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Mai icopa ColTity Animal Care And Control 2500 South 27th Avenue Phoenix, AZ 85009 (602) 506-7387 Tele. (602) 506-2739 Fax KENNEL PERMIT APPLICATION LI New Renewal Permit # Li Name: A .01115 D Kennel Name: M Mailing Address . a-7 /064:)) LIL Kennel Location: )tri 4-) City 9I(\oeno,,i\--c_. ZIP 439;1S- County Supervisorial District Home Phone: _ Kennel Phone: 60Z, 47,20 gO6 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. rn INVe assume complete responsibility for the kennel at the premises for which I/we are making applica 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). I/We certify that I/We have gs and that the kennel meets the definition in statute. 3. IN I/We certify that INVe have not been convicted of a violation of A.R.S. §§ 13-2910 (cruelty to animals) or 13-910.01 (dog fighting), or similar violations of any other state, county or municipal animal welfare law. (Violations of license and leash laws DO NOT apply). y 4. ill . , INVe certify that all dogs over the age of three (3) months that are kept, harbored or maintained on the premis s of the above named kennel have been properly vaccinated against rabies by a veterinarian licensed to practice in the state of Arizona and that 3„9,-,Irrent n'abination cerrate signed by a licensed veterinarian is maintained on the premises for each dog. 6. I /We certify that M !e are submitting a valid copy of the rabies vaccination certificate for each dog this application. 6. I/We understand that a dog remaining within the kennel is not required to be licensed individually under A. .S. 11-1008. l/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. 7.1MiJ. I/We understand that a person who fails to obtain a kennel permit under A.R.S.§11-1009 is subject to a penaltof twenty-five dollars in addition to the annual fee. 8. IANe understand that a person who knowingly fails to obtain a kennel permit within thirty days after written hotification from the county enforcement agent is guilty of a class 2 misdemeanor.. 9.eR. The undersigned understand that that the kennel permit does not authorize the operation of any type of b ess and is solely used for the purpose of licensing multiple dogs. I/We certify that all of the information I/We have provided is true and accurate under penalty of law. Applicant Signature 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 of 2 Maricopa County Animal Care & Control 2500 South 27 th Avenue Phoenix, AZ 85009 Phone: (602) 506-7387 pets.maricopa.gov KENNEL PERMIT PREMISE INSPECTION APPLICANT A), (`__4 k 03 on STREET ADDRESS E, , / 0 01-0 Lrl CITY, STATE, ZIP P At g -S-OED PHONE ALTERNATE PHONE COUNTY DISTRICT 3 KENNEL LICENSE 1/415- OinNUMBER OF DOGS 39 1. Are all dogs over the age of three months properly vaccinated for rabies and in possession of a valid rabies vaccination certificate? Yes No NOTE: Copies of each rabies vaccination certificate must be attached to the Kennel Permit Premise Inspection form. 