Extracted text (via tesseract_tsv)
88270 characters
Maricopa County Animal Care and Control
2500 S. 27th Avenue
Phoenix, AZ 85009-6797
(602) 506-7387
http://pets. maricopa.gov
Receipt Number: R17-273137 Receipt Date: 10/25/2017
Person ID: P0829694
Phone: 480 2835048
ERNESTINA PEREZ
10/25/2017 1:10:57PN can.
9009 S CALLE SAHUARO
GUADALUPE, AZ 85283
Item: Animal ID: Reference No: Price: Each: Amount:
KEN PERMIT AT777777 K18-000063 $328.00 4 $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: $0.00
“Contact Us" to email your comments for our review.
Animal Information:
A7777777 KENNEL PERM - BORN 9/14/1999, SPAYED, UNKNOWN/MIX, TRICOLOR DOG
License Information:
Tag Number: License Expires: Animal# Vacc Date: Vacc Expires:
Please retain this receipt with your pet's records
APODACAP EBUSOFF
k #78 - 000062
Maricopa County
Animal Care and Control
2500 South 27th Avenue
Phoenix, AZ 85009
(602) 506-7387 Tele.
(602) 506-2739 Fax
*90/$- 000063
KENNEL PERMIT
APPLICATION
OlNew &f
Renewal
Name: Lonishinad / phi farpelero Kennel Name: Sam te
Pent ide.
Mailing Address: 204 5. Calle Sehyzre Kennel Address: Sam &
CityvizdaluzNEState: AZ Zip:_So2k 4 City: Some Zip: Same
County Supervisorial District: Aanicepiit?
Sar
Phone: 497) 29 3-52) YY Kennel Phone: q
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
5 1 20 1 3 10 1351 2090 170 39 96.698936 enclosed,
5 1 20 1 3 11 1546 2090 178 31 96.386620 controlled
5 1 20 1 3 12 1746 2097 90 30 97.007530 area,
5 1 20 1 3 13 1862 2088 222 33 96.155144 inaccessible
5 1 20 1 3 14 2105 2090 33 30 96.155144 to
5 1 20 1 3 15 2160 2088 95 32 96.072739 other
4 1 20 1 4 0 229 2136 2021 45 -1
5 1 20 1 4 1 229 2142 149 38 77.501892 animais,
5 1 20 1 4 2 397 2142 29 32 96.905579 in
5 1 20 1 4 3 440 2142 102 32 96.930565 which
5 1 20 1 4 4 556 2150 23 22 96.873299 a
5 1 20 1 4 5 594 2150 122 31 96.483612 person
5 1 20 1 4 6 733 2141 116 39 96.714882 keeps,
5 1 20 1 4 7 867 2141 135 30 96.658730 harbors
5 1 20 1 4 8 1017 2147 37 24 96.609955 or
5 1 20 1 4 9 1068 2139 174 32 96.609955 maintains
5 1 20 1 4 10 1256 2139 62 30 96.615547 five
5 1 20 1 4 11 1332 2147 38 22 96.615547 or
5 1 20 1 4 12 1383 2147 90 22 96.779907 more
5 1 20 1 4 13 1486 2138 89 39 96.623306 dogs
5 1 20 1 4 14 1590 2138 105 31 96.659744 under
5 1 20 1 4 15 1707 2138 176 31 96.353027 controlled
5 1 20 1 4 16 1898 2136 210 32 90.129173 conditions.”
5 1 20 1 4 17 2133 2136 117 30 90.129173 A.R.S.
2 1 21 0 0 0 229 2189 245 40 -1
3 1 21 1 0 0 229 2189 245 40 -1
4 1 21 1 1 0 229 2189 245 40 -1
5 1 21 1 1 1 229 2189 20 40 92.729462 §
5 1 21 1 1 2 265 2189 209 40 85.768867 11-1001(8).
2 1 22 0 0 0 224 2279 2034 186 -1
3 1 22 1 0 0 224 2279 2034 186 -1
4 1 22 1 1 0 227 2279 2025 42 -1
5 1 22 1 1 1 227 2286 49 32 76.621452 An
5 1 22 1 1 2 297 2285 228 36 76.621452 appointment
5 1 22 1 1 3 543 2285 57 31 96.282265 will
5 1 22 1 1 4 615 2285 45 31 95.715302 be
5 1 22 1 1 5 679 2283 189 33 94.848892 scheduled
5 1 22 1 1 6 885 2283 50 32 94.848892 for
5 1 22 1 1 7 949 2282 185 36 95.831818 inspection
5 1 22 1 1 8 1153 2282 40 31 95.831818 of
5 1 22 1 1 9 1207 2282 55 31 96.273941 the
5 1 22 1 1 10 1280 2282 123 31 93.025185 kennel
5 1 22 1 1 11 1417 2280 169 36 95.509880 premises
5 1 22 1 1 12 1604 2280 46 36 95.493446 by
5 1 22 1 1 13 1665 2289 44 23 95.493446 an
5 1 22 1 1 14 1727 2280 129 32 95.971802 Animal
5 1 22 1 1 15 1874 2280 133 32 87.176361 Control
5 1 22 1 1 16 2025 2279 122 33 95.710327 Officer
5 1 22 1 1 17 2162 2286 90 29 96.441582 upon
4 1 22 1 2 0 229 2327 2023 43 -1
5 1 22 1 2 1 229 2333 125 36 92.614433 receipt
5 1 22 1 2 2 366 2333 41 31 97.001961 of
5 1 22 1 2 3 415 2333 65 31 95.926712 this
5 1 22 1 2 4 492 2331 123 33 92.183777 kennel
5 1 22 1 2 5 625 2331 119 36 96.733574 permit
5 1 22 1 2 6 756 2331 194 39 96.542427 application
5 1 22 1 2 7 966 2330 70 33 95.476303 and
5 1 22 1 2 8 1048 2330 65 31 55.448536 fee.
