"Animal Rescue Entity (Are) License Application" - Oregon

Animal Rescue Entity (Are) License Application is a legal document that was released by the Oregon Department of Agriculture - a government authority operating within Oregon.

Form Details:

  • Released on February 1, 2021;
  • The latest edition currently provided by the Oregon Department of Agriculture;
  • Ready to use and print;
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  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Oregon Department of Agriculture.

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Animal Health Program
635 Capitol St, NE, Salem, OR 97301-2532
503-986-4680
| Oregon.gov/ODA
Animal Rescue Entity (ARE) License Application
Please complete and sign this application before submitting to ODA, any incomplete forms may delay processing.
Legal Organization Name
Registered Agent Name
Mailing Address
City, State, Zip
Phone No.
Email
Assumed ARE Name (DBA)
Contact Name
Physical Address
City, State, Zip
Phone No.
Email
Type of Animal Rescue Entity (ORS 609.415)
Animal Control Agency
Animal Sanctuary
Humane Society/Shelter/Rescue
Other (specify)
Type of Animals (mark all that apply)
Dog
Reptile/Amphibian
Cat
Pocket Pet
Bird
Other (specify)
Fish
Livestock (specify)
Does your organization keep, house, or maintain animals at a facility location?
Yes
No
Does your organization utilize foster facilities?
Yes
No
Estimated maximum animal capacity (including foster facilities)
Current number of animals in ARE custody (including foster facilities)
Number of animals received in the last 12 months
Number of animals transferred or adopted out of ARE’s ownership in the past 12 months
Animal Health Program
635 Capitol St, NE, Salem, OR 97301-2532
503-986-4680
| Oregon.gov/ODA
Animal Rescue Entity (ARE) License Application
Please complete and sign this application before submitting to ODA, any incomplete forms may delay processing.
Legal Organization Name
Registered Agent Name
Mailing Address
City, State, Zip
Phone No.
Email
Assumed ARE Name (DBA)
Contact Name
Physical Address
City, State, Zip
Phone No.
Email
Type of Animal Rescue Entity (ORS 609.415)
Animal Control Agency
Animal Sanctuary
Humane Society/Shelter/Rescue
Other (specify)
Type of Animals (mark all that apply)
Dog
Reptile/Amphibian
Cat
Pocket Pet
Bird
Other (specify)
Fish
Livestock (specify)
Does your organization keep, house, or maintain animals at a facility location?
Yes
No
Does your organization utilize foster facilities?
Yes
No
Estimated maximum animal capacity (including foster facilities)
Current number of animals in ARE custody (including foster facilities)
Number of animals received in the last 12 months
Number of animals transferred or adopted out of ARE’s ownership in the past 12 months
Unless a specific exception or exemption applies, a person convicted of violating an ORS Chapter 167 animal
cruelty crime may not possess any animal of the same genus against which the crime was committed or any
domestic animal for a period of five years (for a misdemeanor) or fifteen years (for a felony) following entry
of the conviction.
Please initial, indicating you have read and understand the statement above.
Have any of the ARE’s board members, staff, or volunteers been convicted of an animal cruelty crime under ORS
Chapter 167? If yes, list below their name, court case number, date of conviction, and the genus of the animal
against which the crime was committed.
Yes
No
I hereby certify that the information on this application and the requirements pertaining to this license are true and
correct. I agree to comply with all laws and regulations pertaining to this license. I understand that acceptance and
processing of this application does not constitute the issuance of an Animal Rescue Entity License and that licenses
may be issued once recordkeeping and licensing requirements are met. I will notify the Oregon Department of
Agriculture immediately should any information on this application change.
Print Name
Title
Signature
Date (MM/DD/YYYY)
An ODA representative will contact you upon receipt of the completed application to schedule your initial inspection.
Reference OAR 603-015-0075 to 603-015-0110 for licensing requirements. No licensing fee is due at this time, a
payment form will be issued after May 15, 2021 and a licensing fee of $375 will be due by July 1, 2021 prior to issuance
of a license. Animal Rescue Entity licenses issued do not constitute any land use approval required for operation of
the facility at the property indicated on this application, contact your local land use authorities to confirm your
compliance. An ARE must comply with all other state and county laws and regulations.
RETURN THE COMPLETED FORM TO:
For office use only
Oregon Department of Agriculture
Applicant #
License #
Animal Health Program
635 Capitol St NE Ste 100
Salem, OR 97301-2532
Date Received
Staff Initials
animalrescue@oda.state.or.us
Updated 2/2021
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