KENNEL PERMIT FOR ERICA WELLMAN DBA FRIENDS FOR LIFE.PDF
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Maricopa County
Animal Care and Control
2500 South 27th Avenue
Phoenix, AZ 85009
(602) 506-7387 Tele.
(602) 506-2739 Fax
KENNEL PERMIT K2\~ GoOOIO
APPLICATION
of Renewal
New
fy L,
Name: Fr sends San Kennel Name: _ fr endle Cor Che Mima?
Mailing Address: AG 2 .W mol, di, Ave Kennel Kddeaes: “06 2. - LO Nall Aws
city: Con | Wl state: Az Zip: SC 233 city: Ga lb — zip: $233
County Supervisorial District: 2
Phone:7 £6 H47 ¥24e Kennel Phone: UO Qq) 62974
Please complete and sign this application and return it to the above address with payment in the amount of three
hundred fifty dollars ($350.00) within ten (10) days of receipt.
NOTE: Failure to renew the kennel permit by the expiration date of the previous year kennel permit will result in
penalty fees for each dog being assessed at $6 per month for unaltered dog and $3 per month for altered dog in
addition to the permit fee. It is suggested the renewal application be submitted 4 — 6 weeks in advance of the
expiration date to allow timely processing.
Pursuant to Arizona statute and county ordinance, a person must obtain a kennel permit issued by the Board
of Supervisors if the person operates a kennel in which there are five or more dogs which are not individually
licensed. A.R.S. §11-1009(A). A kennel is defined as “an enclosed, controlled area, inaccessible to other
animals, in which a person keeps, harbors or maintains five or more dogs under controlled conditions.” A.R.S.
§ 11-1001(8).
An appointment will be scheduled for inspection of the kennel premises by an Animal Control Officer upon
receipt of this kennel permit application and fee. This kennel application properly executed and a copy of the
inspection report will then be forwarded to, and must be approved by, the Maricopa County Board of
Supervisors. The kennel permit form will be sent to you after approval and will be valid for one year from the
date of the Board’s approval.
NOTE: Failure to show for a scheduled inspection and/or failure of inspection will warrant a Subsequent
Inspection Return fee of $49 for each additional visit at time of inspection. Failure of inspection may result in
denial of the kennel permit and require individual licensing of each dog under the provisions of A.R.S. §11-
1008.
PLEASE ANSWER THE FOLLOWING QUESTIONS AND INITIAL EACH RESPONSE
co
1. MWe assume complete responsibility for the kennel at the premises for which I/we are making
application for a permit and understand that “kennel” means an enclosed, controlled area, inaccessible to
other animals, in which a person keeps, harbors or maintains five or more dogs under controlled
conditions (ARS 11-1001).
2. tte certify that I/We have aa | 8 dogs and that the kennel meets the definition in statute.
3. <—INe certify that I/We have not been convicted of a violation of A.R.S. §§ 13-2910 (cruelty to animals)
or 13-2910.01 (dog fighting), or similar violations of any other state, county or municipal animal welfare law.
(Violations of license and leash laws DO NOT apply).
4. —<twe-certify that all dogs over the age of three (3) months that are kept, harbored or maintained on the
premises of the above named kennel have been properly vaccinated against rabies by a veterinarian licensed to
practice in the state of Arizona and that a current vaccination certificate signed by a licensed veterinarian is
maintained on the premises for each dog.
(a
5. | We certify that MWe are submitting a valid copy of the rabies vaccination certificate for each
dog with this application.
6. IWe understand that a dog remaining within the kennel is not required to be licensed individually under
A.R.S. § 11-1008. I/we also understand that a dog leaving the controlled kennel conditions shall be licensed
under A.R.S. § 11-1008 except if the dog is only being transported to another kennel which has a permit issued
under this section.
C-— 7
ds IWe understand that a person who fails to obtain a kennel permit under A.R.S.§11-1009 is subject to a
penalty of twenty-five dollars in addition to the annual fee.
8. IWe understand that a person who knowingly fails to obtain a kennel permit within thirty days after
written notification from the county enforcement agent is guilty of a class 2 misdemeanor..
9. The undersigned understand that that the kennel permit does not authorize the operation of any type
of business and is solely used for the purpose of licensing multiple dogs.
I/We certify that all of the information I/We have provided is true and accurate under penalty of law.
Cos bate - a “2Y
Applicant Signature PS ge
IONS An
Applicant Signature Dawe laa
For Official Use Only:
Copies of Valid Rabies Vaccination Certificates for each dog attached
Copy of Person’s Valid Identification Attached
Type of Identification submitted
BOS Approval Date Term of Permit
October 2015
Maricopa County Animal Care and Control
2500 S. 27th Avenue
Phoenix, AZ 85009-6797
(602) 506-7387
http://pets.maricopa.gov
Receipt Number: R21-450921 Receipt Date: 03/04/2021
Person ID: P1279029
Phone: 480 4978296
FRIENDS FOR LIFE RESCUE
3/4/2021 3:29:07PM se.