5 1 22 1 2 9 1149 2330 75 31 62.802448 This
5 1 22 1 2 10 1237 2330 122 31 64.755417 kennel
5 1 22 1 2 11 1372 2328 194 41 95.854431 application
5 1 22 1 2 12 1582 2328 152 40 96.338699 properly
5 1 22 1 2 13 1746 2327 168 33 96.508324 executed
5 1 22 1 2 14 1928 2327 70 33 91.671631 and
5 1 22 1 2 15 2010 2336 21 22 91.671631 a
5 1 22 1 2 16 2046 2336 90 31 95.820099 copy
5 1 22 1 2 17 2147 2327 39 31 96.958557 of
5 1 22 1 2 18 2196 2327 56 31 96.515373 the
4 1 22 1 3 0 228 2375 2030 42 -1
5 1 22 1 3 1 228 2381 185 36 79.296898 inspection
5 1 22 1 3 2 439 2381 109 34 79.296898 report
5 1 22 1 3 3 571 2379 58 33 90.008438 will
5 1 22 1 3 4 652 2379 77 33 51.856915 then
5 1 22 1 3 5 756 2379 45 32 51.856915 be
5 1 22 1 3 6 826 2378 182 33 94.683640 forwarded
5 1 22 1 3 7 1033 2378 40 36 95.632599 to,
5 1 22 1 3 8 1102 2378 71 31 72.220940 and
5 1 22 1 3 9 1196 2378 91 31 72.220940 must
5 1 22 1 3 10 1308 2378 45 31 93.614876 be
5 1 22 1 3 11 1378 2376 173 36 96.129440 approved
5 1 22 1 3 12 1574 2376 51 36 96.467010 by,
5 1 22 1 3 13 1655 2376 55 32 95.811493 the
5 1 22 1 3 14 1737 2376 165 35 90.561104 Maricopa
5 1 22 1 3 15 1931 2376 130 35 90.561104 County
5 1 22 1 3 16 2084 2375 111 31 31.796017 Board
5 1 22 1 3 17 2219 2375 39 31 31.796017 of
4 1 22 1 4 0 224 2423 2028 42 -1
5 1 22 1 4 1 224 2429 231 36 87.754501 ‘Supervisors.
5 1 22 1 4 2 489 2429 65 31 87.754501 The
5 1 22 1 4 3 570 2427 122 33 95.918694 kennel
5 1 22 1 4 4 705 2427 117 36 96.040520 permit
5 1 22 1 4 5 834 2427 80 32 94.844612 form
5 1 22 1 4 6 930 2427 57 32 82.280968 will
5 1 22 1 4 7 999 2427 45 32 91.282249 be
5 1 22 1 4 8 1060 2426 80 33 91.282249 sent
5 1 22 1 4 9 1153 2426 32 31 91.469353 to
5 1 22 1 4 10 1199 2433 67 29 93.637398 you
5 1 22 1 4 11 1281 2426 84 31 93.637398 after
5 1 22 1 4 12 1377 2426 158 34 96.522552 approval
5 1 22 1 4 13 1548 2424 71 33 96.571129 and
5 1 22 1 4 14 1632 2424 57 32 96.572433 will
5 1 22 1 4 15 1701 2424 45 32 91.783875 be
5 1 22 1 4 16 1764 2424 84 32 91.783875 valid
5 1 22 1 4 17 1862 2424 49 32 96.905457 for
5 1 22 1 4 18 1922 2432 67 24 96.441948 one
5 1 22 1 4 19 2007 2430 81 29 96.441948 year
5 1 22 1 4 20 2099 2423 79 31 95.469902 from
5 1 22 1 4 21 2196 2423 56 31 95.469902 the
2 1 23 0 0 0 229 2475 521 41 -1
3 1 23 1 0 0 229 2475 521 41 -1
4 1 23 1 1 0 229 2475 521 41 -1
5 1 23 1 1 1 229 2478 77 32 95.950951 date
5 1 23 1 1 2 321 2477 38 31 95.950951 of
5 1 23 1 1 3 366 2477 57 31 96.458687 the
5 1 23 1 1 4 436 2477 139 31 11.082220 Board's
5 1 23 1 1 5 588 2475 162 41 95.601875 approval.