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 No CORRECTIVE ACTION NEEDED FOR COMPLIANCE AND DAYS GIVEN BEFORE REINSPECTION. (Note: There will be $49 re-inspect fee payable to the Inspector by check upon each return visit.) Deputy Enforcement Agent Date CERTIFICATE OF VACCINATION Certificate No. 0 Date of Vaccination: 06-12-12 Previous Vaccination: Next Vaccination on: 06-12-15 OWNER OF ANIMAL VETERINARY CLINIC Mary Johnson Indian Bend Animal Hospital 2527 E.Tonto Ln, 3923 E. Thunderbird Road Phopniy A7 85050 Phoenix, AZ 85032 602-867-2992 This is to certify... VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. THAT I HAVE Patient information... TAG NO: 1 PATIENT: Cotton BREED: West Highland Terrier SPECIES: Canine AGE: 10 years SEX: Female COLOR: White WEIGHT: 0.00 lbs MICROCHIP: MFG BY: Merial, SERIAL: 18156A, EXPIRES: 12/16/12, ADIVIIN: Sq Signed: —Rettef-Veterin‘a License: Other Vaccinations... CERTIFICATE OF VACCINATION Date of Vaccination: 06-12-12 Certificate No. 0 Next Vaccination on: 06-12-15 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phnpniv L 7 1:1050 06- 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Fancy TAG NO: 5 SPECIES: Canine BREED: Boxer SEX: Spayed Female AGE: 11 years WEIGHT: 68.00 lbs COLOR: Fawn/Blk Mask MICROCHIP: MFG BY: !Vial, SERIAL: 18156A, EXPIRES: 12/16/12, ADMIN: Sq Signed: -4tehief Veterinar icense: Other Vaccinations... Vaccinated By Vaccination Next due 05-27-11 KJA Rabies-Canine lyr, (none) Date of Vaccination: 06-12-12 Certificate No. 0 Next Vaccination on: 06-12-15 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix, AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Tamarah TAG NO: 6 SPECIES: Canine BREED: Labrador Retriever Mix SEX: Spayed Female AGE: 4 years WEIGHT: 33.00 lbs COLOR: Black and White MICROCHIP: MFG BY: MeVal, SERIAL: 18156A, EXPIRES: 12/16/12, ADMIN: Sq Signed: —Re4ief.Veterin ense: Other Vaccinations... Vaccinated By Vaccination Next due 05-27-11 KJA Rabies-Canine 1yr (none) Date of Vaccination: 06-12-12 Certificate No. 0 Next Vaccination on: 06-12-15 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix, AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Toby TAG NO: 4 SPECIES: Canine BREED: Yorkshire Terrier SEX: Neutered Male AGE: 7 years WEIGHT: 0.00 lbs COLOR: Black and Tan MICROCHIP: MFG BY: Mvrial, SERIAL: 18156A, EXPIRES: 12/16/12, ADMIN: Sq Other Vaccinations... Vaccinated By Vaccination Next due 05-27-11 KJA Rabies-Canine 1yr (none) CERTIFICATE OF VACCINATION Date of Vaccination: 06-12-12 Certificate No. 0 Next Vaccination on: 06-12-15 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix, AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Lil Red TAG NO: 5 SPECIES: Canine BREED: Dachshund SEX: Male AGE: 7 years WEIGHT: 0.00 lbs COLOR: Red MICROCHIP: MFG BY: Merial, SERIAL: 18156A, EXPIRES: 12/16/12, ADMIN: Sq Signed: t\4' -114V\ .4ef VeterinNan \\License: .3cos' Other Vaccinations... Vaccinated By Vaccination Next due 05-27-11 KJA Rabies-Canine 1yr, #1 (none) CERTIFICATE OF VACCINATION Date of Vaccination: 06-12-12 Certificate No. 0 Next Vaccination on: 06-12-15 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phnenix. AZ 85050 602-867-2992 This is to certify._ THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Dimples TAG NO: 7 SPECIES: Canine BREED: Dachshund SEX: Female AGE: 4 years WEIGHT: 0.00 lbs COLOR: Dapple MICROCHIP: MFG BY: Mwial, SERIAL: 181660, EXPIRES: 5/4113, ADMIN: Sq Signed: -R-e4ief Veterina r Other Vaccinations... Vaccinated By Vaccination Next due 05-27-11 KJA Rabies-Canine lyr, (none) CERTIFICATE OF VACCINATION Date of Vaccination: 06-12-12 Certificate No. 0 Next Vaccination on: 06-12-15 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix, AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Cookie TAG NO: 1 SPECIES: Canine BREED: Dachshund SEX: Female AGE: 6 years WEIGHT: 0.00 lbs COLOR: Piebald/Red MICROCHIP: MFG BY:41/lerial, SERIAL: 18156A, EXPIRES: 12/16/12, ADMIN: Sq Signed: -dtstEVeterinNn icense: Other' Vaccinations... Vaccinated