BUCKEYE ANIMAL RESCUE KENNEL.PDF

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Maricopa County
Animal Care And Control
2500 South 27th Avenue
Phoenix, AZ 85009
(602) 506-7387 Tele.
(602) 506-2739 Fax
KENNEL PERMIT APPLICATION
El New 'V Renewal Permit # 'Cy -000054
Name: LiHa Mutka Kennel Name: Buckeye Animal Rescue 4rt eve,
Mailing Address: 1919 North 200th Avenue Kennel Location: 1919 North 200th Ave
City: Buckeye Arizona ZIP: 85396 County Supervisorial District: #4
Phone: 623-826-3085 Kennel Phone: 623-826-3085
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 1/we are making
app ion 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_ 341dogs and that the kennel meets the definition in statute.
3. VL'2_. / 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. ML INVe certify that all dogs over the age of three (3) months that are kept, harbored or maintained on the
prerrises 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
maintlioed on the premises for each dog.
5. LV /We certify that I/We are submitting a valid copy of the rabies vaccination certificate for each
dog th this application,
6. I/We understand that a dog remaining within the kennel is not required to be licensed individually under
§ 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.
1A/Ve understand that a person who fails to obtain a kennel permit under A.R.S.§11-1009 is subject to a
pen9.1t,..tof twenty-five dollars in addition to the annual fee.
8. _k,E2 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. _kiln-he 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/VVe certify that all of the infognation i/We have provided is true and accurate under penalty of law.
A) MU:04— q' ' 0305
Applicant Signature Date:
Applicant Signature Date:
For Official Use Only:
Copies of Valid Rabies Vaccination Certificates for each dog attached: YES
Copy of Person's Valid Identification Attached N/A
Type of Identification submitted: N/A
BOS Approval Date Term of Permit
2 of2

Maricopa County Animal Care & Control
KENNEL PERMIT INSPECTION
Date: September a:P., L -P.
Lt Timothy Rummel
Enforcement Division Lieutenant
2630 W. Rio Salado Parkway
Mesa, AZ 85201
(602) 506-6274
trummel@mail.maricopa.gov
Buckeye Animal Rescue / Kennel Permit # 2016-000054
Lilia Mutka - Owner
200th )10 .5
1919 N Avenue
Buckeye AZ 85326
623-826-3085
Number of Dogs —34
• Are all dogs over the age of 3 months properly vaccinated for rabies and in possession of a valid rabies
vaccination certificate? ("Properly Vaccinated" means, by a licensed veterinarian or Maricopa County Animal
Care and Control)
)2( YES Ci NO
• Is the kennel an enclosed, controlled area, inaccessible to other animals, in which a person keeps, harbors or
maintains 5 or more dogs under controlled conditions?
1111 YES NO
• CORRECTIVE ACTION REQUIRED FOR COMPLIANCE - NONE
Lt Timothy Rummel
Maricopa County Animal Care and Control

Maricopa County Animal Care and Control
2500 S. 27th Avenue
Phoenix, AZ 85009-6797
(602) 506-7387
http://pets.maricoba.gov
Receipt Number: R15-205528 Receipt Date: 09/05/2015
Person ID: P2262784
Phone: 623 8263085
BUCKEYE ANIMAL RESCUE KENNELS 9/5/2015 5:39:30PM
1919 N 200TH AVE
BUCKEYE, AZ 85396
Item: Animal ID: Reference No: Price: Each: Amount:
KEN PERMIT A7777777 $328.00 1 $328.00
Total Fees Due: $328.00
Payments: Cash: $0.00
Check: $328.00
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.maricopagov 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
shawcrof EBUSOFF

INTERNAL REVENUE SERVICE DEPARTMENT OF THE TREASURY
P. O. BOX 2508
CINCINNATI, OH 45201
MAR 1 1 2015 Employer Identification Number:
Date: 46-3227031
DLN:
26053464002025
BUCKEYE ANIMAL RESCUE KENNEL Contact Person:
1919 N 200TH AVENUE CUSTOMER SERVICE ID# 31954
BUCKEYE, AZ 85396-0000 Contact Telephone Number:
(877) 829-5500
Accounting Period Ending:
June 30
Public Charity Status:
170 (b)(1)(A) (vi)
Form 990/990-EZ/990-N Required:
Yes
Effective Date of Exemption:
July 15, 2013
Contribution Deductibility:
Yes
Addendum Applies:
No
Dear Applicant:
We're pleased to tell you we determined you're exempt from federal income tax
under Internal Revenue Code (IRC) Section 501(c)(3). Donors can deduct
contributions they make to you under IRC Section 170. You're also qualified to
receive tax deductible bequests, devises, transfers or gifts under Section
2055, 2106, or 2522. This letter could help resolve questions on your exempt
status. Please keep it for your records.
Organizations exempt under IRC Section 501(c)(3) are further classified as
either public charities or private foundations. We determined you're a public
charity under the IRC Section listed at the top of this letter.
If we indicated at the top of this letter that you're required to file Form
990/990-EZ/990-N, our records show you're required to file an annual
information return (Form 990 or Form 990-E2) or electronic notice (Form 990-N,
the e-Postcard). If you don't file a required return or notice for three
consecutive years, your exempt status will be automatically revoked.
If we indicated at the top of this letter that an addendum applies, the
enclosed addendum is an integral part of this letter.
For important information about your responsibilities as a tax-exempt
organization, go to www.irs.gov/charities . Enter "4221-PC" in the search bar
to view Publication 4221-PC, Compliance Guide for 501(c)(3) Public Charities,
which describes your recordkeeping, reporting, and disclosure requirements.
Letter 5436

-2-
BUCKEYE ANIMAL RESCUE KENNEL
Sincerely,
74seviouwi) K4,0(14,02,~e
Director, Exempt Organizations
Letter 5436

RABIES VACCINATION CERTIFICATE
OWNER'S INFORMATION:
LEFEVER APRIL P2361276 (623) 8531332
LAST NAME FIRST NAME PerEsoN ID TELEPHONE NUMBER EXT.
910 N 180TH DR GOODYEAR AZ 85338
STREET ADDRESS APT CITY STATE ZIP CODE
ANIMAL INFORMATION
DOG NEUTERED 9/12/20 it LARGE SAMOYED SIBERIAN HUSKY
ANIMAL TYPE ANIMAL SEX ANIMAL DATE OF BIRTH SIZE PRIMARY BREED SECONDARY BREED
A3661002 AJero 90,5li 2 O. 01,031.43 -151 CREAM WHITE
ANIMAL 1U A NIMAL NAME MICROCHIP NUMBER PRIMARY COLoR SECONDAR? COLOR
VACCINATION INFORMATION
.-
RABDOMUN 12 Months 9/17/2015 9/1712016 9/17/15
1
vAccm. PRODUCER VACO LENGTH DATE VACCINATED VACCINATION EXPIRES PRINT DATE
4,„.-7.4.>-...7_0 (s-- ,
KILLED Marieopa County
Animal Care & Control
VACCINE TYPE ( VETERINARIANS SIGNATURE 2500 S 27thAvenue, Phoenix, AZ 85009
(602) 506-7387
S414181
VACC. SERIAL NO. VETERINARIAN'S UCENSE NUMBER

RABIES VACCINATION CERTIFICATE
OWNER'S INFORMATION:
LEFEVER APRIL P2361276 (623) 8531332
LAST NAME FIRST NAME PERSON ID TELEPHONE NUMBER EXT.'
910 N 180TH DR GOODYEAR AZ 85338
STREET ADDRESS APT CITY STATE ZIP CODE
ANIMAL INFORMATION
....
DOG SPAYED 9/16/2013 LARGE SAMOYED SIBERIAN HUSKY
ANIMAL TYPE ANIMAL SEX ., ANIMAL DATE OF B WM S#ZE PRIMARY BREED SECONDARY BREED
A3661003 / ari 5"5-e- WHITE
ANIMAL 10 PRMARY COLOR SECONDARY COLOR
AMAL N NAME MICROCHIP NUMBER
• VACCINATION INFORMATION
RABDOMUN 12 Months 9/17/2015 9/17/2016 9/17/15
VACCINE PRODUCER VACC. LENGTH DATE VACCINATED VACCINATION EXPIRES PRINT DATE
,,,,,ZAds------4-? ,(s---- • -\".- "64.1
KILLED Maricopa County
Animal Care & Control
VACCINE TYPE - - - - VETERINARIAN'S SIGNATURE
2500 S 27th Avenue, Phoenix, AZ 85009
(602) 506-7387
5414181
VACC. SERIAL NO, VETERINARIAN'S LICENSE NUMBER