2 1 24 0 0 0 228 2567 1977 172 -1
3 1 24 1 0 0 228 2567 1977 141 -1
4 1 24 1 1 0 228 2567 1904 43 -1
5 1 24 1 1 1 228 2573 123 33 96.248573 NOTE:
5 1 24 1 1 2 376 2573 125 31 96.584572 Failure
5 1 24 1 1 3 516 2573 32 31 96.827621 to
5 1 24 1 1 4 559 2573 100 31 96.966850 show
5 1 24 1 1 5 669 2573 51 31 94.070747 for
5 1 24 1 1 6 729 2580 21 23 94.070747 a
5 1 24 1 1 7 763 2571 188 32 96.282768 scheduled
5 1 24 1 1 8 961 2570 185 40 96.066093 inspection
5 1 24 1 1 9 1161 2570 120 31 96.252007 and/or
5 1 24 1 1 10 1290 2570 110 31 87.613136 failure
5 1 24 1 1 11 1413 2570 38 31 96.515442 of
5 1 24 1 1 12 1458 2570 185 39 96.396767 inspection
5 1 24 1 1 13 1658 2568 58 32 90.709732 will
5 1 24 1 1 14 1728 2568 137 32 96.133530 warrant
5 1 24 1 1 15 1885 2576 10 24 96.133530 a
5 1 24 1 1 16 1911 2567 221 40 96.565147 Subsequent
4 1 24 1 2 0 228 2611 1977 62 -1
5 1 24 1 2 1 228 2621 186 40 92.296097 Inspection
5 1 24 1 2 2 429 2621 120 31 96.932793 Return
5 1 24 1 2 3 562 2619 56 32 95.729088 fee
5 1 24 1 2 4 633 2619 38 32 96.338631 of
5 1 24 1 2 5 678 2618 68 36 96.801041 $49
5 1 24 1 2 6 759 2619 51 32 96.595085 for
5 1 24 1 2 7 819 2619 86 32 96.533188 each
5 1 24 1 2 8 918 2618 179 31 96.197960 additional
5 1 24 1 2 9 1110 2618 71 31 96.969986 visit
5 1 24 1 2 10 1191 2618 36 31 96.938881 at
5 1 24 1 2 11 1237 2618 76 31 96.917953 time
5 1 24 1 2 12 1326 2616 39 32 96.947716 of
5 1 24 1 2 13 1371 2616 192 41 96.142220 inspection.
5 1 24 1 2 14 1592 2616 126 32 96.781044 Failure
5 1 24 1 2 15 1731 2616 39 32 96.775101 of
5 1 24 1 2 16 1776 2611 183 62 96.539162 inspection
5 1 24 1 2 17 1974 2622 80 32 95.839722 may
5 1 24 1 2 18 2064 2615 101 31 96.081390 result
5 1 24 1 2 19 2175 2615 30 31 96.427429 in
4 1 24 1 3 0 228 2660 1941 79 -1
5 1 24 1 3 1 228 2669 110 33 96.594055 denial
5 1 24 1 3 2 349 2669 40 36 96.919090 of
5 1 24 1 3 3 396 2669 56 31 96.770760 the
5 1 24 1 3 4 465 2667 122 33 96.479729 kennel
5 1 24 1 3 5 595 2667 119 71 96.052773 permit
5 1 24 1 3 6 724 2667 70 32 95.887871 and
5 1 24 1 3 7 804 2666 126 40 95.887871 require
5 1 24 1 3 8 943 2666 175 33 96.606834 individual
5 1 24 1 3 9 1107 2666 181 70 43.516277 Hicensing
5 1 24 1 3 10 1300 2666 40 31 96.472183 of
5 1 24 1 3 11 1347 2664 86 33 96.684837 each
5 1 24 1 3 12 1447 2660 56 79 91.372452 dog
5 1 24 1 3 13 1522 2673 18 62 50.593105 t
5 1 24 1 3 14 1528 2664 108 32 96.899193 under
5 1 24 1 3 15 1646 2664 55 32 96.164581 the
5 1 24 1 3 16 1713 2663 186 40 96.349808 provisions
5 1 24 1 3 17 1913 2663 37 31 93.085960 of
5 1 24 1 3 18 1955 2663 117 31 88.670998 A.R.S.
5 1 24 1 3 19 2066 2663 82 70 33.003574 St
5 1 24 1 3 20 2139 2663 30 31 23.388809 1-
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3 1 25 1 0 0 226 2305 2027 26 -1
4 1 25 1 1 0 226 2305 2027 26 -1
5 1 25 1 1 1 226 2305 2027 26 95.000000
2 1 26 0 0 0 226 2363 543 11 -1
3 1 26 1 0 0 226 2363 543 11 -1
4 1 26 1 1 0 226 2363 543 11 -1
5 1 26 1 1 1 226 2363 543 11 95.000000
2 1 27 0 0 0 226 2400 2026 27 -1
3 1 27 1 0 0 226 2400 2026 27 -1
4 1 27 1 1 0 226 2400 2026 27 -1
5 1 27 1 1 1 226 2400 2026 27 95.000000
2 1 28 0 0 0 226 2448 2026 27 -1
3 1 28 1 0 0 226 2448 2026 27 -1
4 1 28 1 1 0 226 2448 2026 27 -1
5 1 28 1 1 1 226 2448 2026 27 95.000000
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3 1 29 1 0 0 460 2835 1558 57 -1
4 1 29 1 1 0 460 2835 1558 57 -1
5 1 29 1 1 1 460 2861 156 31 96.083382 PLEASE
5 1 29 1 1 2 628 2835 181 57 96.626907 ANSWER
5 1 29 1 1 3 819 2859 80 32 96.700294 THE
5 1 29 1 1 4 912 2858 245 33 96.026840 FOLLOWING
5 1 29 1 1 5 1171 2858 235 48 96.268059 QUESTIONS
5 1 29 1 1 6 1416 2858 87 30 96.546341 AND
5 1 29 1 1 7 1518 2856 138 32 88.030540 INITIAL
5 1 29 1 1 8 1670 2856 111 32 88.030540 EACH
5 1 29 1 1 9 1796 2855 222 33 95.614250 RESPONSE
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3 1 30 1 0 0 301 2999 2085 103 -1
4 1 30 1 1 0 301 2999 2054 49 -1
5 1 30 1 1 1 301 3005 206 43 86.285896 application
5 1 30 1 1 2 510 3005 94 31 31.492472 fora
5 1 30 1 1 3 610 3003 128 41 32.096081 permit
5 1 30 1 1 4 739 3003 65 32 32.096081 and
5 1 30 1 1 5 811 3003 223 42 65.875237 understand
5 1 30 1 1 6 1035 3002 93 31 94.253517 ‘that
5 1 30 1 1 7 1130 3002 149 33 68.871735 “kennel”
5 1 30 1 1 8 1288 3009 121 24 93.234146 means
5 1 30 1 1 9 1425 3000 532 44 42.822960 an-enclosed;-controlled-area;
5 1 30 1 1 10 1970 2999 239 43 94.173538 inaccessible
5 1 30 1 1 11 2214 2999 121 42 0.000000 to
5 1 30 1 1 12 2345 3008 41 3 60.813511 ~~
4 1 30 1 2 0 1737 3080 17 22 -1
5 1 30 1 2 1 1737 3080 17 22 69.407303 &
2 1 31 0 0 0 2542 1917 8 1376 -1
3 1 31 1 0 0 2542 1917 8 1376 -1
4 1 31 1 1 0 2542 1917 8 1376 -1
5 1 31 1 1 1 2542 1917 8 1376 95.000000
4008.
