CHARLES E SHABAZZ KENNEL PERMIT APPLICATION.PDF

Maricopa County
Animal Care and Control
2500 South 27th Avenue
Phoenix, AZ 85009
(602) 506-7387 Tele.
(602) 506-2739 Fax
KENNEL PERMIT K19 - 0 0 0 0 (02.
APPLICATION
1:1 New [/'Renewal
Name: S4486-I Kennel Name: 0/4-Pli ‘1 6kbqb1c3 Zz
Mailing Address: 2-5 CI co Kennel Address: e- 3T:
City: /9/9‹ State: AZ Zip: City: 14 Zip: OS-
County Supenrisorial District:
Phone: Kennel Phone:'( -i5
Please complete and sign this application and return it to the above address with payment in the amount of three
hundred twenty-eight dollars ($328.00) 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 $4 per month for unaltered dog and $2 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
1. INVe assume complete responsibility for the kennel at the premises for which 1/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. INVe certify that I/We have 7g7 dogs and that the kennel meets the definition in statute.
3. -1 I/We 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),
4.4.4 INVe 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.
5..X I /We certify that I/We are submitting a valid copy of the rabies vaccination certificate for each
dog with this application.
6. -TT I/We 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.
7. JIIIT I/We 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. a-- INVe 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.
Applicant Signature c, Date: 4-0
Applicant Signature Date:
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 Az Dri ve-r5 (tbeA-15e.
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://bets.maricopa.00v
Receipt Number: R18-430934 Receipt Date: 04/19/2018
Person ID: P2054053
Phone: 602 2209523
CHARLES SHABAZZ 4/19/2018 12:03:32PM
2529 E CULVER ST
PHOENIX, AZ 85008
Item: Animal ID: Reference No: Price: Each: Amount:
KEN PERMIT A7777777 K19-000062 $328.00 1 $328.00
Total Fees Due: $328.00
Payments: Cash:
Check: $328.00
Credit Card:
Total Payments Received: $328.00
Thank You!
Would you like to share your experience with our service to you? Change: $0.00
Please visit our website at http://pets.maricopa.gov and click on Balance Due: $0.00
"Contact Us" to email your comments for our review.
Animal Information:
A7777777 KENNEL PERM - BORN 9/14/1999, SPAYED, UNKNOWN/MIX, TRICOLOR DOG
License Information:
Tag Number: License Expires: Animal# Vacc Date: Vacc Expires:
Please retain this receipt with your pet's records
schenone WBUSOFF

Maricopa County
Animal Care & Control
2500 South 27th Avenue
Phoenix, AZ 85009
Phone: (602) 506-7387
pets.maricopa,gov
KENNEL PERMIT K 19-000062
PREMISE INSPECTION
Number of Dogs: 31
Name: Charles E. Shabazz Kennel Name: CHAPAS "SHABAZZ"
Mailing Address: 2529 E CULVER ST Kennel Address: 2529 E CULVER ST
City: PHOENIX State: AZ Zip:85008 City: PHOENIX Zip: 85008
County Supervisorial District: 5
Phone: 602-220-9523 Kennel Phone: 602-220-9523
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 NA DAYS GIVEN
BEFORE RE1NSPECTION. (Note: There will be $49 re-inspect fee payable to the
Inspector by check upon each return visit.)
Kennel property was inspected on May 1, 2018. All dogs on the property, over 3 moth of
age were verified, with matching rabies vaccination certificates. Property was enclosed and
all dogs were secure at this location.
Deputy Enforcement Agent & Badge #: LT. ROMERO #4
Date: 5/7118
October 2015

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
04/27/2018 04/26/2021
NAME: E Shabazz PET: Jack
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 01/09/2016 0 lbs 0 ozs
BREED COLOR
Mix, Pomeranian
Producer: ZOE
Serial Number: 248313C
Vaccine Type: Killed
Duration: 1095
I hereby certify that I have vaccinated this animal in accordance with the company's recommendation
for the vaccine used-en-the-above date.
Signature-a licensed veterinarian administering vaccine.
DerekOsterheld, D.V.M.
Hospital #1656
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MAR1COPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
04/27/2018 04/26/2021
NAME: E Shabazz PET: Zolo
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 0 lbs 0 ozs
BREED COLOR
PomPeechua Hairless
Producer: ZOE
Serial Number: 248313C
Vaccine Type; Killed
Duration: 1095
I hereby certify that I have vaccinated this animal in accordance with the company's recommendation
for the vaccine use_d_on-the-above date.
"
Signature ortioensed veterinarian administering vaccine.
DerekOsterheld, D.V.M.
Hospital #1656
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
04/27/2018 04/26/2021
NAME: E Shabazz PET: Candy
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 0 lbs 0 ozs
BREED COLOR
PomPeechua Red-White
Producer: ZOE
Serial Number: 248313C
Vaccine Type: Killed
Duration: 1095
I hereby certify that I have vaccinated this animal in accordance_with, __— )the company's recommendation
for the vaccine used on_the-al5rnieJate. _
_
egnature of licensed veterinarian administering vacci
DerekOsterheld, D.V.M.