ATBC - Phx
602-943-7729
Animal Summary / Rabies Summary
This is not an invoice.
Owner
B.A.R.K.
1919 North 200th Ave, Buckeye, AZ 85396
623-826-3085
Animal Details Animal's Name: Samantha
Sex: Female
Species: Dog
Age: 1 Years, 0.0 Months
Color: Black / White
Breed: Husky (Alaskan)
Weight: 43.20 lbs
Visit Date: 9/17/2015
Animal Number 15-9574
Microchip Number:
Rabies Vaccine Producer: Boehringer Ingelheim
Type: One Year
Vaccine Lot 1215406A (expires 8/21/2016)
Number:
Date Vaccinated:9/17/2015
Expires: 9/17/2016
Veterinarian: Kellie Ayle, License #
Signature:
ce),A,v,fi
Clinic Info: ATBC - Phx
950 West Hatcher Road, PHOENIX, AZ
85021
602-943-7729
All Products/Services Date Description
9/17/2015 Dog Spay
9/17/2015 Medium Dog - Female
9/17/2015 Rabies 1 year vaccine
This is not an invoice.

ATBC - Phx
602-943-7729
Animal Summary / Rabies Summary
This is not an invoice.
Owner
B.A.R.K.
1919 North 200th Ave, Buckeye, AZ 85396
623-826-3085
Animal Details Animal's Name: Betty White
Sex: Female
Species: Dog
Age:1 Years, 6.0 Months
Color: Tan /
Breed: Cairn Terrier
Weight: 9.74 lbs
Visit Date: 9/17/2015
Animal Number: 15-9585
Microchip Number:
Rabies Vaccine Producer: Boehringer Ingelheim
Type: One Year
Vaccine Lot 1215406A (expires 8/21/2016)
Number:
Date Vaccinated: 9/17/2015
Expires: 9/17/2016
Veterinarian: Shannon Carey, License #
Signature: t\I
Clinic Info:ATBC - Phx
950 West Hatcher Road, PHOENIX, AZ
85021
602-943-7729
All Products/Services Date Description
9/17/2015 Dog Spay
9/17/2015 Rabies 1 year vaccine
This is not an invoice.

.1 I
VACCINATION RECORD
• RABIES VACCINATION C/ERTIFICATE Tag fee $: I Name
ADAPTED NASPHV FORA/1 51 Tag #: - I
Cei/i/Serial tt.':! ileik,3 ILIXABI ES
Owner's Name &Addres PRINT-- use bell point pen or type 0 LYME DISEASE
tgaek, v , MONO'.
PRINT FiRl& Li CANINE DISTEMPER
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atom aethx,TATE 0 CANINE PARAINFLUENZA
NO. fRE71.1 215 0 /-4 e ZIP
0 CANINE ADENOVIRUS 2
/9 9
SPECIES: SEX: i i AGE: SIZE: '-' PRED IN BREED: C017pRS.:: r I 0 CANINE PARVOVIRUS
Dog 6 Male -1.1 3 Mo. to 12 Mo. 0 UndeN/0 lbs. 1.5,t , , I f I 0 CANINE CORONAVIRUS
Cat Ell Female 12 Mo. or older .16 20 - kiThlba 0 0 CANINE BORDETELLA
Other 0 Altered g Over 5.1 lbs. 0 NAME: : O LEPTOSPIROSIS
,.-3 7 1
(Specify) 0 FELINE LEUKEMIA VIRUS
• A - i Alkcilk• T
: 0 FELINE PANLEUKOPENIA
DATE VACCINATED: PRODUCER: ‘ Veterinarlan'- It ....
Licen nu 0 FELINE FIHINOTRACHEITIS
0 FELINE CALICIVIRUS
Month Day Year (First 3 Letters) Veterinarianls-, ......-- '
- 0 FELINE CHLAMYDIA
1 yr. Lic.NacciN Sign guile-; --- - , t' 0 FELINE IMMUNODEFICIENCY
VACCINATION (.., _, Li _ EXPIRES: i Ce. 3 yr. Lic.Nacc. 0 II' 3 . VIRUS
Address
U -ci-c_? ib j
‘,5Ck0 krj A-
Month Day' Year
Vacc. Serial (Lot) No. Boehringer
V*/ Ingelheim
VAC0410001

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SHOT SPOT VACCINATIONS -Please iiifirand press hard-
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Shotspotvacelnations.com V Certificate
(60;) 820-1255 , Date -
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Use of picture for FaceBook and Advertising? ai NO
Is your pet spayed or neutered? (S EP NO Species? V Dog 0 Cat
Is your pet pregnant? YES drID If yes, when is she due? Gender? 0 Male Naemale
Has your pet had any coughing or sneezing in the past week? YES (4j) Purebred? 11 Yes 0 No
Has your pet had any diarrhea or vomiting in the past week? YES CD Special notes:
Has your pet ever had any reaction to any vaccination? YES
Is your pet on antibiotics or any other medications? YES 075
How did you hear about us?
I understand that vaccinations can cause reactions in some patients and that I will be responsible for any costs related to
their treatment. I agree to indemnify and hold harmless Shot Spot Vaccinations, LLC and the attending veterinarian(s) from and
against any and all liability arising out of the performance of all procedures that I have cor loied•tipitoday.
X 4'4_1
Signature of Legal owner or authorized person
X X X THIS SECTION IS FOR SHOT SPOT VACCINATIONS USE ONLY X X X
Weight (lbs.) c -7. 2 Temp (F) / Pulse I ,, Respiration
Body Mass Sic, Dental scale 3
Ab General appearance Ab Mucous membranes Musculoskeletal
Ab Eyes N .)Ab Abdomen Cardiovascular
Ab Ears N fAb Skin Respiratory
Ab Oral N Ab Lymph nodes Neurological
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Exam notes: -
Veterinarian Signature: 1 =.1_, ___ ._- #
Dog Care Provided Today: Cat Care Provided Today:
Rabies (RR) SQ Expires:OVO 2-0112 r!r 1 year El Rabies (RR) SQ Expires: 0 1 year
Manufacturer : Pfizer 0 3 year Manufacturer : Pfizer 0 3 year
Serial # Serial #
El DA2PPV (RS) SQ Expires: El 1-FICPCh (RS) SQ Expires:
El Bordetella (IN) Expires: • FeLV (LR) SQ Expires:
O Rattlesnake (LS) SQ Expires: El Deworm (pyrantel pamoate 50mg/m1) mls PO
El Deworm (pyrantel pamoate 50mg/m1) mls PO O Microchip (mid-shoulder SO)
0 Microchip (mid-shoulder) SO) El FELV/FIV test: Positive Negative
CI Heartworm Test: Positive Negative O Nail Clipping
El Heartworm Preventative Prescribed: 1 year supply O Ear Cleaning
0-25 lbs 26-50 lbs 51-100 lbs CI Other
0 Ear Cleaning , e')Like us on
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Shotspotvaccinations@gmail.com
Shotspotvaccinafions.com Vaccination Certificate
(602) 820-1255 Date
P„ Pet name
Address //? 4.).`,77/7) Breed
City, State, Zip Birthdate
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Is your pet pregnant? YES (N-0) If yes, when is she due? Gender? Et Male , 0 Female
Has your pet had any coughing or sneezing in the past week? YES 601 Purebred? 0 Yes 0 No
Has your pet had any diarrhea or vomiting in the past week? YES (NO Special notes:
Has your pet ever had any reaction to any vaccination? YES fiCd
Is your pet on antibiotics or any other medications? YES /NO)
How did you hear about us?
I understand that vaccinations can cause reactions in some patients and that I will be responsible for any costs related to
their treatment. I agree to indemnify and hold harmless Shot Spot Vaccinations, LLC and the attending Veild veterinarian(s) from and
against any and all liability arising out of the performance of all procedures that I have • tt01
Signature of Legal owner or authorprson
X X X THIS SECTION IS FOR SHOT SPOT VACCINATIONS USE ONLY X X X
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Body Mass 4-1( ci Dental scale 1fr,- -
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Dog Care Provided Tolay: Cat Care Provided Today:
-)D,Rabies (RR) SQ Expires:rvoo 201 bvs1 year 0 Rabies (RR) SQ Expires: 0 1 year
ManufactuR Pfizer Cl 3 year Manufacturer : Pfizer 0 3 year
Serial # cf Serial #
LI DA2PPV (RS) SQ Expires: LI 1-HCPCh (RS) SQ Expires:
LI Bordetella (IN) Expires: O FeLV (LR) SQ Expires:
El Rattlesnake (LS) SQ Expires: LI Deworm (pyrantel pamoate 50mg/m1) rrils PO
LI Deworm (pyrantel pamoate 50mg/m1) mis PO CI Microchip (mid-shoulder SQ)
O Microchip (mid-shoulder) SO) El FELV/F1V test: Positive Negative
LI Heartworm Test: Positive Negative O Nail Clipping
D Heartworm Preventative Prescribed: 1 year supply O Ear Cleaning
0-25 lbs 26-50 lbs 51-100 lbs 0 Other
D Ear Cleaning' 6raf Like us on 1-
0 Nail Clipping 0Anal Glands -acebook
CI Other shotspetvaccinattions/