oh £ ER We assume complete responsibility for the kennel at the premises for which Ave are ‘making
other animals, in which a person keeps, harbors or maintains five or more dogs under controlled
conditions (ARS 11-1001).
2. EVP We certify that I/We have / © dogs and that the kennel meets the definition in statute.
3.£ We certify that I/We have not been convicted of a violation of A.R.S. §§ 13-2910 (cruelty fo 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. Ef \We 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. ZA | We certify that We are submitting a valid copy of the rabies vaccination certificate for each
dog with this application.
6. En 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. ZN. \AVe 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.
ye
8. £ i 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. EP 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.
WWe certify that all of the information We have provided is true and accurate under penalty of law.
Applicant Signature Date:__“% “ia L) WA
Applicant Signaturez/744/% Lf WR ip 2 Date: LoLid L477
- C7 v
2
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 & Control
2500 South 27" Avenue
Phoenix, AZ 85009
Phone: (602) 506-7387
pets.maricopa.gov
KENNEL PERMIT K18-000063
PREMISE INSPECTION
Number of Dogs: 16
Name: Ernestina Perez Kennel Name: Perez Kennels
Mailing Address: 9009 S Calle Sahuaro Kennel Address: Same
City: Guadalupe State: AZ Zip: 85283 City: Buckeye Zip: 85283
County Supervisorial District: 5
Phone: 480-283-5048 Kennel Phone: 480-283-5048
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 N/A DAYS GIVEN
BEFORE REINSPECTION. (Note: There will be $49 re-inspect fee payable to the
Inspector by check upon each return visit.)
NONE
Deputy Enforcement Agent & Badge #: Lt Timothy Rummel Date: 11/3/17
October 2015
Month 2 | DAFR Other cat Dog — PRINT Month => Month Zz DATE Other cat Dog PRINT Owner’s ;
VAC0410001 Month (Specify) SPECIES: Owner's VAC0410001 (Specity) SPECIES:
(J OO is VACCINATION -— OJ a
\ | LAST \7 [ ; GooF LAST Name
Day VAGCINATIOp.EXPIRES: “Day VACCINATED: Name Day Day qa VACCINATED:
{ G 900F"S & _ &
{ Altered Female Male SEX: Ree EXPIRES: AF ’ Altered Female Male SEX: Address
Year 70) ‘Year . Address Year 2) Year ~S
“| kerez.
|
3 AL [| &) Zz yr. 3 1 PR A 27)
yr. |" yr.
PRODUCER: 12 3 AGE: FIRST Lic COE Lic. ODUCER 3 FIRST
Lic.Vacc. “e/ACe Mo. Mo. Calle Mace. (]|12Mo.orolder Mo. Calle
or to RABIES ace. : to RABIES
mK a 12 eR 0 12
- older
Vacc. 4 (First > Mo. Vacc. (First Cirst iS i Mo.
is c 3 PRINT ADAPTED 3 PRINT ADAPTED
Serial OL = C]| - Serial 7” aig [1] -
OY Letters) p — Schovo use . Letters) Shige use VACCINATION
(Lot) ‘ Over Under SIZE: ball VACCINATION (Lot) Over (MN20-sotbs Under SIZE: ball
No. 2: . 50 20-50ibs NASPHV No. 50 NASPHV
3 20 point 20 point
Ibs. Ibs. vw Ibs. Ibs.
Y. pen pen
| [1] OL $+ or FORM [1] £1 or FORM
type -) 0) (CAC type
. Address Signature Cx . NAME: Ae 51 CERTIFICATE Address Signature NAME: Goada 51 CERTIFICATE
Veterinarian’s Veterinarian’s “PREDOMINANT Veterinarian’s Veterinarian’s PREDOMINANT
WAEZLAN (uadohpe, MI CLGie Wer MI
yveet :
- # es
ce pe
SHE License BREED: #__. S BHEED:
J = LicenseNo. col
i i No, | ESS *. BA, . |"
Ko = / f L “ Cert. Tag Tag | { A Lj Cert. Tag Tag
<)} COLORS: 430-2 TELEPHONE #: fee ce J fl 7 x +7 COLORS: % TELEPHONE #: fee
85233 Serial $: | = A Serial $:
Ss — K #: “ S52F3 #:
32 -Z85
375
IS
--50Y% 566
RABIES VACCINATION CERTIFICATE Tag fee $:
ADAPTED NASPHV FORM 57 Tag #:
Owner’s Name & Address PRINT - use ball point pen or type Cert. Serial #:
PRINT LAST FIRST. MI GHZ 504
tere = 33
Sohoao. Gudi TE |e Pee S IG2
“OOF S Calle S
SPEGIES: SEX: _ | AGE: SIZE: PREDOMINANT BR ep: COLORS:
Dog Male A 3 Mo. to 12 Mo. (| Under 20 Ibs. TGNNe (~ iD
Cat O Female (| 12 Mo. or older xl 20 - 50 Ibs —
Other C1 Altered tA Over 50 tbs. Co) NAME: Waa tv
(Specify) Piude
D. VACCINATED: PRODUCER: Veterinarlan’s q # SOY
a" \Y License we
Day Year (First Ess 3 Letters) Veterinarian’s
| é.
