NO PAWS LEFT BEHIND.PDF

Maricopa County Animal Care and Control
2500 S. 27th Avenue
Phoenix, AZ 85009-6797
(602) 506-7387
http://pets.maricopa.gov
Receipt Number: R17-053729 Receipt Date: 02125/2017
Person ID: P1233846
Phone: 623 7347250
NO PAWS LEFT BEHIND KENNELS 2/25/2017 11:30:30AM
19926 W COLTER ST
LITCHFIELD PARK, AZ 85340
Item: Animal ID: Reference No: Price: Each: Amount:
KEN PERMIT $328.00 1 $328.00
Total Fees Due: $328.00
Payments: Cash: $328.00
Check:
Credit Card: $0.00
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.
ho/gums WBUSOFF

Maricopa County
Animal Care And Control
2600 South 27th Avenue
Phoenix, AZ 86009
(602) 606-7387 Tele.
(602) 506-2739 Fax
KENNEL PERMIT APPLICATION
New i Renewal Permit #4‹ a )a-0 I
Nam I lAn Q_Orl- Kennel Name: NO Poto, Lep- 'agil i
Mailing Address: / 9 9,,,) (., if , 6_,$/i-?,e-d-Y- Kennel Location: it411—e._
City TIC/14,74";4/ 194g0 (TS,1 VC County Supervisorial District 11
Home Phone: a-3 73 V -7.„4-T0 Kennel Phone: 3
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.
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. 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. I/We assume complete responsibility for the kennel at the premises for which I/we are making
appli ation 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. IS I/We certify that INVe have dogs and that the kennel meets the definition in statute.
3. 164/ 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. )9 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. n I NVe certify that INVe are submitting a valid copy of the rabies vaccination certificate for each
dog With this application.
6. (IfI/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. 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. V \IC I/We 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. \j\lk 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.
INVe certify that all of th lqifiormation INVe have provided is true and accurate under penalty of law.
Applicant Signature Date:
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
BOS Approval Date Term of Permit
2 of2

Maricopa County
Animal Care & Control
2500 South 27th Avenue
Phoenix, AZ 85009
Phone: (602) 506-7387
pets.maricopa.gov
KENNEL PERMIT K18-000061
PREMISE INSPECTION
Number of Dogs: a 7
Name: Kim PO4Gr Kennel Name: No Paws Left Behind
Mailing Address: 19926 W Colter St Kennel Address: Same
City: Litchfield Park State: AZ Zip: 85340 City: Litchfield Park Zip: 85340
County Supervisorial District: 4
Phone: 623-734-7250 Kennel Phone: 623-734-7250
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: 03/07/17
October 2015

VACCINATION RECORD
RABIES VACCINATION CERTIFICATE Tag fee $:
Name
ADAPTED NASPHV FORM 51 Tag #:
Owner's Name &Address PRINT - use ball point pen or type Cert. Serial #: Li RABIES
o LYME DISEASE
PRINT,I4ST ., _ FIRST MI TELEPHONE
'7.%...t LI CANINE DISTEMPER
12, V\Vitgere-44
Np. . STREET ., i CITY i ill-CIA4“LiSTATE4 ZIP D CANINE PARAINFLUENZA
iq ci 1 ,c). LS I . Cut 4,er iic3q0 IA CANINE ADENOVIRUS 2
SPECIES: SEX: AGE: SIZE: PREDOMINANT BREED: COLORS: 0 CANINE PARVOVIRUS
Dog E Male IT 3 Mo. to 12 Mo. U Under 20 lbs. U 1 A I N. CI CANINE CORONAVIRUS
Cat D Female IC 12 Mo. or older .4 20 - 50 lbs r Ur i' , 0 CANINE BORDETELLA
Other LI Altered gi Over 60 lbs. U NAME: o
LEPTOSPIROSIS
(Specify) < 11(
A40 ( ft3 0 FELINE LEUKEMIA VIRUS
DATE VACCINATED: PRODUCER: D FELINE PANLEUKOPENIA
Veterinarian's # -.• _.5
0 Lice, e No. LI FELINE RHINOTRACHEITIS
Month Day Year (First 3 Letters) 6- ,,,„. 0 FELINE CALICIVIRUS
1 Veterinarian's . - D FELINE CHLAMYDIA
yr. Lic.Nacc. N signature
VACCINATION EXPIRES: D FELINE IMMUNODEFICIENCY
3 yr. Lic.Nacc. D Address 1 1 VIRUS
10 'Is '' k ") kAk&d.1\ 7.24
Month Day Year V
Vacc. Serial (Lot) No. Boehringer
VOIV Ingelheim
VAC0410001

71=1'8 COPY RABIES VACCINATION CERTIFICATE
NASPHV Form #51 Rabies Tag Number
:r b Name and Address , Print - use ball point pen or type
..RINT - Last First Mi. Telephone
CD C'V if),
No. ) C ette00 .ity A (-". Statet A Zip,,,,
U ' C C) ,4 S.A.- (,-- fr,I(\3,-*,e0, , 1--- 615-3(i
Species: Sex: Age: Size: Predominant Breed: Colors:
Dog Male 3 mo to 12 mo Under 20 lbs.
Cat Female 12 mo or older 20 - 50 lbs. El Asan
Other: 0 Neutered Actual Age' Over 50 lbs. 0
(Specify) Actual lbs. Name:
1 COA O.
DATE VACCINATED: Producer: 2_ 0 c Veterinarian's: #
(Licensio. ----"I (—}
(First 3 letters)
--1_ le
Month Day yr. Lic./Vacc. (Signature) ,
3 yr. LIc./Vacc. Address:
VACCINATION EXPIRED: Other nu,,,,,,, k. 6..)....barl- tA1.1
.45- e,:j_ _p_ __ CI i 09 9716 E. Cholla St.
!Month Day Year / Vac. oerial (lot) no. Scottsdale, AZ 85260
I•I
tom?
Ci or\ av
k c
.vb 311601
Name: Number.
V1
Doctor's License
v.) a

RABIES VACCINATION CERTIFICATE
NASPI-14/ Form 451
lame and Address Print - use ball point pen or type
PRINT - Last First lj
or Ar A II ALM. ; .
• treat ' tY /7A°
F- - -I- I 7
Species: Sex: Age: Size: Predominant e
Dog Male 3 mato 12 m Under 20 lbs. G71 L } 4 C ( r r)
Cat 0 Female 12 mo or older 20 - 50 lbs. 0
Other: 0 Neuterec<jJ Actual Age_ Over 50 lbs. El
(Specify) Actual_lbs Narrig:
i<
DATE VACCINATED: Producer: Z 61 E Veterinarian's: # (License 35-'3 No I
(First 3 letters)
. onth .( 4 7 1-4e, 1 yr. Lic./Vacc.
Address -
0 3 yr. Lic./Vacc. C)1.1.-1.4A, k. 4-t.1/4-13aci -'t \Joel
VACCINATION EXPIRED: Other
9716 E. Cholla St
//i77(9_c? Scottsdale, AZ 88280
o nt h clarly— Ye' r Vadc. Serial (lot) no.
Certificate
Sterilization
Name:
1
'a; Doc'for's

VACCINATION RECORD
RABIES VACCINATION CERTIFICATE Tag fee $:
Name
ADAPTED NASPHV FORM 51 Tag it'
Owner's Name & Address PRINT - use ball point pen or type Cert. Serial #: D RABIES
C LYME DISEASE
I RST A MI TELEPHONE
CANINE DISTEMPER
1 ile\13 Ct- ,...
isz, El CANINE PARAINFLUENZA
ppr),ieSTREU 3
T--s3 v3 0 CANINE ADENOVIRUS 2
s (1-/o I k9.'- C- T* /
SPECIES: SEX: AGE: SIZE: PREDOMINANT BREED: COLORS: az CANINE PARVOVIRUS
Dog (19C-- Male 0 3 Mo. to 12 Mo. E Under 20 lbs. (0 0 CANINE CORONAVIRUS
Cat o Female , 12 Mo. or older ,.1K-20 - 50 lbs Iii 11-441Lit 1 glifkIL 0 CANINE BORDETELLA
Other lil Altered Over 50 lbs. D NAME:
LEPTOSPIROSIS
(Specify) Lt...., O FELINE LEUKEMIA VIRUS
r._
DAVACCINATED: PRODUCER: 6 3 I: FELINE PANLEUKOPENIA
Veterinarian' s #
1 6 vi 2 °- i1 Licen - .. LI FELINE RHINOTRACHEITIS
Month Day Year (First 3 Letters) 0 FELINE CALICIVIRUS
Veterinarian's dero
LI FELINE CHLAMYDIA
1 yr. Lic.Nacc.>t Signature ,
VACCINATION EXPIRE; El FELINE IMMUNODEFICIENCY
Q \ (.0 6 3 yr. Lic.Nacc. lil 1 ,.. r ,,„ f _, )i,. os Address VIRUS
) t "211'1
Month Day Year
Vacc. Serial (Lot) No. ath Boehringer
klINV Ingelheim
VAC0410001