By Vaccination Next due 05-27-11 KJA Rabies-Canine 1yr, tt\ (none) Date of Vaccination: 06-12-12 Certificate No. 0 Next Vaccination on: 06-12-15 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix, AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Bambaki TAG NO: 3 SPECIES: Canine BREED: Dachshund SEX: Male AGE: 8 years WEIGHT: 0.00 lbs COLOR: Cream MICROCHIP: MFG BY: %vial, SERIAL: 18156A, EXPIRES: 12/16/12, ADMIN: Sq Signed: Veten rian manse: 3SC,S' Other Vaccinations... Vaccinated By Vaccination Next due 05-27-11 KJA Rabies-Canine 1yr, #1 (none) CERTIFICATE OF VACCINATION Date of Vaccination: 06-12-12 Certificate No. 0 Next Vaccination on: 06-12-15 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix, AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Tiger TAG NO: 6 SPECIES: Canine BREED: Dachshund SEX: Male AGE: 4 years WEIGHT: 10.70 lbs COLOR: Red Brindle MICROCHIP: MFG BY: MNal, SERIAL: 18156A, EXPIRES: 12/16/12, ADMIN: Sq I Signed: SN Other Vaccinations... Vaccinated By Vaccination Next due 05-27-11 KJA Rabies-Canine lyr (none) CERTIFICATE OF VACCINATION Date of Vaccination: 06-12-12 Certificate No. 0 Next Vaccination on: 06-12-15 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix, AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Cash TAG NO: 0 SPECIES: Canine BREED: Dachshund SEX: Male AGE: 6 years WEIGHT: 0.00 lbs COLOR: Cream MICROCHIP: MEG BY: Maria!, SERIAL: 18156A, EXPIRES: 12/16/12, ADMIN: Sq vp/ Signed: Veteringtian Other Vaccinations... Vaccinated By Vaccination Next due 05-27-11 KJA Rabies-Canine 1yr, #1 (none) CERTIFICATE OF VACCINATION Date of Vaccination: 09-23-14 Certificate No. 0 Next Vaccination on: 09-22-17 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix, AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Cleo #1 TAG NO: SPECIES: Canine BREED: Dachshund SEX: Female AGE: 19 months WEIGHT: 11.00 lbs COLOR: Blk & Tan MICROCHIP: MFG BY: B.1., SERIAL: 1A5388 EXPIRES: 06-06-15, ADMIN: RH SQ Signed: Frank Isom, DVM \Licbilse:- 3307 Other Vaccinations... CERTIFICATE OF VACCINATION Date of Vaccination: 06-12-12 Certificate No. 0 Next Vaccination on: 06-12-15 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix, AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Bubbles TAG NO: 9 SPECIES: Canine BREED: Dachshund SEX: Female AGE: 4 years WEIGHT: 0.00 lbs COLOR: Blue and Tan MICROCHIP: MFG BY: M naP , SERIAL: 18156A, EXPIRES: 12116/12, ADMIN: Sq Signed: -ef Veterinan .nse: Other Vaccinations... Vaccinated By Vaccination Next due 05-27-11 KJA Rabies-Canine 1yr, #1 (none) CERTIFICATE OF VACCINATION Date of Vaccination: 06-12-12 Certificate No. 0 Next Vaccination on: 06-12-15 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix, AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Li! Gracie TAG NO: 4 SPECIES: Canine BREED: Dachshund SEX: Female AGE: 3 years WEIGHT: 0.00 lbs COLOR: Choc/Cream MICROCHIP: MFG BY: Kprial, SERIAL: 18156A, EXPIRES: 12/16/12, ADMIN: Sq Signed: -`bIi\f`- fitrIlrf V et erinari ense: Other Vaccinations... Vaccinated By Vaccination Next due 05-27-11 KJA Rabies-Canine 1yr, #1 (none) CERTIFICATE OF VACCINATION Date of Vaccination: 09-23-14 Certificate No. 0 Next Vaccination on: 09-22-17 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix, AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Cooper TAG NO: SPECIES: Canine BREED: Dachshund SEX: Male AGE: 15 months WEIGHT: 8.80 Ibis COLOR: Red MICROCHIP: MFG BY: B.I., SERIAL: 11 88A, EXPIRES: 06-06-15, ADMIN: RH SO Signed: Frank Isom, DVM