4 yr. Lic. Vace. I Signature WAY
eG 3 yr. Lic. Maco) Address
Q Al : Awhes 85
Day! Year
Vacc. Serial (Lot) No.
VAC0410001
PRINT Owner’s
LAST Name
&
Address
Perez
FIRST--~
RABIES
PRINT ADAPTED
-
use VACCINATION
ball
point NASPHV
pen
or FORM
type
51 CERTIFICATE
5 1 5 1 2 3 2223 1387 53 224 34.429955 46233
5 1 5 1 2 4 2210 1639 70 118 57.997734 569%
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3 1 6 1 0 0 2210 23 30 1744 -1
4 1 6 1 1 0 2210 23 30 1744 -1
5 1 6 1 1 1 2210 23 30 1744 95.000000
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3 1 7 1 0 0 2124 447 83 1193 -1
4 1 7 1 1 0 2124 447 83 1193 -1
5 1 7 1 1 1 2129 447 76 150 91.002716 Calle
5 1 7 1 1 2 2127 636 80 291 13.177977 Sahcanm
5 1 7 1 1 3 2124 993 80 341 0.680075 Gvadeglope
5 1 7 1 1 4 2124 1392 78 248 37.548859 85233
2 1 8 0 0 0 2112 24 29 1743 -1
3 1 8 1 0 0 2112 24 29 1743 -1
4 1 8 1 1 0 2112 24 29 1743 -1
5 1 8 1 1 1 2112 24 29 1743 95.000000
2 1 9 0 0 0 1926 245 204 5 -1
3 1 9 1 0 0 1926 245 204 5 -1
4 1 9 1 1 0 1926 245 204 5 -1
5 1 9 1 1 1 1926 245 204 5 95.000000
2 1 10 0 0 0 2090 259 22 61 -1
3 1 10 1 0 0 2090 259 22 61 -1
4 1 10 1 1 0 2090 259 22 61 -1
5 1 10 1 1 1 2090 259 22 61 95.773140 SEX:
2 1 11 0 0 0 2009 1391 6 351 -1
3 1 11 1 0 0 2009 1391 6 351 -1
4 1 11 1 1 0 2009 1391 6 351 -1
5 1 11 1 1 1 2009 1391 6 351 95.000000
2 1 12 0 0 0 1989 1036 8 341 -1
3 1 12 1 0 0 1989 1036 8 341 -1
4 1 12 1 1 0 1989 1036 8 341 -1
5 1 12 1 1 1 1989 1036 8 341 95.000000
2 1 13 0 0 0 1923 785 244 4 -1
3 1 13 1 0 0 1923 785 244 4 -1
4 1 13 1 1 0 1923 785 244 4 -1
5 1 13 1 1 1 1923 785 244 4 95.000000
2 1 14 0 0 0 1924 467 205 4 -1
3 1 14 1 0 0 1924 467 205 4 -1
4 1 14 1 1 0 1924 467 205 4 -1
5 1 14 1 1 1 1924 467 205 4 95.000000
2 1 15 0 0 0 1918 243 16 797 -1
3 1 15 1 0 0 1918 243 16 797 -1
4 1 15 1 1 0 1918 243 16 797 -1
5 1 15 1 1 1 1918 243 16 797 95.000000
2 1 16 0 0 0 1899 1390 8 353 -1
3 1 16 1 0 0 1899 1390 8 353 -1
4 1 16 1 1 0 1899 1390 8 353 -1
5 1 16 1 1 1 1899 1390 8 353 95.000000
2 1 17 0 0 0 1843 1376 478 4 -1
3 1 17 1 0 0 1843 1376 478 4 -1
4 1 17 1 1 0 1843 1376 478 4 -1
5 1 17 1 1 1 1843 1376 478 4 95.000000
2 1 18 0 0 0 1836 25 29 1745 -1
3 1 18 1 0 0 1836 25 29 1745 -1
4 1 18 1 1 0 1836 25 29 1745 -1
5 1 18 1 1 1 1836 25 29 1745 95.000000
2 1 19 0 0 0 1732 27 9 372 -1
3 1 19 1 0 0 1732 27 9 372 -1
4 1 19 1 1 0 1732 27 9 372 -1
5 1 19 1 1 1 1732 27 9 372 95.000000
2 1 20 0 0 0 1528 27 9 373 -1
3 1 20 1 0 0 1528 27 9 373 -1
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3 1 75 1 0 0 2016 2606 243 64 -1
4 1 75 1 1 0 2016 2606 243 64 -1
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3 1 79 1 0 0 2138 2080 364 80 -1
4 1 79 1 1 0 2138 2080 364 80 -1
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3 1 80 1 0 0 2146 1914 127 30 -1
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3 1 81 1 0 0 2136 1962 186 69 -1
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5 1 81 1 2 1 2136 2007 74 24 82.692993 ‘Cert,
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3 1 95 1 0 0 1847 2217 232 176 -1
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3 1 96 1 0 0 1749 2411 149 30 -1
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5 1 99 1 4 1 1812 2753 123 28 96.376488 Signature
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4 1 103 1 1 0 1402 2906 272 30 -1
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3 1 110 1 0 0 1462 2226 41 39 -1
4 1 110 1 1 0 1462 2226 41 39 -1
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4 1 111 1 1 0 1180 2321 599 31 -1
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5 1 111 1 1 6 1420 2328 47 23 95.907761 Mo.
