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7. Yrkk-iNVe understand that a dog remaining within the kennel is not required to be licensed individually under ARS 11-1008. l/we also understand that a dog leaving the controlled kennel conditions shall be licensed under ARS 11-1008 except if the dog is only being transported to another kennel which has a permit issued under this section. 8. 6)----/INVe understand that a person who fails to obtain a kennel permit under ARS 11-1009 is subject to a penalty of twenty-five dollars in addition to the annual fee. 6. CZ I /We certify that I/We are submitting a valid copy of the rabies vaccination certificate for each dog jih this application. 9. INVe understand that a person who knowingly fails to obtain a kennel permit within thirty days after written notifibon from the county enforcement agent is guilty of a class 2 misdemeanor. 10. this kennel permit being obtained for the purposes of operating a bisir E including but not limited to breeders, groomers or boarding establishments? (Please check one) YES 0 NO If the answer is "YES", you will need to provide proof of lawful presence in the United States in order to obtain a kennel permit for the purposes of operating a business. The forms of identification accepted for this purpose are listed below. A.R.S. § 41-1080(A) provides: After September 30, 2008, an agency or political subdivision of this state shall not issue a license to an individual if the individual does not present any of the following documents to the agency or political subdivision indicating that the individual's presence in the United States is authorized under federal law: 1. An Arizona driver license issued after 1996 or an Arizona non-operating identification license. 2. A driver license issued by a state that verifies lawful presence in the United States. 3. A birth certificate or delayed birth certificate issued in any state, territory or possession of the United States. 4. A United State certificate of birth abroad. 5. A United States passport. 6. A foreign passport with a United States visa. 7. An i-94 form with a photograph. 8. A United States citizenship and immigration services employment authorization document or refugee travel document. 9. A United States certificate of naturalization. 10. A United States certificate of citizenship. 11. A tribal certificate of Indian blood. 12. A tribal or bureau of Indian affairs affidavit of birth. Please submit a photocopy of both the front and back of your identification with your completed application. Please also be prepared to present your identification at the time of inspection by the field services officer. If the answer to question 10. above is "NO" please answer question 11. 11. INVe certify that the kennel permit is being used solely for the purpose of licensing my own multiple companion dogs in my household. I/We certify that all o t information I/We have provided is true and ac.surate under penalty of law. aie 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 Maricopa County Animal Care and Control 2500 S. 27th Avenue Phoenix, AZ 85009-6797 (602) 506-7387 http://pets.maricopa.dov Receipt Number: R14-118177 Receipt Date: 06/13/2014 Person ID: P2263346 Phone: 480 5849315 USA PUREBRED LABS LLC KENNELS 6/13/2014 12:51:26PM 27828 N 143RD ST SCOTTSDALE, AZ 85262 Item: Animal ID: Reference No: Price: Each: Amount: KEN PERMIT A7777777 K15-000055 $328.00 1 $328.00 Total Foes Due: $328.00 Payments: Cash: $328.00 Check: $0.00 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.maricopa.gov and click on Balance Due: $0.00 "Contact Us" to email your comments for our review. Animal Information: A7777777 KENNEL PERM - BORN 9/14/1999, SPAYED, UNKNOWN/MIX, TRICOLOR DOG License Information: Tag Number: License Expires: Animal# Vacc Date: Vacc Expires: Please retain this receipt with your pet's records shawcrof EBUSOFF RABIES VACCINATION CERTIFICATE OWNER'S INFORMATION: THOMAS TRACY P2182451 (480) 5849315 LAST NAME FIRST NAME PERSON ID TELEPHONE NUMBER EXT 27828 N 143RD ST SCOTTSDALE AZ 85262 STREET ADDRESS APT CITY STATE ZIP CODE ANIMAL INFORMATION DOG FEMALE 4/30/2013 LABRADOR RETR MIX ANIMAL TYPE ANIMAL SEX ANIMAL DATE OF BIRTH SIZE PRIMARY BREED SECONDARY BREED A3348033 BAILEY BUFF ANIMAL ID PRIMARY COLOR SECONDARY COLOR ANIMAL MA NAME MICROCHIP NUMBER VACCINATION INFORMATION RABDOMUN SPEC 12 Months 7/30/2013 7/30/2014 6/13/14 VACCINE PRODUCER TACO_ LENGTFI DATE VACCINATED VACCINATION EXPIRES PRINT DATE I 4,...Zez.r----2]...