VACCINATION REG
RABIES VACCINATION CERTIFICATE Tag fee $: Name
ADAPTED NASPHV FORM 51 Tag #:
Owner's Name & Address PRINT - use ball point pen or type Cert. Serial #: )<IRBIES
/ouzo, ie Li Y E DISEASE
8,4,, T LAST : VLEPHONE LI CANINE DISTEMPER
6,2) 73,1472S-ei
,D,1901, STREET ifdiete.:00,ST/A__ ATE ci ZI E CANINE PARAINFLUENZA
E CANINE ADENOVIRUS 2
SPECIX:„._ SEX: ,<AGE: SIZE: PREDOMINANT BREED: COLORS: (.......) D CANINE PARVOVIRUS
Deg Male 3 Mo. to 12 Mo. LI Under 20 lbs. 0 1 k-4 LI CANINE CORONAVIRUS
Cal D Female 0 12 Mo. or older X0 -50 lbs X t• St C 0 CANINE BORDETELLA
Other LI Altered )Q......_ Over 50 lbs. 0 NAME:
O LEPTOSPIROSIS
(Specify) D FELINE LEUKEMIA VIRUS
DATE VACCINATED: PRODUCER: 33 SM.— D FELINE PANLEUKOPENIA
rompll Veterinarian's #
License No. 0 FELINE RHINOTRACHEITIS
[ )- i 0 1A.-
Month Day Year (First 3 Letters) D FELINE CALICI VIRUS
Veterinaria '
D FELINE CHLAMYDIA
1 yr. Lic./Vacc. 0 Signature
VACCINATION 1. to EXPIRES: is D FELINE IMMUNODEFICIENCY
t Syr. Lic.Nacc. Address 3 VIRUS
Month Day Year
Vacc. Serial (Lot No. ; Boehringer
CC S--)----' 11r
\d Ingelheim
VAC0410001
VACCINATION RECG
RABIES VACCINATION CERTIFICATE Tag
N e
ADAPTED NASPHV FORM 51 Tag #:
Owner's Name & Address PRINT - use ball point pen or type Cart, Serial 44: RABIES
E ME DISEASE
T LAST AT 0 TELEPHONE
o CANINE DISTEMPER
, 4 '-'?_ 62> 7,3K22cc1)
NO. STREET E E Te.ij , itic , rs , (9.1 Zyri . 4446 ec _S T .2. . _ O CANINE PARAINFLUENZA
o CANINE ADENOVIRUS 2
SPECI k S: SEX: AGE: SIZE: BREED: C ORS: D CANINE PARVOVIRUS
Dog Male 3 Mo. to 12 Mo. 0 Under 20 lbs. XREDOMINANT 1K LI CANINE CORONAVIRUS
Cat Female 12 Mo. or older /\20 - 50 lbs 0 D CANINE BORDETELLA
Other iii Altered Over 50 lbs. 0 NOVIE:
re, 1 t LI LEPTOSPIROSIS
(Specify) n FELINE LEUKEMIA VIRUS
DATE VACCINATED: PRODUCER: 0 FELINE FANLEUKOPENIA
Veterinarian's #
/ ( 0 1 5-- 1 1 Linea 0 FELINE RHINOTRACHEITIS
Month Day Year (First 3 Letters) D FELINE CALICI VIRUS
Veterinaria s
1 yr. Lic.Nacc. n 0 FELINE CHLAMYDIA
VACCINATION i b EXPIRES: Signature ID FELINE IMMUNODEFICIENCY
1 1 e) 3 yr. Lic.Nacck _., Address .. • A. VIRUS
Mo th Day Year S LI 1 1-19qr ..4 .. _ ,. _ • .st iik
Vacc. Arial (Lot) No. Boehringer
VAC0410001 Ingelheim

RABIES VACCINATION CERTIFICATE Tag fee $: VACCINATION RECOh,
Name
ADAPTED NASPHV FORM 51 Tag #:
Owner's Name & Address PRINT. use bell point pen or type Cert. Serial #: XABIES
P T LAS IRST 1 MI TELEPHONE 0 LYME DISEASE
.-.. . 1-0-1_ 7210 0 CANINE DISTEMPER
STREET cinF._ . 0 CANINE PARAINFLUENZA
a ah i 0 CANINE ADENOVIRUS 2
SPECIES SEX: AGE: SIZE: PREDOMINANT BREED: COLO S: 0 CANINE PARVOVIRUS
Dog Male __ 3 Mo. to 12 Mo. 0 Under 20 lbs. 0 1A) 0 CANINE CORONAV1RUS
Cat 0 Female 12 Mo. or older 20 - 50 lbs 0
Other 0 Altered ver 50 lbs. "K\NAME: 0 CANINE BORDETELLA
(Specify) 0 LEPTOSPIROSIS
0 FELINE LEUKEMIA VIRUS
DATE VACCINATED: VACCINATED: PRODUCER: 3 "1 --\-- O FELINE PANLEUKOPENIA
Veterinarian 's #
it- P.EI License No. El FELINE RHINOTRACHEITIS
Month Day Year (First 3 Letters) 0 FELINE CALICIVIRUS
Veterinari.li
1 yr. Lic.Nacc. El FELINE CHLAMYDIA
VACCINATION EXPIRES: Signatur. 0 ,II
3 yr. Lic.Nac 0 FELINE IMMUNODEFICIENCY
Address — A -a VIRUS
onth Day Year _ A
Vacc. Serial (Lot) No. Al A AAA. 41-411.i.ar
q 'S— 2r° r. Boehringer
VAC0410001 klelV Ingelheim
RABIES VACCINATION CERTIFICATE Tag fee $: VACCINATION RECORD
ADAPTED NASPHV FORM 51 Tag #: Na e
Owner's Name & Address PRINT - use ball point pen or type Cert. Serial #: JXLR ABIES
PaTialk_ FIRST 0 LYME DISEASE
MI TELEPHONE , ,.. _
,,f1.43 A._ a 4,1„444,, 4- 1,3-7,3)72s-t CANINE DISTEMPER
(S:EETe4 er) CANINE PARAINFLUENZA
g),523keo CANINE ADENOVIRUS 2
SPECIES: SEX: 4 AGE: I SIZE: „No, PREDOMINANT BREED: COLO S: 0 CANINE PARVOVIRUS
Dog.31SI--- Male 3 Mo. to 12 mo. El Under 20 lbs.AIN. (1Z. o
Cat Female 0 2 Mo. or older 20 - 50 ibs 0 1 ‘C CANINE CORONAVIRUS
Other 0 Altered K. ver 50 lbs. U NAME: El CANINE BORDETELLA
(Specify) 0 LEPTOSPIROSIS
El FELINE LEUKEMIA VIRUS
DATE VACCINATED: PRODUCER: rgral 3 .3.1------ 0 FELINE PANLEUKOPENIA
Veterinarian's #
to IV License No. 0 FELINE FIHINOTRACHEITIS
I
onth Day Year (First 3 Letters) 0 FELINE CALICI VIRUS
Veterinar 's
1 yr. Lic.Nacc. 0 0 FELINE CHLAMYDIA
VACCINATION ii)_,,, EXPIRES: (b 3 Signatur
yr. Lic.Nacc. FELINE IMMUNODEFICIENCY
Address VIRUS
sonth Day Year ill (44 cis--- 311 ti 1351-4.
k
Woo. Serial (Lot) No.
5- 2.-1--- Boehringer
VAC0410001 ii I ingelheim

