Was all of the information received in the annual ACO designation email correct?(Required)

Please complete or make necessary changes below.

Please submit all updated information annually by February 1st, or immediately upon personnel change. 

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    ACO Supervisor Information

    Supervisory Name:
    Supervisor Address:

    Municipal Holding Facility information

    Type of Facility:
    Holding Facility Address:
    Types of animals housed at Facility:
    select as many as apply

    Animal Control Officer(s) Information

    ACO Office Address:
    ACO Status:
    ACO Name:
    Kept internally at MDAR for ACO updates and emergency contact
    Do you have additional ACOs you need to add/remove or update?(Required)
    If yes repeat ACO Information from ACO Status -date of hire.

    2nd Animal Control Officer(s) Information

    ACO Status:
    ACO Name:
    Kept internally at MDAR for ACO updates and emergency contact.
    Do you have additional ACOs you need to add/remove or update?(Required)
    If yes repeat ACO Information from ACO Status -date of hire.

    3nd Animal Control Officer(s) Information

    ACO Status:
    ACO Name:
    Kept internally at MDAR for ACO updates and emergency contact.
    Do you have any additional ACOs you need to add/remove or update?(Required)
    If yes repeat ACO Information from ACO Status -date of hire
    Please list the additional ACO Information from ACO Status thru date of hire.