License: 3307 Other Vaccinations... CERTIFICATE OF VACCINATION Date of Vaccination: 09-23-14 Certificate No. 0 Next Vaccination on: 09-22-17 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 PlinFinix, AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Roxie 1 TAG NO: SPECIES: Canine BREED: Dachshund SEX: Female AGE: 19 months WEIGHT: 13.00 lbs COLOR: Red MICROCHIP: MFG BY: B.I., SERI L 1215388A, EXPIRES: 06-06-15, ADMIN: RH SQ q-1 /./ I i Signed: Frank Isdrin, DAY—. License: 3307 Other Vaccinations... Date of Vaccination: 10-01-14 Certificate No. Next Vaccination Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 86032 nix. AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIE TAG NO: 210 SPECIE ne BREED: Dachshund SEX: Female AGE: 4 years WEIGHT: 0.00 lbs COLOR: Cream MICROCHIP: MFG BY: B.I,\ SERIAL: 1215388A, EXPIRES: 06/06/15, ADMIN: R H So Signed: License: Other Vaccinations... Vaccinated By Vaccination Next due 05-27-11 KJA Rabies-Canine lyr (none) CERTIFICATE OF VACCINATION Date of Vaccination: 06-12-12 Certificate No. 0 Next Vaccination on: 06-12-15 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix. AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Blanca TAG NO: 0 SPECIES: Canine BREED: Dachshund SEX: Female AGE: 6 years WEIGHT: 0.00 lbs COLOR: Cream MICROCHIP: MFG BY: Merial, SERIAL: 18156A, EXPIRES: 12/16/12, ADMIN: Sq Signed: .Fiettef.Veterinar n License: Other Vaccinations... Vaccinated By Vaccination Next due 05-27-11 KJA Rabies-Canine 1yr, #1 (none) CERTIFICATE OF VACCINATION Date of Vaccination: 09-23-14 Certificate No. 0 Next Vaccination on: 09-22-17 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix, AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Minnie TAG NO: SPECIES: Canine BREED: Dachshund SEX: Female AGE: 14 months WEIGHT: 11.40 lbs COLOR: Red MICROCHIP: MFG BY: B.I., SERIAL:11518 EXPIRES: 06-06-15, ADMIN: RH SQ \PD Signed: Frank Isom, DV icense: 3307 Other Vaccinations... CERTIFICATE OF VACCINATION Date of Vaccination: 06-12-12 Certificate No. 0 Next Vaccination on: 06-12-15 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln Phoenix, AZ 85032 Phoenix, AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Lil Tosha TAG NO: 9 SPECIES: Canine BREED: Dachshund SEX: Female AGE: 6 years WEIGHT: 0.00 lbs COLOR: Cream MICROCHIP: MEG BY: Meriial, SERIAL: 18156A, EXPIRES: 12/16/12, ADMIN: Sq Signed: Other Vaccinations... Vaccinated By Vaccination Next due 05-27-11 KJA Rabies-Canine lyr, (none) CERTIFICATE OF VACCINATION Date of Vaccination: 09-23-14 Certificate No. 0 Next Vaccination on: 09-22-17 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix. A7 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Mouse TAG NO: SPECIES: Canine BREED: Dachshund SEX: Female AGE: 14 months WEIGHT: 9.60 lbs COLOR: Red MICROCHIP: MFG BY: B.1., S_E 11115388A, EXPIRES: 06-06-15, ADMIN: RH SQ Signed: Frank Isom; DVM License: 3307 Other Vaccinations... CERTIFICATE OF VACCINATION Date of Vaccination: 06-12-12 Certificate No. 0 Next Vaccination on: 06-12-15 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix, AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Betty Lou TAG NO: 5 SPECIES: Canine BREED: Dachshund SEX: Female AGE: 6 years WEIGHT: 0.00 lbs COLOR: Choc MICROCHIP: MFG BY: Merigl, SERIAL: 18156A, EXPIRES: 12/16/12, ADMIN: Sq Signed: -RettetVeterinan Lic se: SC,,tic Other Vaccinations... Vaccinated By Vaccination Next due 05-27-11 KJA Rabies-Canine 1yr, #1 (none) CERTIFICATE OF VACCINATION Date of Vaccination: 