952 W MELODY AVE
GILBERT, AZ 85233
Item: Animal ID: Reference No: Price: Each: Amount:
KEN PERMIT A7777777 K21-000010 $350.00 1 $350.00
Total Fees Due: $350.00
Payments: Cash:
Check: $350.00
Credit Card:
Total Payments Received: $350.00
Would you like to share your experience with our service to you? Thank You!
Please visit our website at http://pets.maricopa.gov and click on I
5 1 17 1 9 11 1789 1648 123 32 21.834770 change!
5 1 17 1 9 12 2164 1647 101 36 96.603180 $0.00
4 1 17 1 10 0 220 1669 1996 55 -1
5 1 17 1 10 1 220 1673 96 32 96.786827 Want
5 1 17 1 10 2 328 1673 42 31 96.763435 To
5 1 17 1 10 3 384 1672 65 32 96.133873 and
5 1 17 1 10 4 465 1672 141 32 92.720932 Contact
5 1 17 1 10 5 621 1671 162 33 89.984215 MCACC
to email your comments for our : ‘
: - alance Due: $0.00
review.
Animal Information: IIAIIAL A A
A7777777 KENNEL PERM - BORN 9/14/1999, SPAYED, UNKNOWNIMIX, TRICOLOR DOG
License Information:
Tag Number: License Expires: Animal# Vacc Date: Vacc Expires:
Pet Licensed/Registered To: Friends For Life Rescue
Please retain this receipt with your pet's records
APODACAP WBUSOFF
Maricopa County
Animal Care & Control
2500 South 27"* Avenue
Phoenix, AZ 85009
Phone: (602) 506-7387
pets.maricopa.gov
KENNEL PERMIT K21-000010
PREMISE INSPECTION
Number of Dogs: 18
Name: Erica Wellman Kennel Name: Friends For Life
Mailing Address: 952 W. Melody Ave Kennel Address: SAME AS MAIL
City: Gilbert State: AZ Zip: 85283
County Supervisorial District: 2
Phone: 480-497-8296 Kennel Phone: 480-497-8296
1. Are all dogs over the age of three months properly vaccinated for rabies and in
possession of a valid rabies vaccination certificate?
YES
2. Is the kennel an enclosed, controlled area, inaccessible to other animals, in which a
person keeps, harbors or maintains five or more dogs under controlled conditions?
YES
NOTE: Copies of each rabies vaccination certificate must be attached to the Kennel Permit
Premise Inspection form.
CORRECTIVE ACTION NEEDED FOR COMPLIANCE AND WNI/A DAYS GIVEN
BEFORE REINSPECTION. (Note: There will be $49 re-inspect fee payable to the
Inspector by check upon each return visit.)
This is a RENEWAL application.
There are 18 dogs on the kennel premises; all dogs have current rabies vaccinations and all
are confined to the kennel property under controlled conditions.
Deputy Enforcement Agent & Badge #: Lt. Romero #4 Date: 3/15/21
October 2015
RABIES VACCINATION CERTIFICATE
OWNER'S INFORMATION:
RESCUE FRIENDS FOR LIFE P1279029 (480) 4978296 SHELTE
LAST NAME FIRST NAME PERSON ID TELEPHONE HUMBER ExT
952 W MELODY AVE GILBERT AZ 85233
©
STREET ADDRESS APT CITY STATE ZIP CODE
ANIMAL INFORMATION
DOG SPAYED 8/26/2017 SMALL CHIHUAHUA SH PUG
ANIMAL TYPE ANIMAL SEX ANIMAL DATE OF BIRTH SIZE PRIMARY BREED SECONDARY BREED
A4459828 Aja! BLACK TAN
[——~—«CANIALWO ANIMAL NAME MICROCHIP NUMBER ERIMARY. COLOR ~ SECONDARY COLOR
VACCINATION INFORMATION
ZOETIS SUBQ 12 Months 8/30/2020 8/30/2021 8/30/20
VACCINE PRODUCER VACC. LENGTH DATE VACCINATED VACCINATION EXPIRES PRINT DATE
aa
KILLED a4 Afr Le, cas Maricopa County
:
Animal Care & Control
EoaETRe a
2500 S 27th Avenue. Phoenix, AZ. 85009
: (602) 506-7387
412635 AZ3754
VACC. SERIAL NO. VETERINARIANS LICENSE NUMBER
02/17/2021 17:56
RABIES VACCINATION CERTIFICATE
NASPHV FORM 51 (revised 2007)
IRABIES TAG #
Owner's Name & Address MICROCHIP # 981020000937985
LAST FIRST MI. TELEPHONE #
Humane Society of Yuma 9287821621
NO, STREET CITY STATE ZIP
4050 , South Avenue 4 1/2E Yuma AZ 85365
SPECIES AGE SIZE PREDOMINANT BREED PREDOMINANT
Dog Months [_] |Under 20 Ibs. [] COLORS/MARKINGS
Cat eo 20 - 50 Ibs. Mixed Breed (Medium) | ° Grey
Over 50 lbs. [||