VA NATION RECORD
RABIES VACCINATION CERTIFICATE Tag fee $: Ne
ADAPTED NASPHV FORM 51 Tag #: BIES
Cert. Serial #:
PRINT- use ball point pen or type 0 LYME DISEASE
Owner's Name & Address
ki li FIFr / E 0 CANINE DISTEMPER
Ppr ljt S L, FIRST i ll s
t9u B v 0 CANINE PARAINFLUENZA
za,..e.,‘,6
NO. STREET atiric CI 0 CANINE ADENOVIRUS 2
M 9 1' a1 / ASelei sTAIS 0 CANINE PARVOVIRUS
SPECIES: SEX: <AGE: SIZE: PREDOMINANT BREED: .212LC1RS: CI CANINE CORONAVIRUS
Dog );-- k" Male 3 Mo. to 12 Mo . El Under 20 lbs, D a /I A—)
Cat 0 Female 0 2 Mo. or older 5‹. 20 -50 lbs X. O CANINE BORDETELLA
0 Altered Over 50 lbs. CI NflE: D LEPTOSPIROSIS
Other
IA FELINE LEUKEMIA VIRUS
(Specify)
0 FELINE PANLEUKOPENIA
DATE VACCINATED: PRODUCER: Veterinarian's # 0 FELINE RHINOTRACHEITIS
p License 0.
i )-- (0 1 c-- f: 1 FELINE CALICIVIRUS
Month Day Year (First 3 Letters) Veterinaria 's 0 FELINE CHLAMYDIA
1 yr. Lic.Nacc. 0 Signature CI FELINE IMMUNODEFICIENCY
VACCINATION i N.._ 1 0 EXPIRES: le) 3 yr. Lic.Nacc.L..- Address r _ A _,, a I VIRUS
141 144 Lir G,.„..c_4_,,te-
MOng iDay Year (n o Boehringer
Vacc. Serial (Lot) No. S-2-a-r--
ir \IOW Ingelheim
VAC0410001
VACCINATION RECORD
RABIES VACCINATION CERTIFICATE Tag fee $: ;Itce
ADAPTED NASPHV FORM 51 Tag #: RABIES
Owner's Name & Address PRINT - use ball point pen or type Cert. Serial #:
A L ME DISEASE
PipT LAST...-. 74443 1ELEPHONE 0 CANINE DISTEMPER
6 x-T66, . te2.373547,2Xcl
799 tfriSTLET4 4/7/egf C WS7/h ZIPes 3 ,r066 CI CANINE PARAINFLUENZA
El CANINE ADENOVIRUS 2
SPECI S: SEX: AGE: SIZE: PREDO INANT BREED: COLORS: 0 CANINE PARVOVIRUS
Dog Male 3 Mo. to 12 Mo. 0 Under 20 lbs. 0 G i ct.— ( t.,_ 0 CANINE CORONAVIRUS
Cat a Female 12 Mo. or older k 20 - 50 lbs 0 1 -f— D CANINE BORDETELIA
Other 0 Altered Over 50 lbs. NAME: Li LEPTOSPIROSIS
(Specify) K P9, rt)-3D3 0 FELINE LEUKEMIA VIRUS
DATE VACCINATED: PRODUCER: 3 51-- Li FELINE PANLEUKOPENIA
Veterinarian's #
I to ir f I License . 0 FELINE RHINOTRACHEITIS
Month Day Year (First 3 Letters) 0 FELINE CALICIVIRUS
Veterinari. 0 FELINE CHLAMYDIA
VACCINATION EXPIRES: 1 yr. Lic.Nacc. 0 Signature A. 0 FELINE IMMUNODEFICIENCY
to 18 LicAfacckc5 LI/ t49 Gify Address )1--( I k-i (.) .J. .. VIRUS
I 4)- 3 Yr.
Month Day Year
Vacc. Serial (Lot) No, Boehringer
VIR111/ Ingelheim
0001

VACCINATION RECORD
RABIES VACCINATION CERTIFICATE Tag fee $: N e
ADAPTED NASPHV FORM 51 Tag #:
Owner's Name & Address PRINT - use ball point pen or type Cert. Serial #: RABIES
eif 0 LYME DISEASE
pip tivic 044Fikar /I RLEPHONE 0 CANINE DISTEMPER
(P.3 23)00-175
67 a lire/si; om, 17] CANINE PARAINFLUENZA
N y.9 Se.e TREET CI 1>/63CIE
IS-3 — cza I: CANINE ADENOVIRUS 2
SPECIES: SEX: I AGE: SIZE: I P EDOMINANT BREED: COL S; te_t 0 CANINE PARVOVIRUS
Dog )it" Male 0 mo. to 12 Mo. 0 Under 20 lbs. lil 4 i.. 1 i V 1, (1_, 0 CANINE CORONAVIRUS
Cat 0 Female 12 Mo. or older X20 - 50 lbs I VC.---A.— 0 CANINE BORDETELLA
Other 0 Altered Over 50 lbs. 0 NAME: E LEPTOSPIROSIS
(Specify) DAs,s9 vv% 'z— 0 FELINE LEUKEMIA VIRUS
DATE VACCINATED: PRODUCER; 0 FELINE PANLEUKOPENIA
Veterinarian's #
License No. 0 FELINE RHINOTRACHEITIS
Mont Day Year (First 3 Letters) 0 FELINE CALICIVIRUS
Veterinarian' 0 FELINE CHLAMYDIA
1 yr. Lic.Nacc. 0 Signature24 I 9 N
VACCINATION EXPIRES: 0 FELINE IMMUNODEFICIENCY
- I, o I, 0 3 yr. Lic.Nacck Addres A...-v-J44,-- A--"•)=. VIRUS
Month Day Year i ff-D V-
Vacc. Serial (Lot) No. rni Boehringer
Ii I Ingelheim
VAC0410001
V CINATION RECORD
RABIES VACCINATION CERTIFICATE Tag fee $: am e
ADAPTED NASPHV FORM 51 Tag #: ABIES
PRINT - use ball point pen or type Cert. Serial #: L
Owner's Name & Address 0 LYME DISEASE
PT LAST ADIST All. TELEPHONE v72s..c. 0 CANINE DISTEMPER
0 CANINE PARAINFLUENZA
‘9").1:6-cFcr/ft: 4 TY STA
• e/ -s.3 (zo 0 CANINE ADENOVIRUS 2
SPECIES: SEX: GE: SIZE: I PREDOMINANT BREED: CO RS: 0 CANINE PARVOVIRUS
Dog k-- Male 3 Mo. to 12 Mo. 111 Under 20 lbs. 0 ell, ( 14-) 0 CANINE CORONAVIRUS
Cat 171 Female 0 2 Mo. or older 20 - 50 lbs A 1.f...)(.. 0 CANINE BORDETELLA
Other 0 Altered Over 50 lbs. NAME: • 0 LEPTOSPIROSIS
(Specify) B vs 0 FELINE LEUKEMIA VIRUS
DATE VACCINATED: PRODUCER: 3 3.51---, 0 FELINE PANLEUKOPENIA
I 1 0 ( P F-` Veterinarian's # License No 0 FELINE RHINOTRACHEITIS
0 FELINE CALICIVIRUS
Month Day Year (First 3 Letters) Veterinaria s
0 FELINE CHLAMYDIA
1 yr. Lic.Nacc. 0 Signature 0 FELINE IMMUNODEFICIENCY
VACCINATION 1 .., I D EXPIRES: ( (" 3 yr. Lic.Nacc. Address 3 Li i 30 SA"- e;r1je. VIRUS
Month Day Year 4 i 14 g 14, 04P-4•46461-e-/". lir .1
Vacc. Serial (Lot) No. 5S--0" 21 -3-. Boehringer
11111V Ingelheim
VAC0410001

