Mount Holly, MT · Burlington County
Certificate of Exemption From Rabies Vaccination
This certificate documents a veterinarian’s medical determination that an animal should not receive a rabies vaccination and is used by the animal’s owner as proof of exemption.
What this form is
A veterinarian completes this certificate after examining an animal and determining that vaccination is medically contraindicated. It records the owner’s and animal’s details, the veterinarian’s findings and license information, and the exemption period, which cannot exceed one year. The owner acknowledges the exemption and related information by signing. For dogs, the certificate must be presented with a dog license application.
Who needs it
An animal owner seeking a medical exemption from rabies vaccination needs a veterinarian to examine the animal and complete this certificate.
How to submit it
For dogs, present this certificate with an application for a dog license. The certificate says a copy must be provided to the owner and kept as proof of exemption.
About notarization
The veterinarian and owner sign and date this certificate without a notary; no notarized attachment or related step is listed.
How to submit this form
- 1
Download The Certificate
Download the Certificate of Exemption From Rabies Vaccination.
- 2
Complete The Certificate
Have the veterinarian examine the animal, record the medical reason for exemption, and complete the veterinarian fields; the owner completes the owner information and acknowledgment.
- 3
Provide The Owner Copy
Provide a copy of the completed certificate to the animal’s owner, who must keep it as proof of exemption.
- 4
Present With A Dog License Application
For dogs, present the certificate with an application for a dog license.
Frequently asked questions
- Do I need a notary for the Certificate of Exemption From Rabies Vaccination?
- No. The certificate has signature and date fields for the veterinarian and owner, but no notary block or notarized attachment is listed.
- How do I submit the rabies vaccination exemption certificate?
- For dogs, present the certificate with an application for a dog license. The certificate also says to provide a copy to the owner and keep it as proof of exemption.
- Who completes the rabies vaccination exemption certificate?
- A veterinarian records the examination and medical reason vaccination is contraindicated. The animal’s owner provides animal and owner information and signs the acknowledgment.
- How long is the exemption certificate valid?
- The certificate states that it is valid for a period not exceeding one year from the date it is signed.
Need something notarized?
This Certificate of Exemption From Rabies Vaccination doesn’t need a notary — but if you have another Mount Holly form that does, a commissioned online notary can help.