Ferret SEX[_] Male [ANIMAL NAME
Other: IX} Female
Fy
a X} Neutered Dulce
Animal Control License |_|iyr [_]3 yr Other
DATE VACCINATED Product Name: Veterinarian's Name:
Nobivac 3-Rabies Alison Cowie
02/17/2021
Month / Day / Year Manufacturer: ZIO}E| License : Number: ; 7415
ete
[_] 1YrUSDA Licensed Vaccine POS
NEXT VACCINATION ; :
3 Yr USDA Licensed Vaccine |
aris (Veterinarian’s Signature)
; [|] 4 Yr USDA Licensed Vaccine
Address: Humane Society of Yuma Spay and Neuter
02/17/2022 Initialdose —_[_] Booster dose Clinic
Month / Day / Year
444591 ;
4050 S Ave. 41/2 E
Vaccine __ Serial (lot) Number
Yuma, AZ 85365
RABIES VACCINATION CERTIFICATE
OWNER'S INFORMATION:
RESCUE FRIENDS FOR LIFE P1279029 (480) 4978296 SHELTE
LAST NAME FIRST NAME PERSON ID TELEPHONE NUMBER ExT:
952 W MELODY AVE GILBERT AZ 85233
STREET ADDRESS APT CITY STATE ZIP CODE
ANIMAL INFORMATION
DOG NEUTERED 1/29/2015 SMALL CHIHUAHUA SH MIX
ANIMAL TYPE ANIMAL SEX ANIMAL DATE BIRTH SIZE PRIMARY BREED SECONDARY BREED
OF
A4533817 JOEY Heyl ohn WHITE BLACK
ANALG ANIMAL NAME MICROCHIP NUMBER PRIMARY COLOR SECONDARY COLOR
VACCINATION INFORMATION
ZOETIS SUBQ 12 Months 2/1/2021 2/1/2022 2/2/21
-
VACCINE PRODUCER VACC., LENGTH DATE VACCINATED VACCINATION EXPIRES PRINT DATE
KILLED ote wx AA 7 Le, Jur Maricopa County
Animal Care & Control
VACCINE TYPE VETERINARIANS SIGNATURE
2500 S 27th Avenue, Phoenix, AZ 85009
(602) 506-7387
444591 AZ3754
VAGG. SERIALNO. VETERINARIANS LICENSE NUMBER
RABIES VACCINATION CERTIFICATE
OWNER'S INFORMATION:
RESCUE FRIENDS FOR LIFE P1279029 (480) 4978296 SHELTE
LAST NAME FIRST NAME PERSON ID TELEPHONE NUMBER “EXT:
952 W MELODY AVE GILBERT AZ 85233
STREET ADDRESS APT City STATE IP CODE
ANIMAL INFORMATION
DOG NEUTERED 2/4/2017 SMALL CHIHUAHUA SH
ANIMAL TYPE ANIMAL SEX ANWULOMCOFERIN Se PRINARY BREED SECONDARY BREED
A4536718 PASCAL WHITE BLACK
| __—«ANWALTO FRIMARY COLOR SECONOARYCOLOR
ANIMAL NAME MICROCHIP NUMBER
VACCINATION INFORMATION
ZOETIS SUBQ 12 Months 2/9/2021 2/9/2022 2/12/21
VACCINE PRODUCER VACG. LENGTH DATE VACCINATED VACCINATION EXPIRES PRINT DATE
KILLED aes wa AArL, Lhe. Maricopa County
Animal Care & Control
VACCINE TYPE VETERINARIANS SIGNATURE
2500 S 27th Avenue, Phoenix, AZ 85009
(602) 506-7387
444591 AZ3754
VACG. SERIAL NO. VETERINARIANS LICENSE NUMBER
RABIES VACCINATION CERTIFICATE
OWNER'S INFORMATION:
RESCUE *~" FRIENDS FOR LIFE P1279029 (480) 4978296" SHELTE
LAST NAME FIRST NAME PERSON ID TELEPHONE NUMBER EXT:
952 W MELODY AVE GILBERT AZ 85233
STREETADDRESS APT ciry STATE ZIP CODE
ANIMAL INFORMATION
DOG NEUTERED 2/12/2020 SMALL CHIHUAHUA SH
ANIMAL TYPE ANINAL SEX ANIMAL
5 1 44 1 7 6 951 1201 47 16 96.465332 DATE
5 1 44 1 7 7 1003 1201 28 15 96.814293 OF
5 1 44 1 7 8 1037 1201 54 16 96.494781 BIRTH
5 1 44 1 7 9 1292 1195 42 16 89.672249 SIZE
5 1 44 1 7 10 1567 1193 85 16 44.902870 PRIMARY
5 1 44 1 7 11 1657 1194 65 15 96.369759 BREED
5 1 44 1 7 12 2016 1193 118 16 95.254562 SECONDARY
5 1 44 1 7 13 2139 1194 65 15 96.647804 BREED
4 1 44 1 8 0 285 1233 1895 78 -1
5 1 44 1 8 1 285 1255 184 32 15.034027 nas39087
5 1 44 1 8 2 510 1229 44 86 51.464252 |
5 1 44 1 8 3 570 1233 180 78 37.891766 Nugty
5 1 44 1 8 4 765 1265 44 42 37.422924 yy
5 1 44 1 8 5 1623 1251 76 32 96.902199 TAN
5 1 44 1 8 6 2045 1251 135 32 96.741310 WHITE
4 1 44 1 9 0 330 1311 1865 32 -1
5 1 44 1 9 1 330 1311 94 18 24.505205 ARIGLD
5 1 44 1 9 2 690 1327 71 16 85.355347 ANIMAL
5 1 44 1 9 3 766 1327 54 16 94.642975 NAME
5 1 44 1 9 4 1112 1327 107 16 95.530685 MICROCHIP
5 1 44 1 9 5 1224 1327 80 16 95.530685 NUMBER
5 1 44 1 9 6 1587 1315 84 16 32.058815 PRIMARY
5 1 44 1 9 7 1676 1315 67 16 73.245911 COLOR
5 1 44 1 9 8 2004 1314 118 14 0.000000 SECONDS.