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3 1 115 1 0 0 1402 2888 338 4 -1
4 1 115 1 1 0 1402 2888 338 4 -1
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3 1 116 1 0 0 1414 2591 173 3 -1
4 1 116 1 1 0 1414 2591 173 3 -1
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3 1 119 1 0 0 1375 2837 335 57 -1
4 1 119 1 1 0 1375 2837 335 57 -1
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3 1 120 1 0 0 1275 1911 731 36 -1
4 1 120 1 1 0 1275 1911 731 36 -1
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4 1 121 1 1 0 1222 2086 79 23 -1
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3 1 124 1 0 0 1173 2738 221 34 -1
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4 1 135 1 1 0 892 2372 29 27 -1
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4 1 141 1 1 0 799 2285 127 24 -1
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4 1 145 1 1 0 781 1881 1721 15 -1
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Cert, Tag Tag
TELEPHONE #: fee
Serial $:
#:
; a > _
?
4362335698) $5283 B5I83 A ‘4
$: —
fee #: COLORS: 7 7 K
Tag Tag No. i eS
|
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4 1 97 1 3 0 1431 2029 401 25 -1
5 1 97 1 3 1 1431 2031 75 20 93.069603 PRINT
5 1 97 1 3 2 1513 2040 8 5 92.867950 -
5 1 97 1 3 3 1530 2035 42 14 96.010681 use
5 1 97 1 3 4 1581 2029 41 20 90.656921 bail
5 1 97 1 3 5 1629 2029 60 25 96.509331 point
5 1 97 1 3 6 1698 2034 42 20 96.970055 pen
5 1 97 1 3 7 1749 2034 24 14 96.632538 or
5 1 97 1 3 8 1780 2029 52 23 96.750465 type
2 1 98 0 0 0 1741 2418 169 426 -1
3 1 98 1 0 0 1741 2418 169 426 -1
4 1 98 1 1 0 1741 2418 149 30 -1
5 1 98 1 1 1 1741 2418 29 30 13.014126 (CC)
5 1 98 1 1 2 1784 2414 10 38 31.618547 |
5 1 98 1 1 3 1801 2418 89 23 95.672745 NAME:
4 1 98 1 2 0 1801 2822 109 22 -1
5 1 98 1 2 1 1801 2822 109 22 95.725937 Address
2 1 99 0 0 0 1801 2271 289 518 -1
3 1 99 1 0 0 1801 2271 289 518 -1
4 1 99 1 1 0 1801 2271 289 39 -1
5 1 99 1 1 1 1801 2286 190 24 96.336639 PREDOMINANT
5 1 99 1 1 2 1998 2271 92 38 96.336639 BREED:
4 1 99 1 2 0 1803 2762 123 27 -1
5 1 99 1 2 1 1803 2762 123 27 96.457932 Signature
2 1 100 0 0 0 1802 2089 174 634 -1
3 1 100 1 0 0 1802 2089 174 634 -1
4 1 100 1 1 0 1911 2089 29 23 -1
5 1 100 1 1 1 1911 2089 29 23 92.034981 MI
4 1 100 1 2 0 1802 2699 174 24 -1
5 1 100 1 2 1 1802 2699 174 24 90.621376 Veterinarian’s
2 1 101 0 0 0 1945 2342 19 52 -1
3 1 101 1 0 0 1945 2342 19 52 -1
4 1 101 1 1 0 1945 2342 19 52 -1
5 1 101 1 1 1 1945 2342 19 52 0.000000 n
2 1 102 0 0 0 1960 2349 7 17 -1
3 1 102 1 0 0 1960 2349 7 17 -1
4 1 102 1 1 0 1960 2349 7 17 -1
5 1 102 1 1 1 1960 2349 7 17 0.000000 \
2 1 103 0 0 0 2001 2861 87 55 -1
3 1 103 1 0 0 2001 2861 87 55 -1
4 1 103 1 1 0 2001 2861 87 55 -1
5 1 103 1 1 1 2001 2861 87 55 24.425549 L/@:
2 1 104 0 0 0 1782 2399 342 4 -1
3 1 104 1 0 0 1782 2399 342 4 -1
4 1 104 1 1 0 1782 2399 342 4 -1
5 1 104 1 1 1 1782 2399 342 4 95.000000
2 1 105 0 0 0 2116 2070 7 477 -1
3 1 105 1 0 0 2116 2070 7 477 -1
4 1 105 1 1 0 2116 2070 7 477 -1
5 1 105 1 1 1 2116 2070 7 477 95.000000
2 1 106 0 0 0 2007 2613 150 23 -1
3 1 106 1 0 0 2007 2613 150 23 -1
4 1 106 1 1 0 2007 2613 150 23 -1
5 1 106 1 1 1 2007 2615 98 21 96.227295 License
5 1 106 1 1 2 2113 2613 44 23 95.860817 No.