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Shotspotvaccinations.eom Vaccination Certificate
(602) 820-1255 Date
601-j24-" Pet name (.,.\2.1( Uk
Address /9/9 a0-0 44 Breed , A- Lc 1d 4
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Email - 1')2O Mb cue& (MAI; 17, 0-6akr/description —
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Is your pet pregnant? YES i&i.) If yes, when is she due? Gender? Ei Male Li Female
Has your pet had any coughing or sneezing in the past week? YES' tin Purebred? p3iYes 0 No
Has your pet had any diarrhea or vomiting in the past week? YES <0 Special notes:
Has your pet ever had any reaction to any vaccination? YES 40
Is your pet on antibiotics or any other meaions?, YES SP
How did you hear about us? I )1
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their treatment. I agree to indemnify and hold harmless Shot Spot Vaccinations, I-1-C and the attending veterinarian(s) from and
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against any and all liability arising out of the performance of all procedures that I have felt todm
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Signature of Legal owner or authorized person
X X X THIS SECTION IS FOR SHOT SPOT VACCINATIONS USE ONLY X X X
Weight (lbs.) 5i, TTeemmop ((FF)) lb 2 Pulse Respiration
Body Mass Dental scale
Ab General appearance Mucous membranes Ab Musculoskeletal
N Ab Eyes Abdomen N N rAb Cardiovascular
Ab Ears Skin Respiratory
N -Ab „ Oral Lymph nodes Ab Neurological
Exam notes: OW Vc)\.) daAINCA ' 13
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Veterinarian Signature: ), __-2 ________ • Lic # 3LD3D_.
Dog Care Provided Today: Cat Care Provided Today:
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Manufacturer : Pfizer Cl 3 year Manufacturer : Pfizer I113 year
Serial # ,C")1 09ISC-' Serial #
DA2PPV (RS) SQ Expires: D 1-HCPCh (RS) SQ Expires:
Li Bordetella (IN) Expires: O FeLV (LR) SQ Expires:
CI Rattlesnake (LS) SQ Expires: Li Deworm (pyrantel pamoate 50mg/m1) mls PO
Li Deworm (pyrantel pamoate SOmeml) mls PO O Microchip (mid-shoulder SQ)
CI Microchip (mid-shoulder) SQ) O FELV/FIV test: Positive Negative
Li Heartworm Test: Positive Negative o Nail Clipping
Li Heartworm Preventative Prescribed: 1 year supply CI Ear Cleaning
0-25 lbs 26-50 lbs 51-100 Ibs O Other
CI Ear Cleaning
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VACCINATION
LEPTOSPIROSIS
Ingelheim Boehringer DISEASE
CHLAMYDIA CALICIVIRUS LEUKEMIA BORDETELLA PARVOVIRUS ADENOVIRUS DISTEMPER
IMMUNODEFICIENCY RHINOTRACHEITIS PANLEUKOPENIA CORONAVIRUS PARAINFLUENZA RECORD
VIRUS 2

RABIES VACCINATION CERTIFICATE
OWNER'S INFORMATION:
LEFEVER APRIL P2361276 (623) 8531332
LAST NAME FIRST NAME PERSON ID TELEPHONE NUMBER EXT:
910 N 180TH DR GOODYEAR AZ 85338
STREET ADDRESS APT CITY STATE ZIP coor
ANIMAL INFORMATION
DOG NEUTERED 5/5/2010 LARGE SIBERIAN HUSKY MIX
ANIMAL TYPE ANIMAL BEA ANIMAL DATE OF BIRTH SIZE PRIMARY BREED SECONDARY BREED
A3301676 SPARKY WHITE
ANIMAL 10 ANIMAL AM NE MICROCHIP NUMBER PRIMARY COLOR SECONDARY COLOR
VACCINATION INFORMATION
RABDOMUN SPEC 12 Months 9/2/2015 9/2/2016 9/2/15
I
VACCINE PRODUCER VACC. LENGTH DATE VACCINATED VACCINATION EXPIRES PRINT DATE
,6„,..,--,e-k. ____4-d-cs-- • `,-"f1/1
KILLED Maricopa County
Animal Care & Control
VAccINE TYPE VETERJNARIANS SIGNATURE 2500 S 27th Avenue, Phoenix, AZ 85009
(602) 506-7387
S410328
VACC. SERIAL NO. VETERINARIANS LICENSE NUMBER

ATBC - Phx
602-943-7729
Animal Summary / Rabies Summary
This is not an invoice.
Owner
B.A,R.K.
1919 North 200th Aye, Buckeye, AZ 85396
623-826-3085
Animal Details Animal's Name: Oliver Ellington Jenkins
Sex: Male
Species: Dog
Age:0 Years, 3.5 Months
Color: Tan /
Breed: Brussels Griffon
Weight: 8.12 lbs
Visit Date: 9/17/2015
Animal Number: 15-9579
Microchip Number:
Rabies Vaccine Producer: Boehringer Ingelheim
Type: One Year
Vaccine Lot 1215406A (expires 8/21/2016)
Number:
Date Vaccinated: 9/17/2015
Expires: 9/17/2016
Veterinarian: Kellie Ayle, License #
Signature:
yLt- -
Clinic Info:ATBC - Phx
950 West Hatcher Road, PHOENIX, AZ
85021
602-943-7729
All Products/Services Date Description
9/17/2015 Dog Neuter
9/17/2015 Rabies 1 year vaccine
9/17/2015 Hernia Repair
9/17/2015 Buprenorphine
This is not an invoice.

AMC Phx
602-943-7729
Animal Summary / Rabies Summary
This is not an invoice.
Owner
B.A.R.K.
1919 North 200th Ave, Buckeye, AZ 85396
623-826-3085
Animal Details Animal's Name: Gabriela
Sex: Female
Species: Dog
Age:0 Years, 2.5 Months
Color: Yellow /
Breed: Labrador Retriever mixed
Weight: 6.80 lbs
Visit Date: 9/17/2015
Animal Number: 15-9573
Microchip Number:
Rabies Vaccine Producer: Boeh ringer Ingelheim
Type: One Year
Vaccine Lot 1215406A (expires 8/21/2016)
Number:
Date Vaccinated: 9/17/2015
Expires: 9/17/2016
Veterinarian: Kellie Ayle, License #
Signature: ,
Clinic Info: Info:ATBC - Phx
950 West Hatcher Road, PHOENIX, AZ
85021
602-943-7729
All Products/Services Date Description
9/17/2015 Dog Spay
9/17/2015 Rabies 1 year vaccine
9/17/2015 Buprenorphine
This is not an invoice.