5 1 44 1 9 9 2127 1314 68 15 0.000000 CALOF
4 1 44 1 10 0 1100 1366 365 22 -1
5 1 44 1 10 1 1100 1366 176 22 96.493980 VACCINATION
5 1 44 1 10 2 1285 1366 180 22 96.416611 INFORMATION
4 1 44 1 11 0 353 1427 1845 37 -1
5 1 44 1 11 1 353 1431 146 32 92.066933 ZOETIS
5 1 44 1 11 2 514 1431 114 33 92.547081 SUBQ
5 1 44 1 11 3 889 1431 41 32 96.611740 12
5 1 44 1 11 4 957 1431 131 32 96.611740 Months
5 1 44 1 11 5 1257 1432 163 31 95.093613 2/16/2021
5 1 44 1 11 6 1666 1430 182 32 96.724953 2/16/2022
5 1 44 1 11 7 2067 1427 131 32 93.675041 2/16/21
4 1 44 1 12 0 384 1501 1812 17 -1
5 1 44 1 12 1 384 1503 80 15 96.227654 VACCINE
5 1 44 1 12 2 470 1502 107 16 96.116554 PRODUCER
5 1 44 1 12 3 906 1502 55 16 68.737434 VACC,
5 1 44 1 12 4 967 1502 77 16 96.105537 LENGTH
5 1 44 1 12 5 1299 1502 47 16 95.411263 DATE
5 1 44 1 12 6 1351 1502 118 16 87.992554 VACCINATED
5 1 44 1 12 7 1642 1501 125 16 95.825577 VACCINATION
5 1 44 1 12 8 1774 1501 83 16 77.250610 EXPIRES
5 1 44 1 12 9 2085 1501 58 16 95.282623 PRINT
5 1 44 1 12 10 2148 1501 48 16 95.282623 DATE
4 1 44 1 13 0 418 1562 1646 89 -1
5 1 44 1 13 1 418 1599 137 33 96.733559 KILLED
5 1 44 1 13 2 841 1562 228 89 33.062969 jf
5 1 44 1 13 3 1100 1580 62 64 62.619392 wae
5 1 44 1 13 4 1187 1595 140 53 25.198345 Ark,
5 1 44 1 13 5 1350 1585 40 59 49.024273 ad
5 1 44 1 13 6 1409 1585 52 59 0.000000 uitt
5 1 44 1 13 7 1829 1605 129 33 96.908623 Maricopa
5 1 44 1 13 8 1967 1606 97 32 96.896187 County
4 1 44 1 14 0 1788 1645 315 25 -1
5 1 44 1 14 1 1788 1645 100 25 96.280617 Animal
5 1 44 1 14 2 1898 1646 62 24 92.810432 Care
5 1 44 1 14 3 1969 1646 25 24 92.810432 &
5 1 44 1 14 4 2004 1645 99 25 96.104652 Control
4 1 44 1 15 0 418 1668 1804 52 -1
5 1 44 1 15 1 418 1672 81 15 0.000000 WAclne
5 1 44 1 15 2 517 1672 37 15 46.966976 PE
5 1 44 1 15 3 1021 1668 148 52 89.262024 VETERINARIANS
5 1 44 1 15 4 1181 1668 106 52 93.470291 SIGNATURE
5 1 44 1 15 5 1668 1684 67 24 93.177940 2500
5 1 44 1 15 6 1746 1684 15 25 89.668640 S
5 1 44 1 15 7 1772 1683 63 26 96.343880 27th
5 1 44 1 15 8 1841 1684 107 29 96.343880 Avenue,
5 1 44 1 15 9 1959 1683 116 30 95.444153 Phoenix,
5 1 44 1 15 10 2084 1684 47 23 96.863754 AZ
5 1 44 1 15 11 2141 1683 81 26 96.766472 85009
4 1 44 1 16 0 1842 1722 210 32 -1
5 1 44 1 16 1 1842 1722 72 32 96.771408 (602)
5 1 44 1 16 2 1924 1722 128 26 96.783836 506-7387
4 1 44 1 17 0 423 1754 774 33 -1
5 1 44 1 17 1 423 1754 130 33 96.214432 444591
5 1 44 1 17 2 1086 1754 111 25 91.993187 AZ3754
4 1 44 1 18 0 403 1834 915 19 -1
5 1 44 1 18 1 403 1836 55 17 74.511513 VACC.