2 1 107 0 0 0 2139 1971 77 27 -1
3 1 107 1 0 0 2139 1971 77 27 -1
4 1 107 1 1 0 2139 1971 77 27 -1
5 1 107 1 1 1 2139 1971 45 27 93.210197 Tag
5 1 107 1 1 2 2195 1971 21 21 93.078064 #:
2 1 108 0 0 0 2139 1922 126 31 -1
3 1 108 1 0 0 2139 1922 126 31 -1
4 1 108 1 1 0 2139 1922 126 31 -1
5 1 108 1 1 1 2139 1924 45 29 96.871918 Tag
5 1 108 1 1 2 2195 1924 37 23 92.170021 fee
5 1 108 1 1 3 2243 1922 22 27 92.170021 $:
2 1 109 0 0 0 1801 2549 460 67 -1
3 1 109 1 0 0 1801 2549 460 67 -1
4 1 109 1 1 0 1801 2549 460 67 -1
5 1 109 1 1 1 1801 2579 172 37 65.313972 Veterinarian’s
5 1 109 1 1 2 1985 2583 15 23 93.195076 #
5 1 109 1 1 3 2046 2555 102 51 0.000000 Sc
5 1 109 1 1 4 2163 2559 30 45 78.830612 4
5 1 109 1 1 5 2216 2552 25 51 66.400414 [
5 1 109 1 1 6 2243 2549 18 54 34.178650 }
2 1 110 0 0 0 2139 2285 126 22 -1
3 1 110 1 0 0 2139 2285 126 22 -1
4 1 110 1 1 0 2139 2285 126 22 -1
5 1 110 1 1 1 2139 2285 126 22 95.832809 COLORS:
2 1 111 0 0 0 2140 2016 175 23 -1
3 1 111 1 0 0 2140 2016 175 23 -1
4 1 111 1 1 0 2140 2016 175 23 -1
5 1 111 1 1 1 2140 2016 62 23 76.534836 Gert.
5 1 111 1 1 2 2213 2016 70 23 93.038216 Serial
5 1 111 1 1 3 2294 2016 21 21 93.038216 #:
2 1 112 0 0 0 1915 2900 568 6 -1
3 1 112 1 0 0 1915 2900 568 6 -1
4 1 112 1 1 0 1915 2900 568 6 -1
5 1 112 1 1 1 1915 2900 568 6 95.000000
2 1 113 0 0 0 1917 2840 567 6 -1
3 1 113 1 0 0 1917 2840 567 6 -1
4 1 113 1 1 0 1917 2840 567 6 -1
5 1 113 1 1 1 1917 2840 567 6 95.000000
2 1 114 0 0 0 1935 2780 552 6 -1
3 1 114 1 0 0 1935 2780 552 6 -1
4 1 114 1 1 0 1935 2780 552 6 -1
5 1 114 1 1 1 1935 2780 552 6 95.000000
2 1 115 0 0 0 2008 2602 481 6 -1
3 1 115 1 0 0 2008 2602 481 6 -1
4 1 115 1 1 0 2008 2602 481 6 -1
5 1 115 1 1 1 2008 2602 481 6 95.000000
2 1 116 0 0 0 2137 2484 350 7 -1
3 1 116 1 0 0 2137 2484 350 7 -1
4 1 116 1 1 0 2137 2484 350 7 -1
5 1 116 1 1 1 2137 2484 350 7 95.000000
2 1 117 0 0 0 2137 2375 350 6 -1
3 1 117 1 0 0 2137 2375 350 6 -1
4 1 117 1 1 0 2137 2375 350 6 -1
5 1 117 1 1 1 2137 2375 350 6 95.000000
2 1 118 0 0 0 774 2974 1728 12 -1
3 1 118 1 0 0 774 2974 1728 12 -1
4 1 118 1 1 0 774 2974 1728 12 -1
5 1 118 1 1 1 774 2974 1728 12 95.000000
2 1 119 0 0 0 774 2542 1726 11 -1
3 1 119 1 0 0 774 2542 1726 11 -1
4 1 119 1 1 0 774 2542 1726 11 -1
5 1 119 1 1 1 774 2542 1726 11 95.000000
2 1 120 0 0 0 774 2265 1726 12 -1
3 1 120 1 0 0 774 2265 1726 12 -1
4 1 120 1 1 0 774 2265 1726 12 -1
5 1 120 1 1 1 774 2265 1726 12 95.000000
2 1 121 0 0 0 774 2165 1726 13 -1
3 1 121 1 0 0 774 2165 1726 13 -1
4 1 121 1 1 0 774 2165 1726 13 -1
5 1 121 1 1 1 774 2165 1726 13 95.000000
2 1 122 0 0 0 774 2066 1726 13 -1
3 1 122 1 0 0 774 2066 1726 13 -1
4 1 122 1 1 0 774 2066 1726 13 -1
5 1 122 1 1 1 774 2066 1726 13 95.000000
2 1 123 0 0 0 774 1886 1726 13 -1
3 1 123 1 0 0 774 1886 1726 13 -1
4 1 123 1 1 0 774 1886 1726 13 -1
5 1 123 1 1 1 774 1886 1726 13 95.000000
2 1 124 0 0 0 1783 2677 717 7 -1
3 1 124 1 0 0 1783 2677 717 7 -1
4 1 124 1 1 0 1783 2677 717 7 -1
5 1 124 1 1 1 1783 2677 717 7 95.000000
2 1 125 0 0 0 66 29 1088 12 -1
3 1 125 1 0 0 66 29 1088 12 -1
4 1 125 1 1 0 66 29 1088 12 -1
5 1 125 1 1 1 66 29 1088 12 95.000000
2 1 126 0 0 0 66 29 1088 12 -1
3 1 126 1 0 0 66 29 1088 12 -1
4 1 126 1 1 0 66 29 1088 12 -1
5 1 126 1 1 1 66 29 1088 12 95.000000
2 1 127 0 0 0 832 31 322 4 -1
3 1 127 1 0 0 832 31 322 4 -1
4 1 127 1 1 0 832 31 322 4 -1
5 1 127 1 1 1 832 31 322 4 95.000000
2 1 128 0 0 0 832 29 322 5 -1