RABIES VACCINATION CERTIFICATE Tag fee $: VACCINATION RECORD
ADAPTED NASPHV FORM 51 Tag #:
Owner's Name &Address PRINT - use ball point pen or type Cert. Serial #: RABIES
Pp LAST iZioSil;ce 81...../4/ ME DISEASE
.1_;PH 0.73 v ?2 s
ICMC 0 CANINE DISTEMPER
Al .
STREET LI CANINE PARAINFLUENZA
79%4 D CANINE ADENOVIRUS 2
SPECIES: SEX: I AGE; SIZE: PREDOMINANT p ; +- BREED: COLORS: 0 CANINE PARVOVIRUS
Dog ,r Male 0 3 Mo. to 12 Mo. 0 Under 20 lbs. 0 y\ .. —FL e„,1 D
Cat Female 12 Mo. or older X 20 - 50 lbs 0 CANINE CORONAVIRUS
Other 0 Altered Over 50 lbs. .K% NAME: 0 CANINE BORDETELLA
(Specify) . 1 D LEPTOSPIROSIS
/4et 6 1 e.At 0 FELINE LEUKEMIA VIRUS
DATE VACCINATED: PRODUCER: # 0 FELINE PANLEUKOPENIA
Veterinarian's
1 Licen33sr D FELINE RFIINOTFIACHEITIS
Month Day Year (First 3 Letters) 0 FELINE CALICIVIRUS
Veterina a 's
1 yr. Lic.Nacc. El 0 FELINE CHLAMYDIA
VACCINATION EXPIRES: Signet
i )_ I b 3 yr. Llc.Naco. 3iiiti 0 FELINE IMMUNODEFICIENCY
t o Address VIRUS
Month Day Year 514 1 (.1q 14 - 1-1.—%0---1-01-
Vacc. Serial (Lot) No.
Boehringer
VAC0410001 Ingelheim
RABIES VACCINATION CERTIFICATE Tag fee $: VACCINATION RECORD
ADAPTED NASPHV FORM 51 Tag ft: Name
Owner's Name & Address PRINT -use ball point pen or type Cert. Serial #:
IM Tak . /et Ipse...,( Di'ME L DISEASE
TELEPHONE
LI Di /47 0 CANINE DISTEMPER
7154 coSTREtti iiri d NA - 4 .-,,m4„,/," ST TE ZIPiss.,30/4. 0 CANINE PARAINFLUENZA
0 CANINE ADENOVIRUS 2
SPECIES: SEX: AGE: SIZE: PREDOMINANT BREED: C LORS: 0 CANINE PARVOVIRUS
Dog et51- Male 3 Mo. to 12 Mo. 0 Under 20 lbs. 0 p , +- o
Cat 0 Female 4 0 12 Mo. or older X20 -50 lbs LI riNIL..) CAM NE CORONAVIRUS
Other 0 Altered Over 50 lbs. : 0 CANINE BORDETELLA
(Specify) O LEPTOSPIROSIS
0 FELINE LEUKEMIA VIRUS
DATE VACCINATED: PRODUCER:
Veterinarians # Licer____ 0 FELINE PANLEUKOPENIA
a it),ay rr F- a. 0 FELINE RHINOTRACHEITIS
Year (First 3 Letters) 0 FELINE CALICIVIRUS
Veterinar
1 yr. LIc.Nacc. 0 o FELINE CHLAMYDIA
VACCINATION EXPIRES: Signatu
i ...a_. 1 0 I b 3 yr. Lic.Nacc. 7. 'aillv f.ELINE IMMUNODEFICIENCY
r_Address
. ..., VIRUS
Month Day Year Lit 1 ( f LI A. _ _
Vacc. Serial (Lot) No.
Boehringer
VAC0410001 Ingelheim

VACCINATION RECOR.
RABIES VACCINATION CERTIFICATE Tag fee $: Name
ADAPTED NASPHV FORM 51 Tag #:
Owner's Name & Address PRINT - use ball point pen or type Cert. Serial #: )(CIES
L E DISEASE
P a.Alexex.... XeTvAs AM IELEPHONE 0 CANINE DISTEMPER
' /49373X72S -Q,
hove eypezset „it 0 CANINE PARAINFLUENZA
N?„46eTtl.; STATE
SP-S3 Vo 0 CANINE ADENOVIRUS 2
SPECIES: SEX: AGE: SIZE: ,.,,PREDOMINANT BREED: COLORS: 171 CANINE PARVOVIRUS
Dog )T1 Male 0 3 Mo. to 12 Mo. 0 Under 20 lbs. !rs... . Li CANINE CORONAVIRUS
at El Female 12 Mo. or older K20 -50 lbs Li E CANINE BORDETELLA
Other El Altered Over 50 lbs. El NAME: LEPTOSP1ROSIS
(Specify) P4 cd, C 0 FELINE LEUKEMIA VIRUS
DATE VACCINATED: PRODUCER: 0 FELINE PANLEUKOPENIA
Veterinarian's # ise J ,P71%--
is- p p 1 EI FELINE RHINOTRACHEITIS
I) I (2
Month Day Year (First 3 Letters) 0 FELINE CALICIVIRUS
Veterinan 0 FELINE CHLAMYDIA
1 yr. Lic.Nacc. 0 Signatu
JACCINATION to EXPIRES: it? D FELINE IMMUNODEFICIENCY
._ 3 yr. Lic.NaccX5 Li i 14 zi Addr VIRUS
J
o rg Day Year
Vac c. Serial (Lot) No . (Th m Boehringer
Ingelheim
\C0410001
RABIES VACCINATION CERTIFICATE Tag fee $: VACCINATION RECORD
N e
ADAPTED NASPHV FORM 51 Tag ft:
wner's Name & Address PRINT - use ball point pen or type Cert. Serial #: RABIES
llIT LAST ,FIFIST 0 LYME DISEASE
TELEPHONE
3 --2372.....M 0 CANINE DISTEMPER
c:067,TREE-r4j ZIP 0 CANINE PARAINFLUENZA
0 CANINE ADENOVIRUS 2
'ECIES: SEX: AGE: SIZE: PREDOMINANT BREED: CO ORS: D CANINE PARVOVIRUS
ig r Male xi._ 3 Mo. to 12 Mo. 0 Under 20 lbs. n D
,t Female 0 12 Mo. or older 20 - 50 lbs CANINE CORONAVIRUS
ler 0 Altered ver 50 lbs. 0 NAME: El CANINE BORDETELLA
)ecify) D LEPTOSP1ROSIS
Ci yl ON, D FELINE LEUKEMIA VIRUS
TE VACCINATED: PRODUCER: 33s---r D FELINE PANLEUKOPENIA
t o cs-- Veterinarian's #
fa- P F-9 License No. 0 FELINE RHINOTRACHEITIS
Day Year (First 3 Letters) 0 FELINE CALICI VIRUS
VeterInari n'
1 yr. Lic,Nacc. 0 E FELINE CHLAMYDIA
:ICI NATION EXPIRES: Signatur
c..) 1 15 3 yr. Lic.Nacck 5-- giLiggr 0 FELINE IMMUNODEFICIENCY
Address 3•••4 il—f k.) sS Le, r VIRUS
nth Day Year
Vacc. Serial (Lot) No. rfr
i Boehringer
)410001 Ingelheim

VACCINATION RECOR,
RABIES VACCINATION CERTIFICATE Tag fee $:
Name
ADAPTED NASPHV FORM 51 Tag #:
Owner's Name & Address PRINT - use ball point pen or type Cert. Serial #: RABIES
▪ L ME DISEASE
lT LAST DRST A MI TELEPHONE
Pp 01M—ri--- LIM 8 b23725472).51) 17 CANINE DISTEMPER
791%1ST6E2ET ) . ., , "iv STATE A Zk l 0 CANINE PARAINFLUENZA
ivy AV_ nt- Y 0 0 CANINE ADENOVIRUS 2
SPECIES: SEX: I AGE: SIZE: PRE MINANT BREED: CO RS: LI CANINE PARVOVIRUS
Dog KT- Male 0 3 Mo. to 12 Mo. 0 Under 20 lbs. 0 1 -{---- Bitt.,(L) LI CANINE CORONAVIRUS
7\260 -
Cat 0 Female 12 Mo. or older 50 lbs 0 III CANINE BORDETELLA
Other 0 Altered ver 50 lbs. KZE:
O LEPTOSPIROSIS
(Specify) Gt. (....I 1--Dt4
0 FELINE LEUKEMIA VIRUS
DATE VACCINATED: PRODUCER: 3 3 5" o FELINE PANLEUKOPENIA
Veterinarian's #
j - (b IS- f License No. 0 FELINE RHINOTRACHEITIS
Month Day Year (First 3 Letters) 0 FELINE CALICIVIRUS
Veterinari. -
LI FELINE CHLAMYDIA
1 yr. LIc.Nacc. 0 Signature _
VACCINATION EXPIRES: ,... 9 s... 0 FELINE IMMUNODEFICIENCY
I s 3 yr. Lic.Nacc.Le- Addr VIRUS
I? I. °
Month Day Year cTh 14 ( Li 9.
Vacc. Serial (Lot) No. rrn Boehringer
\1111111 Ingelheim
VAC0410001
VACCINATION RECORD
RABIES VACCINATION CERTIFICATE Tag fee $:
Neje
ADAPTED NASPHV FORM 51 Tag #:
Owner's Name & Address PRINT - use ball point pen or type Cert. Serial #: XRABIES
Ppr oicieex..... LAST ,43_,4 Rir a3 0 LYME DISEASE
pH7 ONE se7L
f /ti LI CANINE DISTEMPER
STR STREET LAi, eziv.,_ a C1/60 _i_zzieid 7 LI CANINE PARAINFLUENZA
LICANINE ADENOVIRUS 2
SPECIES: SEX: AGE: SIZE: PREDOMINANT BREED: COLORS: 0 CANINE PARVOVIRUS
Dog Male 3 Mo. to 12 mo. o Under 20 lbsA r 1 t 0 CANINE CORONAVIRUS
Cat Female k12 Mo. or older)Q. 20 - 50 lbs (23 I t•t/ I () II*
El CANINE BORDETELLA
Other U Altered V... Over 50 lbs. 0 NAME:
0 LEPTOSPIROSIS
(Specify) rh:i SS n
f z _ FELINE LEUKEMIA VIRUS
DATE VACCINATED: PRODUCER: r 0 FELINE PANLEUKOPENIA
I ; (0 i s-- 3.F 1 Veterinarian's LIceitse o . LI FELINE RHINOTRACHEITIS
Month Day Year (First 3 Lette rs) 0 FELINE CALICI VIRUS
Veterinarl '
1 yr. LioNacc. o 0 FELINE CHLAMYDIA
VACCINATION EXPIRES: Signature ..._...-•""°----*I....„ JI FELINE IMMUNODEFICIENCY
I 1 0 e) 3 yr. Lic.Nacc. i q
( Address VIRUS
Month Day Year
Vacc. Serial (Lot) No.
,c--?" .•) \---- Boehringer
VAC0410001 iDli Ingelheim

