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HomeMy WebLinkAbout1969_VILLAGE OF POTOSIFORM D. L.-1 N. C. MILLER CO.. MILWAUKEE WISCONSIN STATE DEPARTMENT OF AGRICULTURE DOG REPORT BY ASSESSOR ;i WHITE -LOCAL TREASURER'S COPY CANARY -COUNTY CLERK'S COPY PINK -FILE COPY DATE / / 99(2L, NAME OF OWNER OF DOGS (OR PERSON WHO KEEPS OR HARBORS DOGS) ADDRESS OF OWNER CITY AND STREET NO. OF DOGS COLOR " BREED MALE SPAYED FEMALE UY- SPAYED FEMALE 2 f i 3 �� k 4 6 7 /[ X 9 I 10 11 j 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 Date Returned Signed Assessor Assessment District of County of