RABIES VACCINATION CERTIFICATE
OWNER'S INFORMATION:
KENNELS BUCKEYE ANIMAL RES P2262784 (623) 8263085
LAsT NAME FIRST NAh•IS PERSON io TELEPHONE NUMBER EXT:
1919 N 200TH AVE BUCKEYE AZ 85396
STREET ADDRESS APT CITY STATE ZIP CODE
ANIMAL INFORMATION
DOG NEUTERED 9/4/2013 rieb JACK RUSS TERR
ANIMAL TYPE ANIMAL SEX ANIMAL DATE OF BIRTEI SIZE PRIMARY BREED SECONDARY BREED
A3654085 COPPER 19 D 0000 0.06q (464 WHITE BROWN
ANIMAL ID ANIMAL NAME MICROCHIP NUMEIER. PRIMARY COLOR sECONDARY COLOR
' VACCINATION INFORMATION
RABDOMUN 12 Months 9/412015 9/4/2016 9/4/15
VACCINE PRODUCER VAcC, LENGTH DATE VACCINATED VACCINATION EXPIRES PRINT DATE
,,,,-,..74.<-7"--/--1-?(5---
KILLED Maricopa County
Animal Care & Control
VACCINE TYPE vEyERINARSANS SIGNATURE 2500 S 27th Avenue, Phoenix, AZ 85009
(602) 506-7387
S410328
VACC. SERIAL NO. VETERINARIAN% LICENSE NumSER

71:7[1-igo VACCiWATIKDK U
TerimdevL©uung Cav, Official P r 6ct .
Velterrinary Senviices,m Keep this record in a safe. pleoe_. b, Corporate Office Hours:
Mon - Fri 9:00 am - 5:00 pm
480-699-9950 P.O. Box 7479 • Mesa, AZ 85216
• -FA out secti OFFICIAL RECORD - PLEASE PRINT CLEARLY www.TLOVetServices.com
Last Name: u First Name: I 1
L -1
Address:
City: State: Zi
Email: 0 d c sEa v 1) j; • Pi
1-tome: b 9 _A- ';--71 I Y) 42 Elli Work:
I acknowledge having read and I understand the back of this document. Being aware of
these facts, I give my permission to TENDER LOVING CARE VETERINARY SERVICES X 4 DATE / / 14
LLC hnd/or the Doctor to treat and/or administer the vaccinations listed below. There is a $1-$3 waste disposal fee per animal. Prescription ONLY fee $10.
Newdent Yes t No n How did you bear about this clinic? 4Flyer from Store Mailer fj Referral n Website n Other
,-X„:.4::&•104&*1‘4, 1ANlikilaW
Dog ri Male CI Neutered (male) 0 On Medication dDogA Male Di Neutered (male) (71 On Medication
Cat-OFemale 'Mpayed (female) Pregnant 0 Cat 0 Fem9le 1J (female) n Pregnant
Narne Pi.i/) Age ("check one): Name: Age (vmeck one) :
0 Wks 0 Wks
Mos Breed: .3111 LC-- 0 Mos
Ft Yrs Colors: -Fa-77 ASA 1.-fie Yrs
?LEASE DO NOT .WRITE.BEL:OW THIS - ONE •:-.)FFI.C .k:t4E:pituwaiatots WRITE .15ELOW -TI
Rabies Type: KILLED VIRys Mfg. V 'r, _12 -- li -.el PIM ! NEXT BOOSTERS les LLED VIRUS Mfg. .> RICE Lan_ tia - S-TE . -
Lot # S7') \ 1---.04"--r)Ci Tag # - mops n ol include 3.4 6 12 36 Lot A :5‘ 9)0 - M 0 C . - - I Tag. it ' El i ' indude 12 36
pace of boosleis) Weeks Months Months Months .-0.-1-,th,,,, *1 1 ',Ier% ) Weeks tlanitis Monllis Months
Rabies Date Vaccinated: (9 I . r) , ,---1 .„. .. .. R , N ate Vaccinated: ( .0 / h e) 1 .,. .
Rabies Vaccination Due: ( () , ;--- / i , ..„...„ -. ,. 1 ...) --: -9Ci .1 :- Rabies 'nation Due CP 1 15"% I I ---)
1-Diii: DA2PPviBordetella Nasal! Deworm cc $ l DP1 " Bordetella Nasal / Deworm cc
,CP1- 4-in-1 (EVRCP)/ Leukemia / Deworm cc $ CP1- 4-in- 'tato cc $
- DA2PPy / DA2PPoL I Corona $ DA2PPy / 1 PPv-FL / Corona , $ —MI
_ Bordetella - Nasal I Injectable $ Bordetella - N. o I / In ectable i $
Lyme / Rattle Snake $ I Lyme / Rattle ke i $
Deworming (Protal 50 mg/ml) CC $ Deworming (Praia mg/m1) cc 11$
— t Cat 4-in-1 (FVRCP) 1 Leukemia $ IIII 1 Cat 4-in-1 (EVRCP) eukemia $
Test HeartwomilFELV/ Parvo/ 0 Pos 0 Neq $ r Test: Heartworm / FEW/ P el 0 Pos 0 li-e3 $
Heartworm Mfg: 0 Iverheart Max Cl Heartgard Plus M Heartworm Mfg: CI Iverh w , eartgard Plus CI
_,,Fs.sliyalt: 0 0-25# 0 26-50# 0 51-100# $ Pet's Wei ht: El 0-25/! 0 0 51-100# $
Micro Chip # $ Mf s. Micro Ch. # $ Mfg.
Other: $ Qty: @ $ Other: 11$ Qty L 0 $
Other: $ Qt : @ $ Other: iii $ gy: @ $
Other: $ Qt : , b $ L Other: $ Qty: P $
Treatment Fe-ci„ _ Script Fee: $10 $ Treatment Fee: $ Sri
if '.Exam Peef$5 $20 Health Certificate: $ $C, 00 _ . _ Exam Fee( $5 pa Ite_qltt) Certificate. : \ K. . t'-`.•? i
\../ -Waste Dispo-Sal Fee: ($1 '1 $2 $3 $ t Voo J , Waste Disjio§al Fee:( $1 )$2 $3 - -
HR: , t-- \-) RespN ) ' Pet #1 Total giodairi=tiotnineeciu.)de $ _ ne --..... „V- ;a HR: i I-IS Resp: \' 0 Pet #2 TM . does II. 1 clude 1 .77-+,
Ten4P-7s-- .. kr Weight: .5-1 if 'Ps I.' ir-,) Tem -
PHYS CAL EXAM: -- — Next Booster(s) Due On: , il 1 1-1— P. •‘ PHYSICAL l' -\ EXAM: ig • • Next Booster(s) Du' i l S.-
General Appearance !impel a Abnormal a Next Booster(s) Estimated Price I I kk-1-:,--XJ,- Lief! .,1",,,,r;:, General Appearance Nonnal a AbnomW 0 Next Booster (s) Estima ',!‘ Price (- • ,--r.f.,- --- f ,Z -- . - -4-4•4- - i. - .
Skin 1 Coat ill 17/ NOTES I DOSAGE: i,,,i k-1 ''`‘ Skin 1 Coat ID El NOTES! DOSAGE:
Eyes in El Eyes M 17
Ears Et 0 Ears CI 0
Mouth I Dental 0 Cl vj \ _ Mouth / Dental ri
Respiratiny 0 o Respiratory 0 .
HEALTH WITHVNORMAL LIMITS HEALTH WI IN NORMA LIMITS 1 . .
Xes171 No (3 Yes No 0 .
vaccinations not delivered on schedule Vaccination ot delivered on schedule
'se effectiveness. Returning after loose effectiveness. Returning after
..- booster's due date may require the boosters due date ma y require
iaddilional vaccines for propcir protection . additional vaccines for praper pmtection - • 9'
at an additionalloy to pia , Ai, , \-1*1 a l IM/L. ., at an additional ., cost . to you. Sub Total' $ - )
Veterinarian: J Location: Tech. Int CC Fee: $ '-
State Lic # 1442 Date: ( Y Pd $ Bel $ cash10:: cc 0 cvc Cashier Init itKI\) TOTAL:
While: TLC VETERINARY SERVICES LLC Yellow: CLIENT/ COUNTY