RABIES VACCINATION CERTIFICATE Tag fee $: VACCINATION RECORD
ADAPTED NASPHV FORM 51 Tag #: Name
Owner's Name & Address PRINT - use ball point pen or type Cert. Serial ii: ABIES
PR pW LA_ IR6T MI s D L ME DISEASE
Ofq Eff..._ TELEPHONE i
7. • 0 CANINE DISTEMPER
STREET i . • 4.....„... T A ti.16474, zcy5j, ero CANINE PARAINFLUENZA
GO 4 o CANINE ADENOVIRUS 2
SPECIES: I SEX: AGE: SIZE: I PREDOMINANT BREED: COLORS: El CANINE PARVOVIRUS
Dog Male D 3 Mo. to 12 Mo. 0 Under 20 lbs. E 4-- K El CANINE
Cat Female 12 Mo. or older 20 - 50 lbs • 15Ki 0 CORONAVIRUS
Other 0 Altered Over 50 lbs. D NAME: E CANINE BORDETELLA
(Specify) sil CA El LEPTOSPIROSIS
0 FELINE LEUKEMIA VIRUS
DATE VACCINATED: PRODUCER: 3 7 T o FELINE PANLEUKOPENIA
Il I o IS- Veterinarian's #
f el License o. 0 FELINE RHINOTRACHEITIS
Month Day Year (First 3 Letters) El FELINE CALICIVIRUS
Veterinari ':
1 yr. Lic.Nacc. 0 1,.......„...----- E FELINE CHLAMYDIA
VACCINATION EXPIRES: Signatur
I )...._ ( 0 / e, 3 yr. Lic.Nacc. TTFELINE IMMUNODEFICIENCY
i Address VIRUS
&nth Day Year • a,
Vacc. Serial (L t) No. • -- ,
;(7-0 Bo ehringer
VAC04113001 kei/ Ingelheim
RABIES VACCINATION CERTIFICATE Tag fee $: VACCINATION RECORD
ADAPTED NASPHV FORM 51 Tag II; Name
Owner's Name & Address PRINT - use ball point pen or type Cert. Serial #: ,24:1:40I131ES
PANTV p 7/3 ME DISEASE
por4Ex_ TELEPHONE
71AI 73 K7 0 CANINE DISTEMPER
e/N4...,saedeSTREtti . c2,,sTAT as_3,0 0 CANINE PARAINFLUENZA
0 CANINE ADENOVIRUS 2
SPECIES SEX: AGE: SIZE: PREDOMINANT BREED: COLORS: 0 CANINE PARVOVIRUS
Dog Male D 3 Mo. to 12 Mo. 0 Under 20 lbs.K
Cat Female 12 Mo. or older X 20 - 50 lbs I: h.. t i K 0 CANINE CORONAVIRUS
Other 0 Altered Over 50 lbs. 0 NAME: ID CANINE BORDETELLA
(Specify) 0 LEPTOSPIROSIS
0 FELINE LEUKEMIA VIRUS
DATE VACCINATED: PRODUCER: FELINE PANLEUKOPENIA
t)-- t 0 I P .ei Veterinarlan's-4/ License No. 0 FELINE RHINOTRACHEITIS
Month Day Year
(First 3 Letters) D FELINE CALICIVIRUS
Veterina a
1 yr. Lic.Nacc. 0 r‘.......----- 0 FELINE CHLAMYDIA
VACCINATION I --a.... 1 0 EXPIRES; 1 s Signatu
3 yr. Lic.Nacc.(s ti Li c A c.../h. i i..) , 0 FELINE IMMUNODEFICIENCY
ddress ri VIRUS
Month Day Year Gs ..,dIte,,- ti-
Vacc. Serial (Lot) No.
t CI , c. (7 - 111 Boehringer
VAC0410001 \QV Ingelheim

VACCINATION RECORD
RABIES VACCINATION CERTIFICATE Tag fee $:
ADAPTED NASPHV FORM 51 Tag #: ABIES
Owner's Name & Address PRINT - use ball point pen or type Cert. Serial #:
0 LYME DISEASE
LAST 17 ,,,a...ed Alt TkLEPHONE o CANINE DISTEMPER
Prra—Art__ .73 Y22St
0 CANINE PARAINFLUENZA
>1919c:9.. STREET
C CANINE ADENOVIRUS 2
SPECIES: SEX: KAGE: SIZE: PREDOMINANT BREED: COLORS • 0 CANINE PARVOVIRUS
Dog i)g--- Male 3 Mo. to 12 Mo , 0 Under 20 lbs. . - I el• eV L...) 0 CANINE CORONAVIRUS
Cat Female 0 12 Mo. or older )(t... 20 - 50 lbs L ( 0 CANINE BORDETELLA
Other 0 Altered x .. .... Over 50 lbs. 0 NAME: 0 LEPTOSPIROSIS
(Specify) 0 FELINE LEUKEMIA VIRUS
DATE VACCINATED: PRODUCER: 0 FELINE PANLEUKOPENIA
Veterinarian's # License 33 No. 0 FELINE RHINOTRACHEITIS
I - LT) M— P1-1
0 FELINE CALICI VIRUS
Month Day Year (First 3 Letters) Veterinaria
0 FELINE CHLAMYDIA
1 yr. Lic.Nacc. D Signature ID FELINE IMMUNODEFICIENCY
VACCINATION EXPIRES:
-)..._ to E> 3 yr. Lic.Nacc. Address IL) . VIRUS
Month Day Year .
V acc . Serial (Lot) No, .1."7"I Boehringer
S-D-1 --S—' k1111111) Ingelheim
VAC0410001
I.I
VACCINATION RECORD
RABIES VACCINATION CERTIFICATE Tag fee $: Name
ADAPTED NASPHV FORM 51 Tag 11: .) 41Ev:IES
Owner's Name & Address PRINT - use ball point pen or type Cert. Serial #: L E DISEASE
oTitA ST ELEPHONE 0 CANINE DISTEMPER
Y „2- . 4.),),7:31,7zisla
0 CANINE PARAINFLUENZA
73411:501 41, STRE C114471 STA Z,g3 i _.....- 0 CANINE ADENOVIRUS 2
/4 61( 6--- 0
SPECI SEX: AGE: SIZE: PREDO ANT BREED: COLORS: 0 CANINE PARVOVIRUS
Dog Male 3 Mo. to 12 Mo. 0 Under 20 lbs. 0 i i- -- -774...,-... 1 0 CANINE CORONAVIRUS
Cat 0 Female f1 1' l Mo. or older 20 - 50 lbs 0 0 CANINE BORDETELLA
Other 0 Altered ;4...._ ver 50 lbs. 0 LEPTOSPIROSIS
(Specify) 0 FELINE LEUKEMIA VIRUS
0 FELINE PANLEUKOPENIA
DATE VACCINATED: PRODUCER: NEE Veterinarian 5-S-- O FELINE RHINOTRACHEITIS
License 17).
1 ( (%. i 7 0 FELINE CALICIVIRUS
Month Day Year (First 3 Letters) Veterinari 's FELINE CHLAMYDIA
1 yr. Lic.Nacc. 0 Signature g''..N..._....---- 0 FELINE IMMUNODEFICIENCY
VACCINATION EXPIRES:
(e, 3 yr. Lic.Nacc. Address 3 4 VIRUS
I -- (0 Li i Liq L-I 5
lil onth Day Year CA/04.4,44.4.
Vacc. Serial (Lot) No. , 11 Boehringer
(is. 12)-45" Ingelheim
/AC0410001

