Franklin Lakes, MT · Bergen County
Certificate of Exemption From Rabies Vaccination
This certificate documents a veterinarian’s determination that an animal should not be vaccinated against rabies and is completed by the veterinarian and owner.
What this form is
A veterinarian uses this certificate to record an animal’s rabies vaccination exemption based on an infirmity, other physical condition, or therapy regimen. It asks for owner and animal details, the veterinarian’s examination and explanation, and signatures from the veterinarian and owner. The certificate is valid for up to one year, and for dogs it must accompany a dog-license application.
Who needs it
An animal owner and veterinarian complete this certificate when the veterinarian determines rabies vaccination is medically contraindicated.
How to submit it
For dogs, present this certificate with an application for a dog license. Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This certificate is signed without a notary; the veterinarian and owner sign and date it, and it identifies no notarized attachment or sworn step.
How to submit this form
- 1
Download the Certificate
Download the rabies vaccination exemption certificate.
- 2
Complete the Animal Details
Enter the owner’s contact details and the animal’s name, species, age, weight, breed, color, and other requested information.
- 3
Have the Veterinarian Complete It
The veterinarian records the examination, medical reason for the exemption, license number, and certificate expiration date.
- 4
Sign and Present the Certificate
The veterinarian and owner sign and date it. For dogs, present the certificate with an application for a dog license.
Frequently asked questions
- What is the rabies vaccination exemption certificate for?
- It records a veterinarian’s determination that an animal should not be vaccinated against rabies because of an infirmity, other physical condition, or therapy regimen.
- Who completes this certificate?
- The veterinarian records the examination and medical reason for the exemption. The owner provides owner and animal details and signs the certificate.
- Do I need a notary for this certificate?
- No. The veterinarian and owner sign and date this certificate; it identifies no notarized attachment or sworn step.
- How do I submit this certificate?
- For dogs, present it with an application for a dog license. The document does not name a submission department or address; check the city website for current contact details.