Livestock Registry

2. First Name*

3. Last Name*

5. Street Number*

6. Street Name*

7. Street Type

8. Apt #

10. City*

11. State*

12. Zip*

14. Phone Number*

15. Alternate Phone Number

17. Is this a New or Updated Registration?*
    -- Select One --NewUpdated

18. Livestock Type*

    Please check all that apply.

    1. Cattle
    2. Horses
    3. Goats
    4. Donkeys
19. Other types of Livestock*

21. Livestock Location*

    Physical address is preferred, but a road name with a cross street is acceptable. Please include the city to make the location easier pinpoint.

23. Livestock Description*

    Please describe using color patterns, gender, type and any distinguishing marks

25. Is there anyone the 9-1-1 Center can contact regarding your livestock in the event you cannot be reached?*

    Please list their name(s) and phone number(s)

Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

* indicates a required field