5 1 44 1 18 2 464 1836 67 16 95.318764 SERIAL
5 1 44 1 18 3 536 1836 33 16 95.318764 NO.
5 1 44 1 18 4 992 1834 154 17 44.883675 VETERINARIAN'S
5 1 44 1 18 5 1152 1834 80 16 93.274750 LICENSE
5 1 44 1 18 6 1237 1835 81 15 52.667870 NUMSER
2 1 45 0 0 0 223 1816 2127 114 -1
3 1 45 1 0 0 223 1816 2127 114 -1
4 1 45 1 1 0 223 1816 2127 114 -1
5 1 45 1 1 1 223 1816 2127 114 95.000000
2 1 46 0 0 0 2308 696 71 1179 -1
3 1 46 1 0 0 2308 696 71 1179 -1
4 1 46 1 1 0 2308 696 71 1179 -1
5 1 46 1 1 1 2308 696 71 1179 95.000000
OWNER'S COPY RABIES VACCINATION
CERTIFICATE
Owner's NASPHV Form #51 Rabies Tag Number _|
Name and Address
Print - use ball point pen or type
PRINT -Last-,
Friends C ; First, M.l. | Telephone
foc (i 2,
No. Street
City State
Zip
Species: | Sex: Age:
Size: prsttaniaes
Dog Male \Z1/3moto12m00 Breed: Colors:
Under 20 Ibs. 1]
Cat (]|Female | 12mo or older (2 _ Coc BORE F io Place
20 - 50 Ibs. \eT
Other: (| Neutered\ 7 | Actual rows es pe
a Over 50 Ips. [ : Lo
Actual Ibs, | Name: Podhi
DATE VACCINATED:
Producer: Mie | Veterinarian’s: #
05 05 (License No.) »
2 (First 3 letters)
Month Day Year
Ms yr. Lic./Vacc. (Signature)
03 yr. Lic./Vace. Address:
VACCINATION EXPIRED:
(S05 22
Month Day Year Vacc. Serial
(lot) no. Homeward Bound
1020 E. Pecos Ra. #1
“Chanter i AFZaAroaor
AZ 85225
RABIES VACCINATION CERTIFICATE
OWNER'S INFORMATION:
RESCUE .— FRIENDS FOR LIFE P1279029 (480) 4978296 SHELTE
LAST NAME FIRST NAME PERSON ID TELEPHONE NUMBER EXT:
952 W MELODY AVE GILBERT AZ 85233
STREET ADDRESS APT CITY STATE ZIP CODE
ANIMAL INFORMATION
DOG NEUTERED 2/20/2017 SMALL PUG
ANIMAL TYPE ANIMAL SEX ANIMAL
5 1 39 1 8 6 945 1165 47 14 94.137039 DATE
5 1 39 1 8 7 998 1165 26 14 94.137039 OF
5 1 39 1 8 8 1031 1165 54 14 96.940285 BIRTH
5 1 39 1 8 9 1288 1159 40 14 95.017746 SIZE
5 1 39 1 8 10 1564 1157 84 15 90.169701 PRIMARY
5 1 39 1 8 11 1653 1157 63 15 96.834923 BREED
5 1 39 1 8 12 2010 1156 119 16 87.731628 SECONDARY
5 1 39 1 8 13 2135 1156 64 15 96.807442 BREED
4 1 39 1 9 0 277 1198 1899 71 -1
5 1 39 1 9 1 277 1220 185 31 32.348537 4543735
5 1 39 1 9 2 537 1198 195 66 0.000000 LSekesod.
5 1 39 1 9 3 758 1219 28 50 26.964350 A
5 1 39 1 9 4 796 1209 68 60 26.964350 Von
5 1 39 1 9 5 880 1202 94 60 93.745522 PUL
5 1 39 1 9 6 1602 1214 114 31 96.037651 FAWN
5 1 39 1 9 7 2043 1214 133 31 96.460281 BLACK
4 1 39 1 10 0 335 1273 1855 32 -1
5 1 39 1 10 1 335 1273 83 19 0.000000 RAL
5 1 39 1 10 2 685 1290 69 15 94.859390 ANIMAL
5 1 39 1 10 3 760 1290 52 15 96.710724 NAME
5 1 39 1 10 4 1107 1290 106 14 93.290062 MICROCHIP
5 1 39 1 10 5 1219 1290 79 14 88.595810 NUNBER
5 1 39 1 10 6 1583 1278 156 14 0.000000 ERUEARY.COCOR
5 1 39 1 10 7 1999 1275 37 15 9.610491 SEC
5 1 39 1 10 8 2040 1271 74 42 0.000000 ONDESY
5 1 39 1 10 9 2123 1275 67 14 43.271820 COLOR
4 1 39 1 11 0 540 1329 920 20 -1
5 1 39 1 11 1 540 1345 2 2 65.408829 .