09-23-14 Certificate No. 0 Next Vaccination on: 09-22-17 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix, AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Lucy TAG NO: SPECIES: Canine BREED: Dachshund SEX: Female AGE: 2 years WEIGHT: 14.40 lbs COLOR: Choc/Tan MICROCHIP: MFG BY: B.I., SERIAL,: i121 38A, EXPIRES: 06-06-15, ADMIN: RH SQ Signed: Frank isorri4V1 License: 3307 Other Vaccinations... Vaccinated By Vaccination Next due 06-12-12 RV Rabies-Canine 1yr, #7 (none) CERTIFICATE OF VACCINATION Date of Vaccination: 07-23-13 Certificate No. 0 Next Vaccination on: 07-22-16 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix, AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Trixie TAG NO: 102 SPECIES: Canine BREED: Dachshund SEX: Female AGE: 4 years WEIGHT: 0.00 lbs COLOR: Black and Tan MICROCHIP: MFG BY: Bi;\ SERIAL: 1215372A, EXPIRES: 17/17/14, ADMIN: R H Sq \tv- Signed: Other Vaccinations... Vaccinated By Vaccination Next due 06-12-12 RV Rabies-Canine lyr, #3 (none) CERTIFICATE OF VACCINATION Date of Vaccination: 09-23-14 Certificate No. 0 Next Vaccination on: 09-22-17 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix, AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Ebony TAG NO: SPECIES: Canine BREED: West Highland Terrier SEX: Female AGE: 5 years WEIGHT: 14.80 tbs COLOR: White MICROCHIP: MFG BY: B.I., S7I L: 11215388A, EXPIRES: 06-06-48, ADMIN: RH SQ DO" Signed: Frank .iulrinljDVI -) License: 3307 Other Vaccinations... Vaccinated By Vaccination Next due 05-27-11 KJA Rabies-Canine lyr, (none) CERTIFICATE OF VACCINATION Date of Vaccination: 06-12-12 Certificate No. 0 Next Vaccination on: 06-12-15 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix, AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Yukee TAG NO: 1 SPECIES: Canine BREED: West Highland Terrier SEX: Female AGE: 6 years WEIGHT: 0.00 lbs COLOR: White rI .6-3r MICROCHIP: MFG BY: Menlo', SERIAL: 18156A, EXPIRES: 12/16/12, ADMIN: Sq Signed: --- - - enn ense: Other Vaccinations... Vaccinated By Vaccination Next due 05-27-11 KJA Rabies-Canine lyr (ncne) CERTIFICATE OF VACCINATION Date of Vaccination: 06-12-12 Certificate No. 0 Next Vaccination on: 06-12-15 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix, AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Sierria TAG NO: 9 SPECIES: Canine BREED: West Highland Terrier SEX: Female AGE: 5 years WEIGHT: 0.00 lbs COLOR: White MICROCHIP: MFG BY: Medal,/ SERIAL: 1,8156A, EXPIRES: 12/16/12, ADMIN: Sq Signed: Relief Veterinarian License: 3 . 6 Other Vaccinations... Vaccinated By Vaccination Next due 05-27-11 KJA Rabies-Canine 1yr (none) CERTIFICATE OF VACCINATION Date of Vaccination: 07-23-13 Certificate No. 0 Next Vaccination on: 07-22-16 Previous Vaccination: VETERINARY CLINIC • OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix, AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Sandy's Westie TAG NO: 104 SPECIES: Canine BREED: West Highland Terrier SEX: Female AGE: 5 years WEIGHT: 0.00 lbs COLOR: White MICROCHIP: MFG BY: BL SERIAL: 1215372A, EXPIRES: 17/17/14, ADMIN: R H Sq Signed: Licen Other Vaccinations... Vaccinated By Vaccination Next due 06-12-12 RV Rabies-Canine 1yr, #8 (none) CERTIFICATE OF VACCINATION Date of Vaccination: 06-12-12 Certificate No. 0 Next Vaccination on: 06-12-15 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix, AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Lil Misty TAG NO: 2 SPECIES: Canine BREED: West Highland Terrier SEX: Female AGE: 9 years WEIGHT: 0.00 lbs COLOR: White MICROCHIP: MFG BY: Meriett SERIAL: 18156A, EXPIRES: 12/16/12, ADMIN: Sq Signed: IRelirft/eterinarian Other Vaccinations... Vaccinated By Vaccination Next due 05-27-11 KJA Rabies-Canine 1yr, #1 (none) CERTIFICATE OF VACCINATION Date of Vaccination: 07-23-13 Certificate No. 0 Next Vaccination on: 07-22-16 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix, AZ 85050 602-867-2992 This is to certify.. THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Molly TAG NO: 101 SPECIES: Canine BREED: West Highland Terrier SEX: Female AGE: 6 years WEIGHT: 0.00 lbs COLOR: White MICROCHIP: MFG BY: SERIAL: 1215372A, EXPIRES: 07/17/14, ADMIN: R H Sq Signed: Licens Other Vaccinations... Vaccinated By Vaccination Next due 06-12-12 RV Rabies-Canine lyr, #0 (none) CERTIFICATE OF VACCINATION Date of Vaccination: 06-12-12 Certificate No. 0 Next Vaccination on: 06-12-15 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix, AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Little Lily TAG NO: 9 SPECIES: Canine BREED: West Highland Terrier SEX: Female AGE: 4 years WEIGHT: 0.00 lbs COLOR: White MICROCHIP: MFG BY Meri41, SERIAL: 18156A, EXPIRES: 12/16/12, ADMIN: Sq c-70 Signed: Rehlrf-Veterina Other Vaccinations... Vaccinated By Vaccination Next due 05-27-11 KJA Rabies-Canine lyr, #1 (none) CERTIFICATE OF VACCINATION Date of Vaccination: 07-23-13 Certificate No. 0 Next Vaccination on: 07-22-16 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix, AZ 85050 602-867-2992 This is to certify THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Jasmine TAG NO: 103 SPECIES: Canine BREED: West Highland Terrier SEX: Female AGE: 5 years WEIGHT: 0.00 lbs COLOR: White MICROCHIP: MFG BY: i , SERIAL: 1215372A, EXPIRES: 07/17/14, ADMIN: R H Sq Signed: Licens Other Vaccinations... Vaccinated By CERTIFICATE OF VACCINATION Date of Vaccination: 09-23-14 Certificate No. 0 Next Vaccination on: 09-22-17 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix, AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Wilson TAG NO: SPECIES: Canine BREED: West Highland Terrier SEX: Male AGE: 15 months WEIGHT: 17.40 lbs COLOR: White MICROCHIP: MFG BY: B.I., SE 15388A, EXPIRES: 06-06-15, ADMIN: RH SQ Signed: Frank Isom, D M- License: 3307 Other Vaccinations... CERTIFICATE OF VACCINATION Date of Vaccination: 06-12-12 Certificate No. 0 Next Vaccination on: 06-12-15 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix, AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Skipper TAG NO: 2 SPECIES: Canine BREED: West Highland Terrier SEX: Male AGE: 4 years WEIGHT: 0.00 lbs COLOR: White MICROCHIP: D<6/ MFG BY: Mikrial, SERIAL: 18156A, EXPIRES: 12/16/12, ADMIN: Sq Signed: --Rel+ef-Veterinar n çL ense: Other Vaccinations... Vaccinated By Vaccination Next due 05-27-11 KJA Rabies-Canine 1yr (none) CERTIFICATE OF VACCINATION Date of Vaccination: 06-12-12 Certificate No. 0 Next Vaccination on: 06-12-15 Previous Vaccination: VETERINARY CLINIC OWNER OF ANIMAL Indian Bend Animal Hospital Mary Johnson 3923 E. Thunderbird Road 2527 E.Tonto Ln. Phoenix, AZ 85032 Phoenix. AZ 85050 602-867-2992 This is to certify... THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES. Patient information... PATIENT: Casper TAG NO: 8 SPECIES: Canine BREED: West Highland Terrier SEX: Male AGE: 7 years WEIGHT: 0.00 lbs COLOR: White MICROCHIP: MFG BY: Menai, SERIAL: 18156A, EXPIRES: 12/16/12, ADMIN: Sq Signed: .ftRalisi-Veterinari Lic Other Vaccinations... Vaccinated By Vaccination Next due 05-27-11 KJA Rabies-Canine lyr, (none)