VACCINATION RECORD
RABIES VACCINATION CERTIFICATE Tag fee $: Natfle
ADAPTED NASPHV FORM 51 Tag #:
Owner's Name & Address PRINT - use bid point pen or type Cert. Serial #: ARABIES
ririt4 s „ea, owls LYIvIE DISEASE
Pr LIT
0 A—Itit 7 V22V 0 CANINE DISTEMPER
r„ )cie, STREET J. (7 1. 7144,201( STATE 6zps D CANINE PARAINFLUENZA
U CANINE ADENOVIRUS 2
SPECIES: SEX: AGE: SIZE: PREDOMINANT BREED: COLORS: 0 CANINE PARVOVIRUS
Dog #114- Male C) 3 Mo. to 12 Mo, CI Under 20 lbs. YL, C k; El CANINE CORONAVIRUS
Cat 0 Female 12 Mo. or older l , 20 -50 lbs D 0 CANINE BORDETELLA
Other E Altered Over 50 lbs. 0 NAME:
- 0 LEPTOSPIROSIS
(Specify) 7-1-f-i 0 FELINE LEUKEMIA VIRUS
DATE VACCINATED: PRODUCER: , 0 FELINE PANLEUKOPENIA
Veterinarian's #
1 .., I 0 '5 P F1 I Licerel.S1--- FELINE RHINOTRACHEITIS
Month Day Year (First 3 Letters) D FELINE CALICIVIRUS
Veterinaria 's .0 FELINE CHLAMYDIA
1 yr. Lic.Nacc. 0 Signature
VACCINATION EXPIRES: 0 FELINE IMMUNODEFICIENCY
3 yr. Lic.Nacc. Address 11 114 1\-) SL1"/Ne'ld Se- VIRUS
Mpnth Day Year
1 a- (r) (e) Vacc. Serial (Lot) No. a s- ("R'0 1 Boehringer
5-3
Ingelheim
VAC0410001
RABIES VACCINATION CERTIFICATE Tag fee $: VACCINATION RECORD
Nam
ADAPTED NASPHV FORM 51 Tag #:
Owner's Name & Address PRINT - use ball point pen or type Cert. Serial #: ABIES
PRII T i L .6 k Sk 6/iFijk 0 LYME DISEASE
TELEPHONE, v El CANINE DISTEMPER
rig 6,69323 72,72)
N , STREET 6 tke,sit. Edo/14W SA cItrs3 . .•••0 0 CANINE PARA1NFLUENZA
F Z 0 CANINE ADENOVIRUS 2
SPECIk_ SEX: AGE: SIZE: PREDOMINANT BREED: COLORS: 0 CANINE PARVOVIRUS
Dog Male 0 3 Mo. to 12 Mo. o Under 20 lbs. 0 D
Cat 0 Female 12 Mo. or older .) ‹...20 - 50 lbs X t•- LA. I 0 CANINE CORONAVIRUS
Other CI Altered Over 50 lbs. o NAlvtE: 0 CANINE BORDETELLA
(Specify) 0 LEPTOSPIROSIS
E FELINE LEUKEMIA VIRUS
DATE )— VACCINATED: (0 PRODUCER: Veterinarian' 3 SI---- CI FELINE PANLEUKOPENIA
1 us- f F I License No. 0 FELINE RHINOTRACHEITIS
Month Day Year (First 3 Letters) 0 FELINE CALICI VIRUS
Veterinar an
1 yr.Lic.Nacc. D 0 FELINE CHLAMYDIA
VACCINATION EXPIRES: Signatu
yr. Lic.Nacc. 0 FELINE IMMUNODEFICIENCY
I to j Lis_ Address 3 ti 1 44 VIRUS
Month Day Year
Vacc. Serial (Lot) No.
gF"k'S"----. (IC) Boehringer
VAC0410001 Ingelheim

VACCINATION RECORD
RABIES VACCINATION CERTIFICATE Tag fee $: Name
ADAPTED NASPHV FORM 51 Tag #:
Owner's Name & Address PRINT - uso ball point pan or type Cert. Serial ft• IES
D L 1E DISEASE
p64,7t, LAST 1FIRST T,ELEPHONE . _.„.7230.
0 CANINE DISTEMPER
t4 4141 / 0411f° 48z53 1d 3 23" ,,,,6 LI CANINE PARAINFLUENZA
Nk)riza STREET , foldloioe ST E
D CANINE ADENOVIRUS 2
SPECIES: SEX: I AGE: SIZE: PREDOMINANT BREED: COLORS: D CANINE PARVOVIRUS
Dog Male o 3 Mo. to 12 mo. 111 Under 20 lbs. X .. —1----4.-N E CANINE CORONAVIRUS
Cat 0 Female 12 Mo. or older X20 - 50 lbs 0 E CANINE BORDETELLA
Other 0 Altered Over 50 lbs. 0 NAME: E LEPTOSPIROSIS
(Specify) E FELINE LEUKEMIA VIRUS
ce
DATE VACCINATED: PRODUCER: 3 3 Is— U FELINE PANLEUKOPENIA
Veterinarian's # .
to Is - I License-No. E FELINE RHINOTRACHEITIS
la e
Day Year E FELINE CALICIVIRUS
(First 3 Letters) Veterinarian
'ffi-FELINE CHLAMYDIA
1 yr. Lic.Nacc. D Signature
ic)._ VACCINATION 10181 EXPIRES: E FELINE IMMUNODEFICIENCY
3 yr. Lic.Nacc s____ Addre-s VIRUS
Month Day Year '_Al
Vacc. Serial (Lot) No. Boehringer
\eV Ingelheim
VAC0410001
VACCINATION RECORD
RABIES VACCINATION CERTIFICATE Tag fee $: Nca(e
ADAPTED NASPHV FORM 51 Tag #: RABIES
Owner's Name & Address PRINT - use ball point pen or type Cert. Serial ft:
L ME DISEASE
T LAST MST TELEPHONE LI CANINE DISTEMPER
p 44.57"4._ 4(4103 4,. ‘,2...3 -vy 72s0
0 0 CANINE PARANFLUENZA
N/y 1 i STREET _ 100/Ar Y4 0.7144/Tfi ZiPs_s_.? ,..,..ci
0 CANINE ADENOVIRUS 2
SPECIES' tIrSEX: AGE: PREDOMINANT BREED: COLORS: LI CANINE PARVOVIRUS
Dog Male 0 3 Mo. to 12 Mo. 0 Under 20 lbs. .. atteI I(/3 El CANINE CORONAVIRUS
Cat Female X 12 Mo. or older it 20 - 50 lbs 0 LICANINE BORDETELLA
Other 0 Altered Over 50 lbs. El NAME: o LEPTOSPIROSIS
(Specify) 0 FELINE LEUKEMIA VIRUS
-Ficl tk
DATE VACCINATED: PRODUCER: LI FELINE PAN LEUKOPENIA
Veterinarian's # Licenso. e 3-Y-S-- D FELINE RHINOTRACHEITIS
ita,- 1 P el
Day Year D FELINE CALICIVIRUS
(First 3 Letters) Veterinari. '.
E FELINE CHLAMYDIA
VACCINATION EXPIRES: 1 yr. LIc.Nacc. CI Signature .... E FELINE IMMUNODEFICIENCY
j f..._ i 0 1 5 3 yr. Lic.Naccts 1.4 1 Li 4 q v. Addre s INJ L4 rl VIRUS
Month Day Year A"Mre-no" 414--'
Vacc. Serial (Lot) No. f. Boehringer
IM-- 21--
\eV Ingelheim
VAC0410001

Sun Valley Hope Animal Hospital
7150 North 110th Avenue
Glendale, AZ 85307
(623) 512-4673
Rabies Certificate
Patient ID: 22748
Client ID: 6930 ...Patient Name: Bambi
Client Name: Rescue No Paws Left Behind 4 Species: Canine
Address! 19926 W. Colter Breed: Chihuahua
Sex: • Spayed Female
Litchfield Park, AZ 85340 Color: Tan
Phone: (623)734-7250 Markings:
Birthday: 01/22/2008
Weight: 6.40 pounds on 1/23/2017
Tag Number: 00000000000000000000 Vaccination Date: 1/30/2017
Lot Number: 136109A Expiration Date: 1/30/2020
Rabies Canine 3 Year Booster Vaccination
Producer: Pfizer
K / MLV /13: Killed Virus
Staff Name: Mary K. Burdick DVM
License Number: 4660