5 1 39 1 11 2 1094 1329 176 20 96.387840 VACCINATION
5 1 39 1 11 3 1280 1329 180 20 96.591187 INFORMATION
4 1 39 1 12 0 346 1389 1848 39 -1
5 1 39 1 12 1 346 1395 146 32 92.375023 ZOETIS
5 1 39 1 12 2 508 1395 114 33 91.890099 SUBQ
5 1 39 1 12 3 882 1394 41 31 93.490669 36
5 1 39 1 12 4 951 1393 131 32 93.490669 Months
5 1 39 1 12 5 1253 1394 161 31 96.153542 2/23/2021
5 1 39 1 12 6 1662 1392 181 32 96.430801 2/23/2022
5 1 39 1 12 7 2063 1389 131 31 95.775337 2/24/21
4 1 39 1 13 0 376 1463 1816 18 -1
5 1 39 1 13 1 376 1466 80 15 96.066429 VACCINE
5 1 39 1 13 2 463 1466 107 15 96.420715 PRODUCER
5 1 39 1 13 3 900 1465 51 15 85.110573 VACC,
5 1 39 1 13 4 963 1465 75 15 91.378220 LENGTH
5 1 39 1 13 5 1294 1464 46 15 96.528168 DATE
5 1 39 1 13 6 1347 1464 117 15 83.615799 VACCINATED
5 1 39 1 13 7 1639 1464 124 15 96.177963 VACCINATION
5 1 39 1 13 8 1770 1464 81 15 95.959999 EXPIRES
5 1 39 1 13 9 2082 1463 56 15 96.853546 PRINT
5 1 39 1 13 10 2144 1463 48 15 95.794266 DATE
4 1 39 1 14 0 411 1524 1648 89 -1
5 1 39 1 14 1 411 1563 137 31 96.745598 KILLED
5 1 39 1 14 2 838 1524 93 89 46.004494 je
boas a E nl AY7L, Llib Maricopa County
:
Animal Care & Control
VACCINE TYPE AMT SIGNATURE
2500 S 27th Avenue, Phoenix, AZ 85009
(602) 506-7387
444591 AZ3754
VACC. SERIAL NO. VETERINARIANS LICENSE NUMBER
RABIES VACCINATION CERTIFICATE
OWNER'S INFORMATION;
RESCUE FRIENDS FOR LIFE P1279029 (480) 4978296 SHELTE
LAST NAME FIRST NAME PERSON ID TELEPHONE NUMBER EXT
952 W MELODY AVE GILBERT AZ 85233
STREET ADDRESS APT CITY STATE ZIP CODE
ANIMAL INFORMATION
DOG NEUTERED 3/1/2018 SMALL DACHSHUND
ANINAL TYPE ANIMAL SEX ANIMAL DATE OF BIRTH SIZE PRIMARY BREED SECONDARY BREED
A4548680 TINY BLACK WASH BROWN
ARTAALTO ANIMAL NAME MICROCHIP NUMBER ERIMARY:COLOR SECONDARY COLOR
VACCINATION INFORMATION
ZOETIS SUBQ {42 Months 3/5/2021 3/5/2022 3/5/21
VACCINE PRODUCER VACC. LENGTH DATE VACCINATED VACCINATION EXPIRES PRINT DATE
KILLED Vazaw ee Af7L, tke. Maricopa County
if Animal Care & Control
TENET ee
2500 S 27th Avenue, Phoenix, AZ 85009
(602) 506-7387
444591 AZ3754
VACC. SERIAL NO. VETERINARIANS LICENSE NUMBER
RABIES VACCINATION CERTIFICATE
OWNER'S INFORMATION:
RESCUE FRIENDS FOR LIFE P1279029 (480) 4978296 “SHELTE
TAST NAME FIRST NAME PERSON ID TELEPHONE NUMBER EXT:
952 W MELODY AVE GILBERT AZ 85233
STREET ADDRESS APT city STATE ZIP CODE
ANIMAL INFORMATION
DOG NEUTERED 3/4/2019 SMALL DACHSHUND CHIHUAHUA SH
ANIMAL TYPE ANIMAL SEX ANIMAL DATE OF BIRTH SIZE PRIMARY BREEO SECONDARY BREED
4550091 BROWN WHITE
lay by ohplCe
ARAL: ERIMAE COCO SEPONISEEUECRS
ANIMAL NAME MICROCHIP NUMBER
VACCINATION INFORMATION
ZOETIS SUBQ 12 Months 3/7/2021 3/7/2022 3/7/21
VACCINE PRODUCER VACG. LENGTH DATE VACCINATED VACCINATION EXPIRES PRINT DATE
KILLED ages al AL7L, - oO Maricopa County
Animal Care & Control
VACCINE TYPE VETERINARIANS SIGNATURE
2500 S 27th Avenue, Phoenix, AZ 85009
(602) 506-7387
444591 AZ3754
VACC. SERIAL NO. VETERINARIAN'S LICENSE NUMBER
RABIES VACCINATION CERTIFICATE
OWNER'S INFORMATION:
