Transcription of Microchip No: UPDATE OWNER OR PET DETAILS …
1 UPDATE OWNER OR PET DETAILSuUpdate your OWNER or pet contact DETAILS FREE online at select Register a Pet' from the menu bar, then select Amend Registrations and Print Certificates . In the Membership Access section enteryour Member ID and Password. To make amendments select either Edit Member DETAILS or Edit Pet DETAILS .uIf you are not able to complete the changes online yourself due to loss of Member ID and Password you can fillout the form below and send it to us to make the is a $ (subject to change) processing fee for all changes made by Petsafe on your behalf. A new certificate will also be issued to RETURN ORIGINAL SIGNED DOCUMENT BY MAIL TO PO BOX 6804 BAULKHAM HILLS NSW 2153 Petbase Pty Ltd ABN 46 095 610 334 Trading as Petsafe PO Box 6804 Baulkham Hills NSW 2153 Unit 1C 5 Salisbury Road Castle Hill NSW 2154 Phone: 02 8850 6800 Fax.
2 02 9894 5782 CURRENT DETAILST itleResidential AddressSuburb/CitySurnameFirst NamePostcodeStatePostal Address(if different)Suburb/CityPostcodeStateHome Tel ( )Mobile ( )Work Tel ( )Alt Contact NameMobile ( )Phone ( )Local Council (Mandatory for VIC, QLD, TAS registration)Fax ( )EmailYOUR NEW DETAILST itleResidential AddressSuburb/CitySurnameFirst NamePostcodeStatePostal Address(if different)Suburb/CityPostcodeStateHome Tel ( )Mobile ( )Work Tel ( )Alt Contact NameMobile ( )Phone ( )Local Council (Mandatory for VIC, QLD, TAS registration)Signed:Date:Fax ( )EmailI confirm that all DETAILS described here are correct and request that Petsafe UPDATE its records to reflect thisPET DETAILSNameName on card:Signature:Date:Card number:Exp date:PAYMENT DETAILSI have included a cheque or money order BreedMenacingDangerousFemaleEntireDesexe dIs the dog - Pet Address (if different to above)PostcodeStateSuburb/CitySecond MicrochipPlease charge my Credit Card $ code: Microchip No:Member ID:Collar Tag.