Sun Valley Hope Animal Hospital
7150 North 110th Avenue
Glendale, AZ 85307
(623) 512-4673
Rabies Certificate
Client ID: 6930 Patient ID: 26473
Client Name: Rescue No Paws Left Behind Patient Name: Pretty Girl
Address: 19926 W. Colter Species: Canine
Breed: Chihuahua
Litchfield Park, AZ 85340 Sex: Female
Color: White
Phone: (623)734-7250 Markings:
Birthday: 10/11/2011
Weight:
Tag Number: 00000000000000000000
Lot Number: 136109A Vaccination Date: 10/14/2016
Rabies Canine 1 Year Booster Vaccination Expiration Date: 10114/2017
Producer: Pfizer
K / MLV / R: Killed Virus
Staff Name: Mary K. Burdick DVM •/
License Number: 4660

Sun Valley Hope Animal Hospital
7150 North 110th Avenue
Glendale, AZ 85307
(623) 512-4673
Rabies Certificate
Client ID: 6930 Patient ID: 26474
Client Name: Rescue No Paws Left Behind Patient Name: Princess
Address: 19926 W. Colter Species: Canine
Breed: Chihuahua
Litchfield Park, AZ 85340 Sex: Spayed Female
Color: Black
Phone: (623)734-7250 Markings:
Birthday: 10/11/2008
Weight:
Tag Number: 00000000000000000000
Lot Number: 136109A Vaccination Date: 10/14/2016
Rabies Canine 1 Year Booster Vaccination Expiration Date: 10/14/2017
Producer: Pfizer
K/ MLV / R: Killed Virus
7 <0, -ey•-•
Staff Name: Mary K. Burdick DVM
License Number: 4660

Sun Valley Hope Animal Hospital
7150 North 110th Avenue
Glendale, AZ 85307
(623) 512-4673
Rabies Certificate
Client ID: 6930 Patient ID: 20024
Client Name: Rescue No Paws Left Behind Patient Name: Sasha
Address: 19926 W. Colter Species: Canine
Breed: Chihuahua
Litchfield Park, AZ 85340 Sex: Spayed Female
Color: Blackaan
Phone: (623)734-7250 Markings:
Birthday: 06/22/2007
Weight:
Tag Number: 00000000000000000000 Vaccination Date: 10/14/2016
Lot Number: 136109A Expiration Date: 10/14/2017
Rabies Canine 1 Year Booster Vaccination
Producer: Pfizer
K / MLV / R: Killed Virus
Staff Name: Mary K. Burdick DVM
License Number: 4660

„EY-1IT5VET
ko..i
Animal Hospital
15808 N. El Mirage Rd.
Surprise, AZ, 85378
(623) 910-3242
Date of Rabies Vaccination: 09-12-14 Certificate No: 0
Next Rabies Vaccination On 09-11-17
OWNER OF ANIMAL
Joanne Maillet
16509 Quail Run Road
Surprise, AZ 85387
County: Maricopa
This is to certify...
THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW.
Patient information...
PATIENT: Buddy Jr SEX: Neutered Male
SPECIES: Canine AGE: 12Y
WEIGHT: 13.40 Color and markings: White
Signed
Vaccinations done...
09-12-14 KU Rabies Canine, 3yr
Rabies Vaccine Information...
MFG BY: FFIZE SER.NO: S303971C
LOT EXP: 11/04/14 ADM: SQ

VACCINATION CERTIFICATE
Account #: 30000 Animal: Bacardi
Owner: Porter, Kim No Paws Left Behind Species: Canine
Address: 19926 W. Colter St. Breed: Chihuahua
Litchfield Park, AZ 85340 Color: TAN
Gender: Male Neutered
Phone: (623)734-7250 Birthdate: 416/2011
(623)910-6671 Age: 5 years 9 months
Weight: 3.12
Chip #: 911001001402543
rate VEVIR174 Manufacturer Serial # Type Tag # Due on
01/04/2017 Rabies - 3 year ZOE 120622 Killed 01/01/2020
Mobile Animal Surgical Hospital, Inc.
9716 E. Cholla Street
DV
Scottsdale, AZ 85260
(480) 656-4479 ulia Neufekl, DVM
marshapptsgmolcom www.mashvetnet 3538

VACCINATION CERTIFICATE
Account #: 30000 Animal: Paris
Owner: Porter, Kim No Paws Left Behind Species: Canine
Address: 19926 W. Colter St. Breed: Miniature Poodle
Litchfield Park, AZ 85340 Color: WHITE
Gender: Female Spayed
Phone: (623)734-7250 Birthdate: 3/4/2011
(623)910-6671 Age: 5 years 9 months 5 days
Weight: 9.00
Chip #: 911001001343582
Date Vaccine Manufacturer ElifITREJ Type Tag # Due on
12/07/2016 Rabies -3 year ZOE 120622 Killed 12/04/2019
03/04/2015 Rabies-Rescue 1 year PFI S406597 Killed 03/02/2016
(w/Surgery)
Mobile Animal Surgical Hospital, Inc.
9716 E. Cholla Street
Scottsdale, AZ 85260 n gik,+4,144. OVVP la-
(480) 656-4479 Julia Neufeld, DVM 1 /07 016
mashappts@aolcom • www.mashvetnet 3538

VACCINATION CERTIFICATE
Account #: 30000
Owner: Porter, Kim No Paws Left Behind Species: Animal: Mika
Address: 19926 W. Colter St. Breed: Canine
Litchfield Park, AZ 85340 Terrier
Color: TAN
Phone: (623)734-7250 Gender: Female Spayed
Birthdate: 2/8/2013
(623)910-6671 Age: 4 years 1 day
Weight: 16.15
Chip #:
Date Vaccine Manufacturer Serial # Type
02/08/2017 Rabies - 3 year ZOE Tag # Due on
120622 Killed 02/05/2020
Mobile Animal Surgical Hospital, Inc.
9716 E. Cholla Street
Scottsdale, AZ 85260
(480) 656-4479 1 ik4.4 ia4,1 \in, 1 171--
rnashapptsgaol.com ): uiia Neufeld, i0V1131- 02/08/ 017
• www.mashvetnet 3538
VACCINATION CERTIFICATE
Account #: 30000 Animal: Gabe
Owner: Porter, Kim No Paws Left Behind Species: Canine
Address: 19926 W. Colter St. Breed: Chihuahua X
Litchfield Park, AZ 85340 Color: BROWN
Gender: Male Neutered
Phone: (623)734-7250 Birthdate: 2/8/2009
(623)910-6671 Age: 8 years 2 days
Weight: 19.05
Chip #:
Date Vaccine Manufacturer Tag # Due on
02108/2017 Rabies - 3 year ZOE 120622 Killed 02/05/2020
Mobile Animal Surgical Hospital, Inc.
9716 E. Cholla Street .)0 ?1*
Scottsdale, AZ 85260
(480) 656-4479 Julia Neufeld, DVM 02 8/2 17
mashappts@aol.corn • www.mashvetnet 3538

VACCINATION CERTIFICATE
Account #: 30000 Animal: Dio
Owner: Porter, Kim No Paws Left Behind Species: Canine
Address: 19926 W. Colter St. Breed: Chihuahua
Litchfield Park, AZ 85340 Color: TAN
Gender: Male Neutered
Phone: (623)734-7250 Birthdate: 2/8/2013
(623)910-6671 Age: 4 years 1 day
Weight: 16.07
Chip #:
Date 037=1 Villf=1117111 MIME Type Tag #
02/08/2017 Rabies -3 year ZOE 120622 Killed 02/05/2020
Mobile Animal Surgical Hospital, Inc.
9716 E. Cholla Street
Scottsdale, AZ 85260 )61i 7
(480) 656-4479 Neufeld, DVM 02/08/2017
mashappts@mgcorn • www.mashvet.net 3538
VACCINATION CERTIFICATE
Account #: 30000 Animal: Daisy
Owner: Porter, Kim No Paws Left Behind Species: Canine
Address: 19926 W. Colter St. Breed: Chihuahua
Litchfield Park, AZ 85340 Color: BROWN
Gender: Female Spayed
Phone: (623)734-7250 Birthdate: 2/8/2008
(623)910-6671 Age: 9 years 3 days
Weight: 7.80
Chip II:
Date 0712MTII 12i111=n12111 Serial # Type Tag #
02/08/2017 Rabies -3 year ZOE 120622 Killed 02/05/2020
Mobile Animal Surgical Hospital, Inc.
9716 E. Cholla Street 1:_i$M1 )(till
Scottsdale, AZ 85260
(480) 656-4479 Julia Neufeld, DVM 02/08/2017
mashappts@aoLcorn • www.mashvetnet 3538