3 1 128 1 0 0 832 29 322 5 -1
4 1 128 1 1 0 832 29 322 5 -1
5 1 128 1 1 1 832 29 322 5 95.000000
2 1 129 0 0 0 1343 37 16 1744 -1
3 1 129 1 0 0 1343 37 16 1744 -1
4 1 129 1 1 0 1343 37 16 1744 -1
5 1 129 1 1 1 1343 37 16 1744 95.000000
2 1 130 0 0 0 1379 286 90 998 -1
3 1 130 1 0 0 1379 286 90 998 -1
4 1 130 1 1 0 1379 286 36 998 -1
5 1 130 1 1 1 1383 1132 32 152 96.129272 RABIES
5 1 130 1 1 2 1381 837 32 285 95.879158 VACCINATION
5 1 130 1 1 3 1379 553 33 271 95.711563 CERTIFICATE
5 1 130 1 1 4 1384 366 29 45 96.880287 Tag
5 1 130 1 1 5 1384 316 23 41 93.208061 fee
5 1 130 1 1 6 1382 286 27 23 93.074585 $:
4 1 130 1 2 0 1430 333 39 840 -1
5 1 130 1 2 1 1438 1000 31 173 93.203857 ADAPTED
5 1 130 1 2 2 1438 835 29 154 90.641762 NASPHV
5 1 130 1 2 3 1437 718 30 110 96.261421 FORM
5 1 130 1 2 4 1437 672 29 36 63.657269 51
5 1 130 1 2 5 1430 366 28 45 93.058304 Tag
5 1 130 1 2 6 1431 333 21 23 87.608261 #:
2 1 131 0 0 0 1474 234 50 1526 -1
3 1 131 1 0 0 1474 234 50 1526 -1
4 1 131 1 1 0 1474 234 50 1526 -1
5 1 131 1 1 1 1501 1654 23 106 89.738403 Owner’s
5 1 131 1 1 2 1501 1569 22 75 93.282593 Name
5 1 131 1 1 3 1500 1542 23 18 93.121140 &
5 1 131 1 1 4 1500 1428 23 107 95.935165 Address
5 1 131 1 1 5 1491 1042 18 76 92.991516 PRINT
5 1 131 1 1 6 1500 1026 3 9 90.703171 -
5 1 131 1 1 7 1495 976 14 43 96.970993 use
5 1 131 1 1 8 1489 927 20 42 75.788002 ball
5 1 131 1 1 9 1489 858 23 62 96.588898 point
5 1 131 1 1 10 1494 808 18 44 95.605293 pen
5 1 131 1 1 11 1494 775 14 25 95.564560 or
5 1 131 1 1 12 1489 717 23 53 96.891182 type
5 1 131 1 1 13 1476 348 23 60 96.752502 Cert.
5 1 131 1 1 14 1474 266 23 72 93.216553 Serial
5 1 131 1 1 15 1475 234 22 23 93.216553 #:
2 1 132 0 0 0 1542 37 193 1721 -1
3 1 132 1 0 0 1542 37 193 1721 -1
4 1 132 1 1 0 1542 37 94 1721 -1
5 1 132 1 1 1 1557 1674 24 84 96.726158 PRINT
5 1 132 1 1 2 1557 1596 23 69 96.822227 LAST
5 1 132 1 1 3 1543 1256 91 310 9.732332 ‘oe
5 1 132 1 1 4 1549 609 23 29 18.268337 m
5 1 132 1 1 5 1548 357 79 57 21.578112 Ti
5 1 132 1 1 6 1542 37 94 248 23.739086 293.5078'
4 1 132 1 2 0 1645 126 90 1631 -1
5 1 132 1 2 1 1654 1460 81 297 19.594679 “Q0sG S LAK —
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5 1 5 1 1 6 2203 1584 70 178 0.000000 3-50%
4 1 5 1 2 0 2083 84 121 1553 -1
5 1 5 1 2 1 2126 84 63 149 72.212868 G60
5 1 5 1 2 2 2083 249 121 69 24.463110 q
5 1 5 1 2 3 2124 360 68 57 92.192482 S
5 1 5 1 2 4 2121 496 77 163 91.168869 Calle
5 1 5 1 2 5 2118 705 81 285 76.549477 Schvam
5 1 5 1 2 6 2106 1048 90 299 19.979115 Guedalupe
5 1 5 1 2 7 2104 1390 91 247 24.575752 85283 7s
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5 1 40 1 17 1 1596 91 18 32 70.233414 er
5 1 40 1 17 2 1585 235 23 31 60.796177 ad
5 1 40 1 17 3 1587 346 18 41 66.452759 “ar
5 1 40 1 17 4 1558 664 29 62 93.907890 (First
5 1 40 1 17 5 1561 735 23 15 90.182037 3
5 1 40 1 17 6 1552 760 31 97 95.146957 Letters)
5 1 40 1 17 7 1530 1069 29 173 92.922516 Veterinarian’s
5 1 40 1 17 8 1448 1461 180 90 73.107445 Z
4 1 40 1 18 0 1431 54 102 1377 -1
5 1 40 1 18 1 1491 54 29 188 93.305473 VACCINATION
5 1 40 1 18 2 1486 252 26 125 40.385357 ExPiREs:
5 1 40 1 18 3 1479 400 52 19 79.402649 |
5 1 40 1 18 4 1479 431 52 9 26.303009 |
5 1 40 1 18 5 1467 504 57 21 0.000000 e
5 1 40 1 18 6 1503 560 30 91 64.883095 aco.
5 1 40 1 18 7 1470 1068 29 123 96.747856 Signature
5 1 40 1 18 8 1431 1350 74 81 36.123428 = A 7 Mo.
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