password: ^(confirm)

Password Information: In order to comply with CJIS standards we have employed the use of a password complexity monitor. As you enter your password, we will display an indicator of complexity. You will only be able to submit passwords that are sufficiently complex as to be considered 'safe' by CJIS standards. The visual indicator will turn Blue or Green to indicate that your password is safe.

Important: CJIS requires we maintain a strict password policy and system of checks. As such, we check the following items as you enter your new password:

The password must be a minimum length of eight (8) characters on all systems
The password must not be a dictionary word
The password must not be the same as your email address
The password must not be a proper name

Current Residence Address: ^{(this may be different than your mailing address)}

Address Line 1:

Address Line 2:

City:

State:

Zip Code: ^{(postal code)}

Country:

^{Mailing Address Different:}

Yes No

Present Mailing Address: ^{(if different from residence address)}

Address Line 1:

Address Line 2:

City:

State : ^(region)

Zip Code: ^{(postal code)}

Country:

Spouse Residence Address:

Address Line 1:

Address Line 2:

City:

State : ^(region)

Zip Code: ^{(postal code)}

Country:

Add Dog:

Attach Documentation:

To upload documentation, please use the button below to begin the process. Please scan each document individually. The maximum size of individual files is 5 MB.

Rabies Vaccination Documents - REQUIRED
Spay-Neuter Documents - IF APPLICABLE
Dog's Photo - OPTIONAL

Uploaded Files:

I will mail or fax these documents.

Add files...

Please select a document type then, click on the “Attach” button to complete the upload process.

Select Your Application Type:

Unaltered Male Renewal

Neutered Male Renewal

Unaltered Female Renewal

Spayed Female Renewal

Total Fee:

$0

I hereby certify under penalty of perjury under the laws of the State of Connecticut that the information submitted on this application is true and correct, including that my dog is CURRENT with regards to his/her rabies vaccination and my dogs spay or neuter status.

Please enter your e-Signature

Your Initials:

For security purposes, we logged your IP Address: 216.73.217.93, 104.23.243.160:45260, 40.1.3.198

Required signature

Application Qualification Questions:

Yes No

May we release your phone number to a citizen that finds your dog?

Yes No

Do you have a previous dog tag?

Yes No

Is your dog microchipped?

Your Initials:

Back To Previous Step

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

← prior month
← prior week

first available →
next week →
next month→

None Selected

Your Initials:

Back To Previous Step

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

← prior month
← prior week

first available →
next week →
next month→

None Selected

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

← prior month
← prior week

first available →
next week →
next month→

None Selected

Cromwell Town Clerk, CT - Dog Licenses

Dog License Application Please Enter All Information

Please read the following before proceeding:

Applicant Information:

Current/Previous Dog License Info: ^{enter your existing permit # and the issuing county}

Telephone Number: ^{(###-###-####)}

Email:

Please Create A Password: ^{(you can use this to track progress, and we may need to contact you during the process)}

Current Residence Address: ^{(this may be different than your mailing address)}

Present Mailing Address: ^{(if different from residence address)}

Spouse Residence Address:

Add Dog:

Attach Documentation:

Uploaded Files:

Select Your Application Type:

Total Fee:

$0

Please enter your e-Signature

Application Qualification Questions:

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

Please select a time below:

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

Please select a time below:

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

Please select a time below:

Dog License Application Please Enter All Information

Add An Address

Add An Alias

Add a reference

Update a reference

Add Dog

Please read the following before proceeding:

Applicant Information:

Current/Previous Dog License Info: enter your existing permit # and the issuing county

Telephone Number: (###-###-####)

Email:

Please Create A Password: (you can use this to track progress, and we may need to contact you during the process)

Current Residence Address: (this may be different than your mailing address)

Present Mailing Address: (if different from residence address)

Spouse Residence Address:

Add Dog:

Attach Documentation:

Uploaded Files:

Select Your Application Type:

Total Fee:

$0

Please enter your e-Signature

Application Qualification Questions:

You Must Select An Appointment: your appointment will be confirmed prior to checkout

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

Please select a time below:

Your Appointment Choice Is:

No Appointments Available

Your signature is required.

Error processing application

Error processing application

You must be a US Citizen

Required field missing

Required field missing

Permit Expired

Permit Expired

Permit Expired

No Appointments Available

Permit Expires Soon

Permit Expired

Donations cant be taken with cash

You Must Select An Appointment: your appointment will be confirmed prior to checkout

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

Please select a time below:

Your Appointment Choice Is:

No Appointments Available

You Must Select An Appointment: your appointment will be confirmed prior to checkout

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

Please select a time below:

Your Appointment Choice Is:

No Appointments Available

Current/Previous Dog License Info: ^{enter your existing permit # and the issuing county}

Telephone Number: ^{(###-###-####)}

Please Create A Password: ^{(you can use this to track progress, and we may need to contact you during the process)}

Current Residence Address: ^{(this may be different than your mailing address)}

Present Mailing Address: ^{(if different from residence address)}

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}