RABIES VACCINATION CERTIFICATE
OWNER'S INFORMATION:
RESCUE ANGELS HELPING ANII P2184279 (623) 7428229
LAST NAME FIRST NAME PERSON ID TELEPHONE NUMBER EXT,
12402 W PERSHING ST EL MIRAGE AZ 85335
STREETADDRESS APT CITY STATE ZIP CODE
ANIMAL INFORMATION
DOG NEUTERED 10/26/2012 MED AUST CATTLE DOG MIX
ANIMAL TYPE ANIMAL SEX ANIMAL DATE OF BIRTH SIZE PRIMARY BREED SECONDARY BREED
A3594433 LUCKY(Sipit\i) GRAY BLACK
ANIMAL ID ANIMAL BLAME N MICROCHIP NUMBER PRIMARY COLOR SECONDARY COLOR
VACCINATION INFORMATION
RABDOMUN SPEC 12 Months 4/30/2015 4/30/2016 4/30/15
VACCINE PRODUCER VACC. LENGTH DATE VACCINATED VACCINATION EXPIRES PRINT DATE
cs--
,47:,..-,---
KILLED Maricopa County
Animal Care & Control
VACCINE TYPE VETERINARIANS SIGNATURE 2500 S 27th Avenue, Phoenix, AZ 85009
(602) 506-7387
S410325
VACC. SERIAL NO. VETERINARIAN'S LICENSE NUMBER

RABIES VACCINATION CERTIFICATE
OWNER'S INFORMATION:
RESCUE PAW IT FORWARD P2252655 (480) 4981155 KERRI
LAST NAME FIRST NAME PERSON ID TELEPHONE NUMBER EXT:
5990 E 20TH AVE APACHE JUNCTION AZ 85119
sTREETADoREss APT CM STATE ZIP CODE
ANIMAL INFORMATION
DOG MALE 5/3/2009 LARGE SIBERIAN HUSKY MIX
ANIMAL TYPE ANIMAL SEX ANIMAL DATE OF BIRTH SIZE PRIMARY BREED SECONDARY BREED
A3599984 ni 011h k--0 TAN BLACK WASH
ANIMAL IU ANIPAAL NAME , MICROCHIP NUMBER PRIMARY COLOR SECONDARY COLOR
..,
VACCINATION INFORMATION -
,
RABDOMUN SPEC 12 Months 5/812015 5/8/2016 5/8/15
VACCINE PROOLIcER VACC LENGTH DATE VACCINATED VACCINATION EXPIRES PRINT DATE
KILLED , d74,-. -,e- 4---' Marieopa County
Animal Care & Control
VACCINE TYPE VETERINARIANS SIGNATURE 2500 S 27th Avenue, Phoenix, AZ 85009
(602) 506-7387
8409070
VACC. SERIAL NO. VETERINARIANS LICENSE NUMBER

RABIES VACCINATION CERTIFICATE
NASPHV FORM 51 (Revised 2007)
MICROCHIP NUMBER •
Print Clearly 985112004429219
FIRST M.I. TELEPHONE
Vanessa (602)332-3862
CITY STATE ZIP
Phoenix AZ 85019
SEX AGE SIZE PREDOMINANT BREED PREDOMINANT
Male Months 0 Under 20 lbs O Shepherd Mix COLORS/MARKINGS
Female 1 Years 20 - 50 lbs Black & Brown
Neuter Over 50 lbs • NAME
Roman
Animal Control License 0. 1 Yr 0 3 Yr 0 Other
MACCINATED PRODUCT NAME Veterinarian: Valerie Moser, DVM
poi5 License No:
MANUFACTURER
(First 3 Letters)
VACCINATION Veterinarian
Y: El 1 yr USDA Licensed Vaccine Signature #4 9 8
filtff2016 O 3 yr USDA Licensed Vaccine Address M irge Wright Low-Cost Spay/Neuter
O 4 yr USDA Licensed Vaccine 11 W. Hatcher Rd.
Initial dose 0 Booster dose Phoenix, AZ 85021
S406515
Vacc. Serial (Lot) No.

RABIES VACCINATION CERTIFICATE Tag fee $: VACCI N RECORD
ADAPTED NASPHV FORM 51 Tag #: Name
Owner's Name &Address PRINT - use ball point pen or type Cert. Serial it: RABIES
PRINT LAST MitIFIRi ii2t.... MI 0 LYME DISEASE
TELEPHONE
0 CANINE DISTEMPER
NO. STREET STREET CITY STATE ZIP o CANINE PARAINFLUENZA
CANINE ADENOVIRUS 2
SPECIES: SEX: AGE: ii SIZE PREDOMINANT BREED: COLORS: 0 CANINE PAR VOVIRUS
Dog Male X 3 Mo. to 12 Mo. igg Under 20 lbs. /.. ...471/2/V j2 '(
Cat 0 Female 0 12 Mo. or older 0 20 -50 lbs 1 0 CANINE CORONAVIRUS
Other 0 Altered EX. Over 50 lbs. 0 NAME: 0 CANINE BORDETELLA
(Specify) O LEPTOSPIROSIS
ii•e)(
O FELINE LEUKEMIA VIRUS
DATE VACCINATED: PRODUCER:
Veterinarian's # 0 FELINE PANLEUKOPENIA
40)- 0/ /S License No. -6 0 FELINE RHINOTRACHEITIS
Month Day Year
( irst 3 Letters) 0 FELINE CALICI VIRUS
VeteFinarian:s _ ,
1 yr. Lic.Nacc. 6( K. Vq.u..,...buleiL by1-..- 1 0 FELINE CHLAMYDIA
VACCINATION 0/ EXPIRES: / c:__e, 54,anc.7 Signature
3 yr. Lic.Nacc. 0 Addreas' 971 6 E. ChoLa St. 0 FELINE IMIVIUNODEFICIENC
Month Day Year Scottsdale, ik, 8526u VIRUS
Vacc. Serial (Lot) No.
(Fr; Boehringer
VAC0410001
Ingelheim
RABIES VACCINATION CERTIFICATE Tag fee $: VACCINON RECFg
ADAPTED NASPHV FORM 51 Tag 44: N e Li
Owner's Name & Address PRINT .: use ball point pen or typo Cert. Serial #: ABIES
6 7,7 FI
PRINT LAST 0 LYME DISEASE
a 6 E CV.=e. MI TELEPHONE
CANINE DISTEMPER
NO. STREET CITY STATE ZIP 0 CANINE PARAINFLUENZA
0 CANINE ADENO VIRUS 2
SPECIE4 SEX: AGE: ki SIZE: u PREDOMINANT BREED: COLORS: 0 CANINE PARVOVIRUS
D g OR Male 3 Mo. to 12 Mo. KO—Under 20 Ihs- PR' bbffp,r eveam o
Cat 0 Female 12 Mo. or older 0 20 - 50 lbs 0 O CANINE CORONAVIRUS
Other 0 Altered Over 50 lbs. 0 NAME: 0 CANINE BORDETELLA
.,
(Specify) 0 LEPTOSPIROSIS
0 /) bLe .. 0 FELINE LEUKEMIA VIRUS
DATE VACCINATED: PRODUCER:
men Veterinarian's # 0 FELINE PANLEUKOPENIA
03. 40/ /S License No. 0 FELINE FiHINOTRACHEITIS
Month Day Year
( irst 3 Letters) 0 FELINE CALICIVIRUS
Veterinarian's
VACCINAT51,XPM • 1 yr. Uc.Nacc.p 0 FELINE CHLAMYDIA
3 _ 4676/0 Signatu11 Lt A k.
yr. Lic.Nacc. a D FELINE IMMUNODEFICIENC't
079 Address
Month . Day Year VIRUS
Vacc. Serial (Lot) No.
Boehringer
VAC0410001
kailV Ingelheim

ATBC - Phx
602-943-7729
Animal Summary / Rabies Summary
This is not an invoice.
Owner
B.A.R.K,
1919 North 200th Ave, Buckeye, AZ 85396
623-826-3085
Animal Details Animal's Name:Takani
Sex: Female
Species: Dog
Age:0 Years, 4.0 Months
Color: White /
Breed: Husky (Siberian) mixed
Weight: 33.80 lbs
Visit Date: 8/27/2015
Animal Number: 15-8716
Microchip Number:
Rabies Vaccine Producer: Boehringer Inge!helm
Type: One Year
Vaccine Lot 1215406A (expires 8/21/2016)
Number:
Date Vaccinated: 8/27/2015
Expires: 8/27/2016
Veterinarian: Kellie Ayle, License #
Signature:
12t
Clinic Info:ATBC - Phx
950 West Hatcher Road, PHOENIX, AZ
85021
602-943-7729
All Products/Services Date Description
8/27/2015 Dog Spay
8/27/2015 Rabies 1 year vaccine
8/27/2015 Pyrantel
8/27/2015 Medium Dog - Female
This is not an invoice.

