CAT Microchip Registration Form Animal DetailsAnimal Name Impant Date(Required) DD slash MM slash YYYY Date of Birth or Age(Required) C.A.R. Tag Breed(Required) Species(Required) Colour(Required) Sex(Required) Female Male Desexed(Required) Yes No Address (If Different to Owner's Address) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Microchip Number(Required) Source No. (VIC ONLY) Breeder Supply No. (QLD ONLY) This animal has been declared as Dangerous Dog Menacing Dog Restricted Breed Implanting Vet Clinic/Organisation DetailsClinic/Organisation Name(Required) Implanter Full Name(Required) Clinic/Organisation Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country PhoneEmail Authorised Implanter Number (VIC) Implanter Number (Other States) Owner/Breeder DetailsNo joint owners | No nicknames | Owner must be 18+Owner Name or Business/Kennel Name(Required) Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone(Required)Email(Required) Alternate Contact Name(Required) Alternate Contact Number(Required) By signing, I declare that the information above is true and correct and I am the legal owner of the animal outlined in the subscription. I agree to the terms outlined on this form and I confirm that I have read and understand the Central Animal Records Privacy Policy as it appears on www.car.com.au.(Required) Details True & Correct + Read & Understand Privacy PolicyBy signing, I declare that the information above is true and correct and I am the legal owner of the animal outlined in the subscription. I agree to the terms outlined on this form and I confirm that I have read and understand the Central Animal Records Privacy Policy as it appears on www.car.com.au.By signing, I agree to the terms outlined on this form and I confirm that I authorise CAR to provide my owner and pet information to authorised users to enable the return of my pet(s) to me. Alternate contacts have no authority over the account to confirm or change details Owner!(Required) I agree to Authorisation for CAR to Provide Owner/Pet Details to Return Petsthe privacy policy.By signing, I agree to the terms outlined on this form and I confirm that I authorise CAR to provide my owner and pet information to authorised users to enable the return of my pet(s) to me. Alternate contacts have no authority over the account to confirm or change details Owner!Signer Name(Required) First Last Signature(Required)Date(Required) DD slash MM slash YYYY
