Working Dog Registration Form

Privacy Collection Notice

The Shire of Denmark collects your personal information to deliver services and meet our legal obligations under relevant laws. We handle your information in accordance with the Privacy and Responsible Information Sharing Act 2024 and other applicable legislation. Your information is stored securely and kept only as long as required. It may be shared internally at the Shire of Denmark to aid our customer service delivery and may be shared with other government agencies if required by law. If you do not provide your information, the Shire may not be able to provide services to you.

You can request access to or correction of your personal information by contacting the Shire of Denmark Privacy Officer at info@denmark.wa.gov.au. For more information, visit www.denmark.wa.gov.au/privacy


Declaration

I declare that the above-mentioned dog meets the essential criteria of being trained and used primarily for the droving or tending of stock.

I understand failure to satisfy that my dog meets at least three of the following criteria may result in my application being refused.

The property that the dog works on is larger than 2 hectares*This field is required.
I am a primary producer with a PIC and ABN*This field is required.
There are more than 8 head of stock on the property that the dog works on.*This field is required.
My dog is a recognised working dog breed.*This field is required.
Section 20 (1) (b) of the Dog Act 1976 state that it is an offence, for the purpose of obtaining any benefit or avoiding any penalty, to wilfully make or cause to be made any representation or statement which is false or misleading in any material form. The penalty for an offence relating to a dog other than a dangerous dog is a fine of $5000. Are you willing to submit this application, and by doing so declare that all information provided is true and correct?*This field is required.