VACCINATION RECORD
RABIES VACCINATION CERTIFICATE Tag feu $:
Name
ADAPTED NASPHV FORM 51 Tag #:
Owner's Name & Address PRINT - use ball point pen or type Cert. Serial if: 0 RABIES
0 LYME DISEASE
PRINT FIRST' 1 TELEPHONE /6'2' 0 CANINE DISTEMPER
IL1 CANINE PARAINFLUENZA
o CANINE ADENOVIFIUS 2
SPECIES: AGE: SIZE: LI CANINE PARVOVIFIUS
Dog 3 Mo. to 12 Mo. o Under 20 lbs. Li D CANINE CORONAVIRUS
Cat 12 Mo. or older . la 20 - 50 lbs o Li CANINE BORDETELLA
Other o Over 50 lbs.
171 LEPTOSPIROSIS
(Specif)) D FELINE LEUKEMIA VIRUS
DATE VACCINATED: :PRODUCER: U FELINE PANLEUKOP-ENIA
Veterinarian's # '
Licerise No.: I 0 FELINE RHINOTRACHEITIS
Month Day Year (First 3 Letters) 0 FELINE CALICI VIRUS
Veterinarian's
0 FELINE CHLAMYDIA
1 yr. Lic:A/acc..0 • Signature
VACCINATION EXPIRES: 0 FELINE IMMUNODEFICIENCN
3 yr, Lic,A/ace. 0 Address VIRUS
Month Day Year
Vacc. Serial (Lot) No. r") Boehringer
\nell Ingelheim
VAC0410001
VACCINATION RECORD
RABIES VACCINATION CERTIFICATE Tag fee $: • Name
ADAPTED NASPHV FORM 51 Tag #:
D:RABIES-
Owner's Name & Address PRINT- use ball point pen or type Cert. Serial it
111 LYME DISEASE
PRINT LAST? -) , i IF).,,ST _, . , TELEPHON_E [1 CANINE DISTEMPER .
,?"-.. _. ' _ ,,_ ,.,-i'i 14.11.4... ' I--'? e. ," ., . ..- rd.---0:2 `1.- "- '' - .. (....' .'25 . f: j_.;- ..e._. ,_ C.
...--., 0 CANINE PAFtAINELUENZA
NO STREET ' ' C TY,: ,_, 4, STATE_, ., ZIP .
, e 11:-- - --- ., . - , LI CANINE•APENOVIRUS 2L- .
SPECIES SEX: AGE: SIZE: PREDOMINANT BREED: COLORS: p CANINE pARVOVIRUS .
Dog 10 male ID 3 Mo. to 12 Mo. El Under 20 lbs. 01 1 LI CANINE CORONAVIRUS
Cat 0 Female LI 12 Mo or older 0 20 - 50 lbs D . !Li CANINE BORDOELLA •
Other P Altered 0 Over 50 lbs. I) NAME:
0 LEPTOSPIROSIS ..
(Specify) i., D FELINE LEUKEMIA VIRUS
- -
DATE VACCINATED: PRODUCER:— "-- 0 FELINE PANLEUKOPFNIA
, Veterinarian's # : _' -- . -
License 4- No LI FELINE RHINOTRACHEITIS
Month Day Year (Fir'st 3 Letters) D FELINE CALICIVIRUS .
Veterinarian's '-
.0 FELINE CHLAMYDIA
1 yr. Lic./Vacc..P Signature
VACCINATION EXPIRES: D. FELINE IMMUNODEFICIENCY
3 yr. Lic./Vacc. p , Address ; VIRUS •
Month Day Year - 1 .
Vacc, Serial (Lot) No. 1 (M k behringer
Ingeiheim
VAC0410001

RABIES VACCINATION CERTIFICATE
ADAPTED Tag fee $: , VACCINATION RECORD
Owners Name & Address NASPHV FORM 51 Tag #: Name
PRINT LAST PRINT - use ball point pen or tYPo Cert. Serial If: 0 RABIES
ma FIRST /27 . od. ieesocetell
TELEPHONE 6 z 0 LYME DISEASE
No. i 9 / 4-REET Ai/ , e:30 adry Ai az._ gZio .3 a-135 0 CANINE DISTEMPER
ciao
STATE ZIP 9 67 0 CANINE PARAINFLUENZA
SPECIES: SEX: AGE: SIZE: ,863 0 CANINE ADENOVIRUS
Dog I7 Male r 3 Mo. to 12 Mo. 0 Under PR DOMINANT BREED: COLORS: 0 CANINE 2
Cat 0 Female 20 lbs. PARVOVIRUS
Other 0 Altered 12 Mo. or older tp, 20 -50 tbs till A 4) 4-1 iel '- 0 CANINE CORONAVIRUS
otiizkei ,p Over 50 lbs. 0 NAME LIL4-)1/- 0 0 CANINE
(SpeciMieko a 5 / / g 0 03 05 9 tec4/ ore I, BORDETELLA
LEPTOSPIROSIS
DATE VACCINATED: PRODUCER: 0 FELINE LEUKEMIA VIRUS
Uil 3 / Veterinarians # (5 Lc o FELINE PANLEUKOPENIA
Month Day Year ESE Lic-n - • • 0 FELINE
(First 3 Letters) RHINOTRACHEITIS
VACCINATION! 1 yr. Lic./Vacc. 0 I Veterinarian' .,dir 07 0 FELINE CALICI VIRUS
EXPIRES: 3 yr. Signatu . AV 0 FELINE CHLAMYDIA
Month i I Lic.Naccil V Addres • AL 0 FELINE IMMUNODEFICIENCY
Day Year d (F:\ ktOlj gi MIIIMM. VIRUS
Vacc. Serial (Lot) No. 1.11AVICIWak _
/AC0410001
( Boehringer
III I Ingelheirn

VACCINATION RECORD
RABIES VACCINATION CERTIFICATE Tag fee $: Name
ADAPTED NASPHV FORM 51 Tag #:
Owner 's Name &Address PRINT- use ball point pen or typo Cert. Serial #: 0 RABIES
0 LYME DISEASE
PRINT LAST ina‘l.MRST 6.7a,bt-,..e..,1 ' MI TELEPHONE
tag- 0 CANINE DISTEMPER
35 CANINE PAFIAINFLUENZA
NO.1 2f) 1 3EET io , pantait5t, ' P CM TY l, ,,,... STATEict ZIP
35 O CANINE ADENOVIRUS 2
SPECIES: SEX: ACE: SIZE: PR OM INANT BREED: CO ORS: 0 CANINE PAR VOVIRUS
Dog kt-16 Male 0 3 Mo. to 12 Mo. 0 Under 20 lbs. 0 Lea- 44014 CI CANINE CORONAVIRUS
Cat 0 Female (J1 12 Mo. or older 4-1: 20 - 50 lbs 0 " . it 0 CANINE BORDETELLA
Other 0 Altered JO Over 50 lbs. Igr, NAME: LI LEPTOSPIROSIS
ciac,
(Specify) 0FELINE LEUKEMIA VIRUS
DATE VACCINATED: PRODUCER: i ` i-i 0 FELINE PANLEUKOPENIA
Veterinarian's # 0 %...(A .
9 -9) IS ç No. FEUNE RHINOTRACHEITIS
A
Month Day Year (First 3 Letters) 0FELINE CALICIVIRUS
Veterinarian's
0 FELINE CHLAMYD1A
1 yr. Lic.Nacc. 0 Signature
VACCINATION q 3 EXPIRES: i g 0 FELINE IMMUNODEFICIENC)
3 yr. Lic.Nacc. Address l ALCM] VIRUS
w 1)—i —Sgt1E14 ,\ 1
Morith Day Year /
Vacc. Serial (Lot) No. Boehringer
illht Ingelheirn
VAC0410001
VACCINATION RECORD
RABIES VACCINATION CERTIFICATE Tag fee $: Name
ADAPTED NASPHV FORM 51 Tag #:
Owner's Name &Address PFI1NT- use ball point pen or type Cert. Serial #: U RABIES
212.71- 0 LYME DISEASE
PRINT LAST y'7 it , MI TELEPHONE tg,2-5
274. ocgs 0 CANINE DISTEMPER
gti aiaMTATE g 63 9 69 D CANINE PARAINFLUENZA
art_ (ii, ZIP
Na, 9 isITET Ai 20 olth 0 CANINE ADENOVIRUS 2
SPECIES: SEX: AGE: SIZE: PREDOMINANT BREED: COLORS: ju) 0 CANINE PARVO VIRUS
Dog (0 Male 0 3 Mo. to 12 Mo. 0 Under A i 1 t3rt mitt , CANINE CORONAVIRUS
Cat 0 Female .Fl 12 Mo. or older Le 20 - 50 2O lbs b5.€. LA( PA WA-t1- 0 CANINE BORDETELLA
Other D Altered .e Over 50 lbs. CI NAME:
LEPTOSPIROSIS
(Specify) .6 0FELINE LEUKEMIA VIRUS
114-elL
DATE VACCINATED: PRODUCER: 0 FELINE PANLEUKOPENIA
Veterinarian's # *
CI I mem "igr 0 FELINE RHINOTRACHEITIS
- 3 5
Month - Day Year (First 3 Letters) / 0FELINE CALICIVIRUS
Veterinarian's
l0 0 FELINE CHLAMYDIA
. 1 yr. Lic.Nacc. 0 Signature .../..11,...- , ,Ai v
VAQ, CINATIO,N EXPIRES: 3 0 FELINE IMMUNODEFICIENCY
( 1 3 i 1 ( Yr-uc'ivacc 1 i al ir 4 Addr VIRUS
MOnth - Day Year , 'Y e -C::37V-7
Vacc. Serial (Lot) No. (Do i Boehringer
\
4011!V ingelheim
VAC0410001

