The report of the presence of a wild animal shall be made on the following form:
Report No. ______ ...........................................................................
Report of the Presence of Wild Animals
The information recorded here is essential to emergency services personnel so that they may protect themselves and your neighbors, provide for the safety of your animals, ensure the maximum protection and preservation of your property, and provide you with emergency services without unnecessary delay.
Every person in New York State, who owns, possesses, or harbors a wild animal, as set forth in General Municipal Law, § 209-cc, must file this Report annually, on or before April 1 of each year, with the clerk of the city, village or town (if outside a village) where the animal is kept. A list of the common names of animals to be reported is enclosed with this form. Failure to file as required will subject you to penalties under law.
A separate Report is required to be filed annually for each address where a wild animal is harbored.
Exemptions: Pet dealers, as defined in section 752-a of the General Business Law, zoological and other exhibitors licensed pursuant to 7 USC sections 2133 and 2134, and licensed veterinarians in temporary possession of dangerous dogs, are not required to file this report.
Instructions for completing this form:
Name: ......................................................................................................
Business Name (if a business): ......................................................................................................
Street Address: ......................................................................................................
City, State and Zip: ......................................................................................................
Telephone Number: ......................................................................................................
Address Where Animal is Located (if different than above):
_______________
_______________
Name of Emergency Contact: ......................................................................................................
Daytime phone number: ......................................................................................................
After-hours phone number: ......................................................................................................
Signature and title (if a business) of person completing form:
_______________
_______________
THIS FORM MUST BE FILED WITH YOUR CITY, TOWN (IF THE ANIMAL IS LOCATED OUTSIDE A VILLAGE) OR VILLAGE CLERK. DO NOT FILE THIS FORM WITH THE NYS DEPARTMENT OF STATE.
Instructions to the Municipal Clerk:
Forward copies of this Report to:
Report No. ______ .......................................................................
Report of the Presence of Wild Animals
List of Animals at this Address
Common name of animal | Number of such animals at this location | Scientific name (genus and species), if known |
N.Y. Comp. Codes R. & Regs. Tit. 19 § 820.3