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DOG LICENSE APPLICATION OWNER INFORMATION Name Residence Address City Zip

00 Female or Spayed Female 1000 Amount Enclosed MAKE CHECKS PAYABLE TO COUNTY OF LOUDOUN HSHQGLQJ57347RQ57347RXU57347GRJ57526V rabies expiration date you have the option to purchase a one two or three year dog license RJ57347OLFHQVHV57347HSLUH57347W

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DOG LICENSE APPLICATION OWNER INFORMATION Name Residence Address City Zip




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