RABIES VACCINATION CERTIFICATE Tag fee $: VACCINATION RECORD
ADAPTED NASPHV FORM51 Tag #: Name
Owner's Name &Address PRINT - use ball point pen or type Cert. Serial #: RABIES
a avele_ In.
PRINT& ektv jIRSTaitim Ml &A, 0 LYME DISEASE
o CANINE DISTEMPER
NO) 9,19,TREK I, 90 alii
CITY61 STATE& ZIP 0 CANINE PARAINFLUENZA
0 CANINE ADENOVIRUS 2
SPECIES: SEX: AGE: SIZE: 'PREDOMINANT I3REED: CM tit D CANINE PARVOVIRUS
Dog 9- Male g 3 Mo. to 12 Mo. 0 Under 20 lbs. 0
Cat Ili Female 0 12 Mo. or older -,:,{0. 20 - 50 Ihs 1:4 -Sk4 0 CANINE CORONAVIRUS
Other El Altered Over 50 lbs. 0 NAME: Go 10 `/,,e_ 0 CANINE BORDETELLA
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D FELINE LEUKEMIA VIRUS
DATE VACCINATED: PRODUCER: 7. )
Veterinarian's # • 0 FELINE PANLEUKOPENIA
O le--1 I s- b 0 & Ucens No. 0 FELINE RHINOTRACHEITIS
Month Day Year
(First 3 Letters) 0 FELINE CALICI VIRUS
Veterinarian's
1 yr. Lic./VaccJh El FELINE CHLAMYDIA
VACCINATION BORES: Signature
r_Q 1C1 )0 3 yr. Lic.Nacc. 0 0 FELINE IMMUNODEFICIENCY
Address , VIRUS
Month Day Year OA SIA' C‘JU k/16 .6/ 3 9-s-
Vace. Serial (Lot) No.
;MI Boehringer
VAC0410001 VI/ Ingelheim
VACCINATION RECORD
RABIES VACCINATION CERTIFICATE Tag fee $:
Name
ADAPTED NASPI-11/ FORM 51 Tag #:
El RABIES
Owner's Name & Address - PRINT - use ball point pen or type Cert. Serial #:
0 LYME DISEASE
PRI ST6 I egi-- ltPttl,71/1)25 El CANINE DISTEMPER
Irnd 0-5 MI
al ,sr 5.3 0 CANINE PARAINFLUENZA
NO/ 9/ 1ST7 ,,,,„, a, crrY6 STATE ZIP 9k
0 CANINE ADENOVIRUS 2
SPECIES: SEX: AGE: SIZE Pa lL iB(REED: COWIQRS: 0 CANINE PARVO VIRUS
Dog Ziel Male 0 3 Mo. to 12 Mo. 0 Under 20 lbs. D Lvteniffli 0 CANINE CORONAVIRUS
Cat 0 Female 4 12 Mo. or order ,fr42_ 20 - 50 lbs Cit 0 CANINE BORDETELLA
Other 0 Altered TM Over 50 lbs. 0 NAME: , o LEPTOSPIROSIS
i
(Specify) 0 FELINE LEUKEMIA VIRUS
LOCILCi
DATE VACCINATED: PRODUCER: • 0 FELINE PANLEUKOPENIA
Veternarard#
U7 e . 0 FELINE RHINOTRACHEITIS
:7 9
Month Day Year 0 FELINE CALICI VIRUS
(First 3 Letters) Veterinarian's
0 FELINE CHLAMYDIA
1 yr. Lic.Nacc.A. Signature
VACCINATION EXPIRES: WOW— 0 FELINE IMMUNODEFICIEN(
c9 IC,1 I kfl 3y. LicdVacc. 0 Address f .. , VIRUS
N S 1466 A V iel-C3 D / TS-
. Month Day Year •
Vacc. Serial (Lot) No. Boehringer
keti Ingelheim
VAC0410001

RABIES VACCINATION CERTIFICATE
,
OWNER'S INFORMATION:
MUTKA LILIA P2285030 (623) 8263085
LAST NAME FIRST NAME PERSON ID TELEPHONE NUMBER EXT:
2910 N 190TH DR LITCHFIELD PARK AZ 85340
STREET ADDRESS APT CITY STATE ZIP CODE
I
ANIMAL INFORMATION
DOG SPAYED 12/13/2013 SMALL CHINESE SHARPE! AUST CATTLE DOG
ANIMAL TYPE ANIMAL SEX ANIMAL DATE OF EN RTH SIZE PRIMARY BREED _ sECONOARY BREED
A3547175 ea6)e, 000iseAgoei WHITE BLACK
ANIMAL-1D ANIMAL NAME MICROCHIP NUMBER PRIMARY COLOR SECONDARY COLOR
VACCINATION INFORMATION
RABDOMUN 12 Months I 12/19/2014 12/19/2015 12119/14
VACCiNE PRODUCER vACC. LENGTH DATE VACCINATED VACCINATION EXPIRES PRINT DATE
. 4,x,, Lee _ ,,I• . , _ _
KILLED ------- \ r Maricopa County
" - -- - ---- -- -- • - - - -- .- —Animal-Care-Et-C-0121Tel- — - -
VACCINE TYPE VETERINARIANS =NATURE 2500 S 27th Avenue, Phoenix, AZ 35009
(604506-7387
5313833
VACC. SERIAL NO. VETERINARIANS LICENSE NUMBER

RABIES VACCINATION CERTIFICATE
OWNER'S INFORMATION:
RESCUE , ANGELS HELPING ANIf P2184279 - (623) 7428229
LASTNAME . FlrisT NAME PERSON ID InEPHONB NUmBER . EXT: '
12402 W PERSHING ST EL-MIRAGE AZ 85335
STREET ADDRFES • APT COY STATE ZIP CODE
ANIMAL INFORMATION
. . -
DOG NEUTERED 1/16/2014 SMALL CHIHUAHUA SH MIX
ANIMAL TYPE-1 ANMAL SEX ANIMAL DATE OF BIRTH SOS PRIMARY BREED SECONDARY BREED
A3562890 -Tueizzy 99e00000t9o365 TAN
ANIMAL ID ANMAL NAME MICROCHIP NtilAUFR PRIMARY COLOR SECONDAR COLOR
VACCINATION INFORMATION
RABDOMUN 12 Months 1/26/2015 1/26/2016 2125/15
VACCINE PRollUcER VAcC, LENGTH DATE VACCINATED VACCINATOR EXPIRES PRINT DATE
A-,,,,z/eu - . ..,-. ..
KILLED Maricopa County
Animal Care & Control
VACGNE TYPE VEi ERIELMBANS SIGNATURE 2500 S 27th Avenue, Phoenix, AZ 85009
. (602) 506-7387
8406516
VACC. SERIAL No, VETERIXARiAN'S LICENSE M.IMBER-