VACCImaTvoN CERTIFICATE
Account #: 30000 Animal: Lefty
Owner: Porter, Kim No Paws Left Behind Species: Canine
Address: 19926 W. Colter St. Breed: Chihuahua
Litchfield Park, AZ 85340 Color: VVHITE
Gender: Male Neutered
Phone: (623)734-7250 Birthdate: 1/4/2014
(623)910-6671 Age: 3 years 1 day
Weight: 13.15
Chip #:
171:12 Vaccine Manufacturer Serial # Type Tag # Due on 1
01/04/2017 Rabies - 3 year ZOE 120622 Killed 01/01/2020
Mobile Animal Surgical Hospital, Inc.
9716 E. Cholla Street V. Cri±te4. (Alt II
Scottsdale, AZ 85260
480) 656-4479 Julia Neufeld, DVM 01/04/2017
mashappts@aol.com • www.mashvet.net 3538

VACCINATION CERTIFICATE
Account #: 30000 Animal: Ziggy
Owner: Porter, Kim No Paws Left Behind Species: Canine
Address: 19926 W. Colter St. Breed: Chihuahua
Litchfield Park, AZ 85340 Color: BLK TAN
Gender: Male Neutered
Phone: (623)734-7250 Birthdate:
(623)910-6671 Age:
Weight: 9.01
Chip #:
Date Vaccine Manufacturer Serial # Type Tag # Due' on
12/07/2016 Rabies - 3 year ZOE 120622 Killed 12/04/2019
Mobile Animal Surgical Hospital, Inc.
9716 E. Cholla Street
1)- h
Scottsdale, AZ 85260 r_11.4aeL Dvill 77
(480) 656-4479 Julia Neufeld:DVM 1//07/ 016
mashappts@aol.corn • www.mashvet.net 3538

VACCINATION CERTIFICATE
Account #: 30000 Animal: Bear
Owner: Porter, Kim No Paws Left Behind Species: Canine
Address: 19926 W. Colter St. Breed: Chihuahua
Litchfield Park, AZ 85340 Color: TAN
Gender: Male Neutered
Phone: (623)734-7250 Birthdate:
(623)910-6671 Age:
Weight: 8.01
Chip #:
Date Vaccine Manufacturer Serial # Type Tag # Due on
12/07/2016 Rabies - 3 year ZOE 120622 Killed 12/04/2019
Mobile Animal Surgical Hospital, Inc.
9716 E. Cholla Street 1I 16i
Scottsdale, AZ 85260 k. Dlivt p(t
(480) 656-4479 Julia Neufeld, DVM 2 7/
mashappts@aol.com • www.mashvetnet 3538
VACCINATION CERTIFICATE
Account #: 30000 Animal: Bobo
Owner: Porter, Kim No Paws Left Behind Species: Canine
Address: 19926 W. Colter St. Breed: Chihuahua
Litchfield Park, AZ 85340 Color: TAN/WIIT
Gender: Male Neutered
Phone: (623)734-7250 Birthdate:
(623)910-6671 Age:
Weight: 11.00
Chip #:
Date Vaccine Manufacturer Serial # Type Tag # Due on
12/07/2016 Rabies - 3 year ZOE 120622 Killed 12/04/2019
Mobile Animal Surgical Hospital, Inc.
9716 E. Cholla Street nta4,
Scottsdale, AZ 85260 114iatk• DI" D17)16
(480) 656-4479 Julia Neufeld, DVM 2/0 /2016
mashappts@aol.corn • www.mashvetnet 3538

VACCINATION CERTIFICATE
Account #:30000 Animal:Paige
Owner: Porter, Kim No Paws Left Behind Species: Canine
Address: 19926 W. Colter St. Breed: Chihuahua
Litchfield Park, AZ 85340 Color: TAN
Gender: Female Spayed
Phone: (623)734-7250 Birthdate:
(623)910-6671 Age:
Weight: 13.04
Chip #:
Date Vaccine Manufacturer Serial # Type Tag # Due on
12/07/2016 Rabies - 3 year ZOE 120622 Killed 12/04/2019
Mobile Animal Sur gical Hospital, Inc.
9716 E. Cholla Street
Scottsdale, AZ 85260 ntat:4 DVfv) )7)1b
(480) 656-4479 Neufeld, DVM 12 07/ 016
mashappts @aolcom • www.mashvetnet 3538
VACCINATION CERTIFICATE
Account #:30000 Animal:Mia
Owner: Porter, Kim No Paws Left Behind Species: Canine
Address: 19926 W. Colter St. Breed: Chihuahua
Litchfield Park, AZ 85340 Color: TAN
Gender: Female Spayed
Phone: (623)734-7250 Birthdate:
(623)910-6671 Age:
Weight: 12.00
Chip #:
Date Vaccine Manufacturer Serial # Type Tag # Due on
12/07/2016 Rabies - 3 year ZOE 120622 Killed 12/04/2019
Mobile AnimalSur gical Hospital, Inc.
9716 E. Cho/la Street
Scottsdale, AZ 85260 ' qt,t +.1e‘. DVni 7)1,ty
(480) 656-4479 Neufeld, DVM 1 07/ 016
rnashappts @aotcom • www.mashvetnet 3538

VACCINATION CERTIFICATE
Account #: 30000 Animal: Lilly
Owner: Porter, Kim No Paws Left Behind Species: Canine
Address: 19926 W. Colter St. Breed: Chihuahua
Litchfield Park, AZ 85340 Color: WHITE
Gender: Female Spayed
Phone: (623)734-7250 Birthdate:
(623)910-6671 Age:
Weight: 6.12
Chip #:
Date Vaccine Manufacturer Serial # Type Tag # Due on
12/07/2016 Rabies - 3 year ZOE 120622 Killed 12/04/2019
Mobile Animal Surgical Hospital, Inc.
9716 E. Cholla Street
Scottsdale, AZ 85260 r)ti.JA:€4 C.L.4.4414. /44
(480) 656-4479 Julh Neufeld, DVM 12/07/2016
mashappts@fiot corn • www.mashvetnet 3538
VACCINATION CERTIFICATE
Account #: 30000 Animal: Mama
Owner: Porter, Kim No Paws Left Behind Species: Canine
Address: 19926 W. Colter St. Breed: Chihuahua
Litchfield Park, AZ 85340 Color: TAN
Gender: Female Spayed
Phone: (623)734-7250 Birthdate:
(623)910-6671 Age:
Weight: 9.13
Chip #:
Vaccine Manufacturer Serial # Type Tag # Due on
Date 12/07/2016 Rabies - 3 year ZOE 120622 Killed 12/04/2019
Mobile Animal Surgical Hospital, Inc.
9716 E. Cholla Street nti) A:A Cli"tat( DWY1 1?-_17 110
Scottsdale, AZ 85260 Juli Neufeld, DVM 1 /07/2016
(480) 656-4479
rnashappts@aol.com • www.mashvet.net 3538

VACCINATION CERTIFICATE
Account ti: 30000 Animal: Sunshine
Owner: Porter, Kim No Paws Left Behind Species: Canine
Address: 19926 W. Colter St. Breed: Chihuahua
Litchfield Park, AZ 85340 Color: TAN
Gender: Female Spayed
Phone: (623)734-7250 Birthdate:
(623)910-6671 Age:
Weight: 7.04
Chip #:
Date Vaccine Manufacturer Serial # Type Tag # Due on
12/07/2016 Rabies - 3 year ZOE 120622 Killed 12/04/2019
Mobile Animal Surgical Hospital, Inc.
9716 E. Chalk, Street
Scottsdale, AZ 85260 ept44-atk, Min-) ).? -7
(480) 656-4479 JÜlia Neufeld, DVM 12/0 /2016
mashappts@aol.com • www.mashvetnet 3538
VACCINATION CERTIFICATE
Account #: 30000 Animal: Remington
Owner: Porter, Kim No Paws Left Behind Species: Canine
Address: 19926 W. Colter St. Breed: Shih Tzu
Litchfield Park, AZ 85340 Color: TAN/WHT
Gender: Male
Phone: (623)734-7250 Birthdate:
(623)910-6671 Age:
Weight: 11.15
Chip #:
Dale Vaccine Manufacturer Serial # Type Tag # Due on
12107/2016 Rabies - 3 year ZOE 120622 Killed 12/04/2019
Mobile Animal Surgical Hospital, Inc.
9716 E. Cholla Street
Scottsdale, AZ 85260 0-4:et 4. iliwv,i4 Dveel 1 II°
(480) 656-4479 Ju -... a Neufeld, DVM I 1 ) /07/2 41.- 16
mashapptsgaoLcorn • www.mashvetnet 3538