RESCUE FRIENDS FOR LIFE P1279029 (480) 4978296 SHELTE
TAST NAME FIRST NAME PERSON IO TELEPHONE NUMBER EXT:
952 W MELODY AVE GILBERT AZ 85233
STREET ADDRESS APT CITY STATE ZIP CODE
ANIMAL INFORMATION
DOG SPAYED 2/24/2016 SMALL SCHNAUZER MIN MIX
ANIMAL TYPE ANIMAL SEX ANIMAL DATE OF BIRTH SIZE PRIMARY BREED SECONDARY BREED
A4547534. | > ad \o BLACK
AREAL PRIMARY.COLOR ‘SECONDARY COLOR
ANIMAL NAME MICROCHIP NUMBER
VACCINATION INFORMATION
ZOETIS SUBQ 12 Months 2/26/2021 2/26/2022 3/1/21
VACCINE PRODUCER VACG. LENGTH DATE VACCINATED VACCINATION EXPIRES PRINT DATE
KILLED Fe Fo btve,, Mere Maricopa County
Animal Care & Control
VACCINE TYPE VETERINARIANS SIGNATURE
2500 S 27th Avenue, Phoenix, AZ 85009
(602) 506-7387
444591 AZ3754
VACC. SERIAL KO. VETERINARIANS LICENSE NUMBER
RABIES VACCINATION CERTIFICATE
OWNER'S INFORMATION:
RESCUE. ™ FRIENDS FOR LIFE P1279029° (480) 4978296 SHELTE
LAST NAME . FIRST NAME PERSON IO TELEPHONE NUMBER EXT:
952 W MELODY AVE GILBERT AZ 85233
STREET ADDRESS APT city STATE ZIP CODE
ANIMAL INFORMATION
DOG SPAYED 10/3/2020 LARGE PLOTT HOUND MIX
ANIMAL TYPE ANIMAL SEX ANIMAL DATE OF BIRTH SIZE PRIMARY BREED SECONDARY BREED
4549731 Mad | cin BROWN
AED ANIMAL NAME MICROCHIP NUMBER ERIMARY COLOR Sue CoE
VACCINATION INFORMATION
ZOETIS SUBQ 12 Months 3/7/2021 3/7/2022 3/7/21
VACCINE PRODUCER VACC. LENGTH DATE VACCINATED VACCINATION EXPIRES PRINT DATE
KILLED fo ete a. ewe:
AA 7 Le, Maricopa County
Animal Care & Control
seer ELE ENE NR
2500 $ 27th Avenue, Phoenix, AZ 85009
(602) 506-7387
444591 AZ3754
VACC. SERIAL NO. VETERINARIAN S LICENSE NUMBER
RABIES VACCINATION CERTIFICATE
OWNER'S INFORMATION:
RESCUE . | FRIENDS FOR LIFE P1279029 (480) 4978296 SHELTE
LAST NAME FIRST NAME PERSON ID TELEPHONE NUMBER EXT:
952 W MELODY AVE GILBERT AZ 85233
STREET ADDRESS APT CITY STATE ZIP CODE
ANIMAL INFORMATION
DOG SPAYED 2/14/2019 LARGE GERM SHEPHERD MIX
ANIMAL TYPE ANIMAL SEX ANIMAL DATE OF BIRTH SIZE PRIMARY BREED SECONDARY BREED
A4539843 TAN WHITE
ae _ UA
ARINALTO Baad ANIMAL naead) MICROCHIP NUMBER PEMA COLOR SECONIARY COLOR
VACCINATION INFORMATION
ZOETIS SUBQ 12 Months 2/18/2021 2/18/2022 2/18/21
VACCINE PRODUCER ° VACC. LENGTH DATE VACCINATED VACCINATION EXPIRES PRINT DATE
KILLED Vga Lo «eu
AY7L, Maricopa County
:
Animal Care & Control
VACCINE TYPE VETERINARIANS SIGNATURE
2500 S 27th Avenue, Phoenix, AZ 85009
(602) 506-7387
444591 AZ3754
VACC. SERIAL NO. VETERINARIAN'S LICENSE NUMBER
RABIES VACCINATION CERTIFICATE
OWNER'S INFORMATION:
RESCUE FRIENDS FOR LIFE P1279029 (480) 4978296 SHELTE
LAST NAME FIRST NAME PERSON IO TELEPHONE NUMBER EXT
952 W MELODY AVE GILBERT
AZ 85233
STREET ADORESS APT CITY STATE ZIP CODE
ANIMAL INFORMATION
DOG SPAYED 6/21/2016 SMALL CHIHUAHUA SH
ANIMAL TYPE ANIMAL SEX ANIMAL DATE OF BIRTH Size PRIMARY BREED SECONDARY BREED
A4098955 BEENIE TAN
ARINALTO
ANIMAL NAME MICROCHIP NUMBER PRIMARY COLOR SECONDARY. OULU
VACCINATION INFORMATION
ZOETIS Months 3/5/21
VACCINE PRODUCER VACC. LENGTH DATE VACCINATED VACCINATION EXPIRES PRINT DATE
KILLED fen od Dum.