RABIES VACCINATION CERTIFICATE
OWNER'S INFORMATION:
RESCUE ANGELS HELPING ANI1 P2184279 (623) 7428229
LASTNAME IIRST NAME PERSON ID TELEPHONE NUMBER EXT:
12402 W . PERSHING ST EL MIRAGE
AZ i 85335
STREET ADDRESS APT C T' STATE ZIP CODE
ANIMAL INFORMATION
DOG NEUTERED 3130/2014 LARGE POINTER PIT BULL
ANIMAL TYPE 1 ANIMAL Si( ANIMAL DATE OF BIRTH SIZE PRIMARY BREED SECONDARY aRao
A3.528396 • - CHEVY WHITE BRINDLE
ANIMAL ID
ANNAL WLME MICROCHIP NUMBER PRIMARY COLOR SEZ-ON6ARY COLOR
VACCINATION INFORMATION
1
RABDOMUN 12 Months 10/30/2014 ' 10/30/2015 10/31/14
VACCINE PRODUCCR VACC, LENGTH DATE VACCINATED VACCINATiON E.XPIRES PRINT DATE
4,_,* .4•,..?cs--. NI-7-1/144
KILLED
Maricopa County
VACCINE TYPE VETERINARIANS SIGNATURE Animal Care & Control
2500 S 27thAvenue, Phoenix, AZ 85009
S313833 (602) 506-7387
VACC. slam_ NO. VETERINAR LANs LICENSE NUMBER

ATBC - Phx
602-943-7729
Animal Summary / Rabies Summary
This is not an invoice.
Owner
BARK.
1919 North 200th Ave, Buckeye, AZ 85396
623-826-3085
Animal Details Animal's Name: Dougie
Sex: Male
Species: Dog
Age: 0.00 Years, 10.0 Months
Color: Tan /
Breed: Border Collie
Weight: 59.00 lbs
Visit Date: 3/25/2015
Animal Number: 15-3196
Microchip Number:
Rabies Vaccine Producer: Boehringer Ingelheim
Type: One Year
Vaccine Lot Number: 1215399A (expires 12/2/2016)
Date Vaccinated: 3/25/2015
Expires: 3/25/2016
Veterinarian: Shannon Carey, License #
Signature: _
Clinic Info: ATBC - Phx
950 West Hatcher Road, PHOENIX, AZ
85021
602-943-7729
All Date Description
Products/Services
3/25/2015 Dog Neuter
3/25/2015 Rabies 1 year vaccine
3/25/2015 Large Dog - Male
This is not an invoice.

RABIES VACCINATION CERTIFICATE Tag fee $: VACCINATION-SECORID
ADAPTED NASPHV FORM 5/ Tag #:
Owner's Name & Address PRINT - use ball point pen ortype Cert. Serial #: AB1ES
PRINT LAST MI tea_S 0 LYME DISEASE
P)airr
nip -3 ?54f, 0 CANINE DISTEMPER
NO., 9/ ITREN ,,, du/ cingueb4.0, STAT6 ZIP 9 0 CANINE PARAINFLUENZA
(2 0 CANINE ADENOVIRUS 2
SPECIE: SEX: AGE: SIZE: PfIlEDOMINANT , BREED: COLORS: 0 CANINE PAR VOVIRUS
Dog 101 Male o 3 Mo. to 12 Mo. X Under 20 lbs. . 0 0 i i y 0 CANINE CORONAVIRUS
Cat D Female 12 Mo. or older 20 - 50 lbs is t
Other 0 Altered Over 50 lbs. 0 NAME: CANINE BORDETELLA
Lia o LEPTOSPIROSIS
(Specify) et
il 1) 0 FELINE LEUKEMIA VIRUS
DATE VACCINATED: PRODUCER: VC .„.., --) cc- 0 FELINE PANLEUKOPENIA
Veterinarian's . --) ,.) , I (J
U) ')-) K- ) LTcense No. 0 FELINE RHINOTRACHEITIS
Month Day Year irst 3 Letters) EI FELINE CALICIVIRUS
a Veterin 1/4.. 'taut k. ir4w..11.1.04_ tyvon
I yr. Lic.Nacc. 0 FELINE CHLAMYDIA
VACCINATION (.)) 2) EXPIRES: to Signature 9716 t. U,DcgJam St. 0 FELINE IMMUNODEFICIENCY
3 yr. lic.Nacc. 0 40,341 Address
Scciiiitillagr,s., AM' 0.52.6-‘2 VIRUS
Month Day Year
Vacc. Serial (Lot) No.
Boehringer
VAC0410001 ingelheim

RABIES VACCINATION CERTIFICATE Tag fee $: VACC1
ADAPTED NASPHV FORM 51 Tag #: 1115rne
'owner's Name & Address Tr r PRINT - use ball point pen or type Cert. Serial #: Ly RABIES
PRINT LAST MI &Z. 0 LYME DISEASE
TELEPHONE 0
No./ 9./ ,9TFIEw iv/ a& ug, _ 3 0-36 0 CANINE DISTEMPER
6202) A STATE ZIP ee3 0 CANINE PAFIAINFLUENZA
96,
SPECIES: SEX: D CANINE ADENOVIRUS 2
Dog Male 0 AGE: SIZE: PREDOMINANT i J. BREED: Calm: 0 CANINE PARVOVIFtUS
3 Mo. to 12 Mo. Under 20 lbs. CI t)
Cat n ti-Att- . Li V.Z. M. efi zWIA CANINE CORONAVIRUS
Other 0 Altered Over 50 lbs. 0 'ME: 0 CANINE BORDETELLA
(Specity) o LEPTOSPIROSIS
1 Glk 0 FELINE LEUKEMIA VIRUS
DATE VACCINATED: PRODUCER:
. Veterinarian's # ; 0 FELINE PANLEUKOPENIA
(1 3 1C,-) IN License No. 0 FELINE RHINOTRACHEITIS
Month Day Year /
irst 3 Letters) volfficrwxya) 0 FELINE CALIC1V1RUS
1 yr. Lic./Vacc. (. uluel, k. (CIAA.,./liet b Virn ID FELINE CHLAMYDIA
VACCINATION EXPIRES: _ Signature
LI) —...) 3 yr. Lio./Vacc. U Address 971IS E. Gbwrillia M. 0 FELINE IMMUNODEFICIENCY
1 VIRUS
Month Day Year S1 0-1-C Scoitsdalle, AT. 85260
Vacc. Serial Lot No,
r, . Boehringer
VAC0410001 f ii Ingelheim

RABIES VACCINATION CERTIFICATE
OWNER'S INFORMATION:
_
MUTKA LILIA P2285030 (623) 8263085
LAST NAME FIRST NAME PERSON ID TELEPHONE NUMBER EXT:
'
BUCKEYE AZ 85396
STREET ADDRESS APT CITY STATE ZIP CODE
ANIMAL INFORMATION
DOG SPAYED 7/8/20)2, LARGE GERM SHEPHERD MIX
ANIMAL UPS ANIMAL SEX ANIMAL DATE OF BIRTH SIZE PRIMARY BREED SECONDARY BREED
A3628519 D.e/12 04205/522_, WHITE
07 /16-P-46-e #6,0fit
AERIAL II) PRIMARY COLOR SECONDARY COLOR
ANIMAL NAME MICROCHIP NUMBER
VACCINATION INFORMATION
RABDOMUN 12 Months 7/15/2015 7/15/2016 7/15/15
VACCINE PRODUCER VACC. LENGTH DATE VACCINATED • VACCINATION EXPIRES PRINT DATE
"ki,,,,ZA&SI7 ____-4,----------t
KILLED Maricopa County
Anima! Care & Control
VACCINE TYPE VETERINARIANS SIGNATURE
2500 S 27th Avenue, Phoenix, AZ 85009
(602) 506-7387
S410328
VACC SERIAL NO. VETERiNARINIS LICENSE NUMB Z R