Hospital #1656
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: Curly
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 02/01/2013 5 lbs 0 ozs
BREED COLOR
Chinese Crested Black
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
I hereby certify that I hve vaccinated thi§ animal in accordance with the company's recommendation
for the vaccine u the abovL
1
, Alif I A
igafore of 1 I - n I-
NeilF arringt /, 1
Hospital #165
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: Blk Top Male
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 02/01/2013 6 lbs 0 ozs
BREED COLOR
Chinese Crested Black
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
I hereby certify that I have vaccinated this wimal in accordance with the company's recommendation
for the vaccine used on the above date.
.gnitugefik nied veterinari41 admirfigeting vaccine.
NeilFarringto P , D.V.M.
Hospital #1%; 6
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: June Bug
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 02/01/2013 0 lbs 0 ozs
BREED COLOR
Chinese Crested Black
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
I hereby certify that I have vaccinated this animal in accordance with the company's recommendation
71)111111T ifTTTI1T 7)7111r-1 T TIrlitt7
Signature fir iy. .rn— sed veterinar ng vaccine.
NeilFarri D.V.M.
Hospital,' pe 6
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: Cotton
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 02/01/2014 6 lbs 0 ozs
BREED COLOR
Mix, Pomeranian White
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
I hereby certify that I have vaccinated this animal in accordance with the company's recommendation
for the vaccine used t the above date.
1
,.„
AO All
Signatu e of
NeilFarringto ;„ r
Hospital #16
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: Quick
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 02/01/2011 5 lbs 0 ozs
BREED COLOR
Mix, Pomeranian
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
I hereby certify that I have vaccinated this animal in accordance with the company's recommendation
for the vaccine used on the above da
Agel,
orrg Arture -nsed veterin. rr
NeilFarrin t D.V.M.
Hospital #1 ''56
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: Coco
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 02/01/2009 4 lbs 0 ozs
BREED COLOR
Powder Puff Lt Brn
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
I hereby certify that have vaccinated this animal in accordance with the company's recommendation
for the vaccine us
/ A if
g cure Aficensed veteriir r,,,r tering vaccine.
NeilFarrinii4n, D.V.M.
Hospital; 656
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: Cream
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 0 lbs 0 ozs
BREED COLOR
Chinese Crested Black
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
I hereby certify that I have vaccinated thisAnimal in accordance with the company's recommendation
for the vaccine used on the above date
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: Slick 6/
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 02/01/2011 5 lbs 0 ozs
BREED COLOR
Chinese Crested No Hair
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
I hereby certify that I have vaccinated j17is animal in accordance with the company's recommendation
for the vaccine usi on the above d
AfAlAd
Signature i -nse-d veten
NeilFarri / sty , D.V.M.
Hospital # A56
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: Suga
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 02/01/2008 6 lbs 0 ozs
BREED COLOR
Chinese Crested Black
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
I hereby certify that I have vaccinated this animal in accordance with the company's recommendation
for the vaccine usedAn the aboveda
• II 411, -/ A
Signatre offir sad vete" f
NeilFarrin D.V.M. /
Hospital
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: Solo
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 02/01/2011 4 lbs 0 ozs
BREED COLOR
Mix, Pomeranian White
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
I hereby certify that I have vaccinated this animal in accordance with the company's recommendation
for the vaccine used ton the above date.
„if/JAI
Sign.fiur 'of 1
NeilFarringt c o,
Hospital #1 56
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: Fuzzy
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 02/01/2014 3 lbs 0 ozs
BREED COLOR
Mix, Pomeranian White
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
I hereby certify that I have vaccinated this animal in accordance with the company's recommendation
for the vaccirh ALI the above date
t[r.rialfi
gnature or f :/ e d veterinar
NeilFarringto V.M.
Hospital #16.
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: Bru
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 02/01/2009 5 lbs 0 ozs
BREED COLOR
Mix, Pomeranian White
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
I hereby certify that I have vaccinated this animal in accordance with the company's recommendation
for the vaccine used the above date.
gnature of ed veterinarian
NeilFarringt v. M.
Hospital #165
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: Smash
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 02/01/2012 5 lbs 0 ozs
BREED COLOR
Mix, Pomeranian White
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
I hereby certify that I have vaccinated this animal in accordance with the company's recommendation
for the vaccine used on the above date.
Sip.% tui-e elk istering vaccine.
NeilFarringto
Hospital #1
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: Diamond
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 02/01/2011 6 lbs 0 ozs
BREED COLOR
Mix, Pomeranian White
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
I hereby certify that I have vaccinated this animal in accordance with the company's recommendation
for the vaccine used on the above date
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: Satan
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 02/01/2009 7 lbs 0 ozs
BREED COLOR
Powder Puff Sable
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
I hereby certify that I have vaccinated this animal in accordance with the company's recommendation
for the vaccine used on the above date.
censed vete, ering vaccine.
on, D.V.M.