AAS7L, Maricopa County
Animal Care & Control
VACCINE TYPE VETERINARIANS SIGNATURE
2500 S 27th Avenue, Phoenix, AZ 85009
oe) 602) 506-7387
SN267254 AZ3754
VACC. SERIAL NO. VETERINARIAN S LICENSE NUMBER
RABIES VACCINATION CERTIFICATE
OWNER'S INFORMATION:
RESCUE FRIENDS FOR LIFE P1279029 (480) 4978296 SHELTE
LAST NAME FIRST NAME PERSON ID TELEPHONE NUMBER EXT:
952 W MELODY AVE GILBERT AZ 85233
STREET ADDRESS APT CITY STATE ZIP CODE
ANIMAL INFORMATION
DOG SPAYED 6/21/2016 SMALL CHIHUAHUA SH
ANIMAL TYPE ANIMAL SEX ANIMAL DATE OF BIRTH SIZE PRIMARY BREED SECONDARY BREED
A4098956 STELLA BROWN
AWAED ANIMAL NAME MICROCHIP NUNBER PRIMARY.GOLOR SECONDARY COLOR
VACCINATION INFORMATION
ZOETIS SUBQ 12 Months 3/2/2021 3/2/2022 3/5/21
VACCINE PRODUCER VACC. LENGTH DATE VACCINATED VACCINATION EXPIRES PRINT OATE
KILLED GF ln Le A47L, Jute
Maricopa County
Animal Care & Control
VACCINE NPE VETERINARIANS SIGNATURE
2500 S 27th Avenue, Phoenix, AZ 85009
(602) 506-7387
444591 AZ3754
VACC. SERIAL NO. VETERINARIANS LICENSE NUMBER
RABIES VACCINATION CERTIFICATE
OWNER'S INFORMATION:
RESCUE FRIENDS FOR LIFE P1279029 (480) 4978296 SHELTE
LAST NAME FIRST NAME PERSON ID TELEPHONE NUMBER EXT
952 W MELODY AVE GILBERT AZ 85233
STREET ADDRESS APT city STATE ZIP CODE
ANIMAL INFORMATION
DOG NEUTERED 3/1/2020 SMALL POODLE MIN MIX
ANIMAL TYPE ANIMAL SEX ANIMAL DATE OF BIRTH SIZE PRIMARY BREED SECONDARY BREED
aasase6s | Boysen WHITE
ARIMALRD ae PURE OOS SECONDARY COLOR
NAME MICROCHIP NUMBER
VACCINATION INFORMATION
ZOETIS SUBQ 12 Months 3/4/2021 3/4/2022 3/4/24
VACCINE PRODUCER VACC. LENGTH DATE VACCINATED VACCINATION EXPIRES PRINT DATE
KILLED fr Bate os Hoyt:
A47L, Maricopa County
Animal Care & Control
VACCINE TYPE VETERINARIAN'S SIGNATURE
2500 S 27th Avenue, Phoenix, AZ 85009
(602) 506-7387
444591 AZ3754
VACC. SERIAL NO. VETERINARIAN'S LICENSE NUMBER
Apache Junction Animal Control
725 E. Baseline Rd.
Apache Junction, AZ 85119
(480) 983-4405
Certificate of Rabies Vaccination
| Date. | | January 12, 2021
- Adopter FRIENDS FOR LIFE RESCUE
Address 952 W MELODY AVE
EE | GILBERT, AZ 85233
“Telephone | | (480) 497-8297
- Animal pos GINGER
Information. SEX: SPAYED FEMALE
~ A013308 |
Soe ne eae | BREED: QUEENSLAND HEEL MIX
3
COLOR: RED
AGE: 3Y
TATTOO:
Rabies Vaccination
VACCINATION DATE: 01-09-2021
TERM: 36 MONTHS
EXPIRES: 01-09-2024
MANUFACTURER: ELANCO
LOT NUMBER: D0143393A
VIRUS TYPE: KILLED
RABIES TAG: U21-000592
(\utew K Dungecet 3538
Veterinarian Signature Veterinarian License Number