1656
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: Flopsi
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 02/01/2013 6 lbs 0 ozs
BREED COLOR
Chinese Crested Black
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
I hereby certify that I have vaccinated this anima) in accordance with the company's recommendation
for the vaccine used on the above date.
Signature of lice ed veterinarian ring vaccine.
NeilFarrington,A .V.M.
Hospital #1656
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: Sally
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9623 (602)
SPECIES SEX AGE WEIGHT
Canine 02/01/2011 5 lbs 0 ozs
BREED COLOR
Chinese Crested White
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
y
I hereby certify that I have vaccinated this anim9{ in accordance with the company's recommendation
for the vaccine used on the above date.
Sigrrattire office sed veterinarian alti;finiffefitf6 vaccine.
Neil Farringto .V.M.
Hospital #1
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: Kookie
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 02/01/2011 0 lbs 0 ozs
BREED COLOR
Chinese Crested Black
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
I hereby certify that I have vaccinated this animal in accordance with the company's recommendation
for the vaccine used on the above date.
Signature oft/
NeilFarringt
Hospital #1
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: Spike
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 02/01/2014 4 lbs 0 ozs
BREED COLOR
Mix, Pomeranian White
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
hereby certify that I have vaccinated this animal in accordance with the company's recommendation
for the vaccine used on the above date.
Signature of lic sed veterinarian
NeilFarringto D,V.M.
Hospital #1
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: Baldy
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 02/01/2014 5 lbs 0 ozs
BREED COLOR
Chinese Crested No Hair
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
I hereby certify that I have vaccinated this animal in accordance with the company's recommendation
for the vaccine used on the above date.
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: Velvet 7-
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 02/01/2013 3 lbs 0 ozs
BREED COLOR
Mix, Pomeranian Red
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
I hereby certify that I have vaccinated this animal in accordance with the company's recommendation
for the vaccine used on the above date.
Signature of
NeilFarringt ,
Hospital #56
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: Jitter Bug /7
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 02/01/2013 4 lbs 0 ozs
BREED COLOR
Chinese Crested No Hair
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
I hereby certify that I have vaccinated this animal in accordance with the company's recommendation
for the vaccine used on the above date.
41 IL
SidnatUre tensed vete adm Ing vaccine.
NeilFarringtr.n, D.V.M.
Hospital # 656
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: Mellow Yellow
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 02/01/2012 3 lbs 0 ozs
BREED COLOR
Mix, Pomeranian Yellow
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
I hereby certify that I have vaccinated this animal in accordance with the company's recommendation
for the vaccine used)on the above dat
Signature f Ii
NeilFarringto ,
Hospital #1
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: April/
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 02/01/2012 6 lbs 0 ozs
BREED COLOR
Mix, Pomeranian
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
I hereby certify that I Fyave vaccinated this animal in accordance with the company's recommendation
for the vaccine used,tn the above date.
Sighature of lir - nsed vetirinarian ad ring vaccine.
NeilFarringt7 , D,V.M.
Hospital # 56
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: Dot
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 02/01/2006 5 lbs 0 ozs
BREED COLOR
Mix, Pomeranian White
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
I hereby certify that I h e vaccinated this animal in accordance with the company's recommendation
for the vaccine used the above date
ler.
- YAr m i
Sjna tire of . / 1 -:sed vetenn ird : nis
NeilFarrington .V.M. /
Hospital #16 - s
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: Blue
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 02/01/2011 5 lbs 0 ozs
BREED COLOR
Mix, Pomeranian White
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
I hereby certify that I have vaccinated this animal in accordance with the company's recommendation
for the vaccine usedion the above date.
AM010111.711,
Signature of nsed veterinarian, ints
NeilFarringtoif,[\I 11
Hospital #1656
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: Ugly Betty /
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 02/01/2012 7 lbs 0 ozs
BREED COLOR
Mix, Pomeranian White
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
I hereby certify that I have vaccinated this animal in accordance with the company's recommendation
for the vaccine used on the above date.
Signatre of lic sed veterinar)o i fadmi r
NeilFarringto D.V.M.
Hospital #1;; 6
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051

RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES TAG NUMBER
03/20/2017 03/19/2020
NAME: E Shabazz PET: Hanna
2529 E Culver St
Phoenix, AZ 85008 TELEPHONE: 220-9523 (602)
SPECIES SEX AGE WEIGHT
Canine 0 lbs 0 ozs
BREED COLOR
Mix, Pomeranian White
Producer: Nobivac
Serial Number: 170031A
Vaccine Type: Killed
Duration: 1095
I hereby certify that I have vaccinated this animal in accordance with the company's recommendation
for the vaccine used on the above date.
Sigrid-tura of lic6n496c1 veterinarian astrninfsfering vaccine.
NeilFarrington, x v. M.
Hospital #165
Catalina Animal Hospital
9023 N 35th Ave
Phoenix, AZ 85051