-s-- KILLED Maricopa County Animal Care & Control VACCINE TYPE VETERINARIANS SIGNATURE 2500 S 27th Avenue, Phoenix, AZ 85009 (602) 506-7387 S280898A VACC. SERIAL NO. VETERINARIANS LICENSE NUMBER RABIES VACCINATION CERTIFICATE OWNER'S INFORMATION: THOMAS TRACY P2182451 (480) 5849315 LAST NAME FIRST NAME PERSON ID TELEPHONE NUMBER EXT: 27828 N 143RD ST SCOTTSDALE AZ 85262 $TRruADDREss APT CITY STATE ZIP CODE ANIMAL INFORMATION DOG MALE 4/30/2013 LABRADOR RETR MIX ANIMAL TYPE ANIMAL SEX ANIMAL DATE OF BIRTH SIZE PRIMARY BREED SECONDARY BREED A3348037 DUKE YELLOW AN1MALID ANIMAL NAME IAICRCICAP NUMBER PRIRY MA COLOR SECOND COW VACCINATION INFORMATION RABDOMUN SPEC 12 Months 7/30/2013 7/30/2014 7/30/13 VACCINE PRODUCER VACC. LENGTH DATE VACCINATED VACCINATION EXPIRES PRINT DATE 44.9,e '---/-___1"...Z.s----- , KILLED Maricopa County Animal Care & Control VACCINE TYPE VETERINARIANS SIGNATURE 2500 S 27th Avenue, Phoenix, AZ 85009 (602) 506-7387 S280898A VACC. SERIAL NO. VETERINARIANS LICENSE NUMBER RABIES VACCINATION CERTIFICATE OWNER'S INFORMATION: THOMAS TRACY P2182451 (480) 5849315 LAST NAME FIRST NAME PERSON ID TELEPHONE NUMBER EWE 27828 N 143RD ST SCOTTSDALE AZ 85262 5-MEE-TAM:MESS APT CITY STATE ZIP CODE ANIMAL INFORMATION DOG FEMALE 11/30/2012 LABRADOR RETR MIX ANIMAL TYPE ANIMAL SEX ANIMAL DATE OF BIRTH SIZE PRIMARY BREED SECONDARY BREED A3348025 STELLA YELLOW ANIMAL 10 PRIMARY COLOR SECONDARY COLOR I AN IFAAL NAME MICROCHIP NUMBER VACCINATION INFORMATION RABDOMUN SPEC 12 Months 7130/2013 7/30/2014 7/30/13 VACCINE PRODUCER VACC. LENGTH DATE VACCINATED VACCINATION EXPIRES PRINT DATE 1 ,,,,are-,S-_,--,.. KILLED Maricopa County Animal Care & Control VACCMETYPE VETERINARIANS SIGNATURE 2500 S 27th Avenue, Phoenix, AZ 85009 . (602) 506-7387 S280898A VACC. SERIAL NO. VETERINAFUANS LICENSE NUMBER RABIES VACCINATION CERTIFICATE OWNER'S INFORMATION: THOMAS TRACY P2182451 (480) 5849315 LAST NAME FIRST NAME PERSON ID TELEPHONE NUMBER EKE: 27828 N 143RD ST SCOTTSDALE AZ 85262 STREETADDRESS .... APT CITY STATE ZIP CODE ANIMAL INFORMATION DOG FEMALE 10/30/2012 UNKNOWN MIX ANIMAL TYPE ANIMAL SEX ANIMAL DATE OF earmi SIZE PRIMARY BREED SECONDARY BREED A3348026 •PERKY YELLOW ANIMAL ID PRIMARY COLOR SECONDARY COLOR ANIAL M NAME MICROCHIP NUMBER VACCINATION INFORMATION RABDOMUN SPEC 12 Months 7/30/2013 7130/2014 7/30/13 VACCINE PRODUCER VACC. LENGTH DATE VACCINATED VACCINATION EXPIRES PRINT DATE A„,;, ss--- KILLED Maricopa County Animal Care & Control VACCINE TYPE VETERINARIANS SIGNATURE 2500 S 27th Avenue, Phoenix, AZ 85009 (602) 506-7387 S280898A VACC. SERIAL NO. VETERI RAMAN'S LICENSE NUMBER RABIES VACCINATION CERTIFICATE OWNER'S INFORMATION: THOMAS TRACY P2182451 (480) 5849315 LA-ST NAME FIRSTNAME PERSON ID TELEPHONE NUMBER EU: 27828 N 143RD ST SCOTTSDALE AZ 85262 STREET ADDRESS APT . CITY STATE ZIP CODE ANIMAL INFORMATION DOG FEMALE 4/30/2013 LABRADOR RETR MIX ANIMAL 'TYPE ANIMAL SE% ANIMAL DATE OF BIRTH SITE PRIMARY BRF_ED SECONDARY BREED A3348031 ASHLEY CHOCOLATE ANIMAL ID PRIMARY - COLOR SECONDARY -COLOR ANIMAL NAME . MICROCHIP NUMBER VACCINATION INFORMATION - RABDOMUN SPEC 12 Months 7/30/2013 7/3012014 7130/13 VACCINE PRODUCER VACC. LENGTH DATE VACCINATED VACCINATION EXPIRES PRINT DATE AAr.C..-ef__--;.. ,...r<--- KILLED ,--_3 ' Maricopa County Animal Care & Control VACCINE TYPE VETERINARIANS SIGNATURE 2500 S 27th Avenue, Phoenix, AZ 85009 (602) 506-7387 S280898A VACC. SERIAL NO. VETERJNAFLLANS LICENSE NUMBER RABIES VACCINATION CERTIFICATE OWNER'S INFORMATION: THOMAS TRACY P2182451 (480) 5849315 LAST NAME FIRST NAM PERSON ID III EPHONE NUMBER PET: 27828 N 143RD ST SCOTTSDALE AZ 85262 STREET ADDEIEss APT CITY STATE ZIP CODE ANIMAL INFORMATION DOG MALE 7/30/2012 CHOW CHOW LABRADOR RETR ANIMAL TYPE ANNAL SEX ANIMAL DATE OF BIRTH SIZE PRIMARY BREED SECONDARY BREED A3348018 CHOW CHOW BLACK BLACK ANIMAL 10 AN ANIMAL NAME MICROCHIP NUMBER PRIMARY COLOR sEouNDARY COLOR VACCINATION INFORMATION RABDOMUN SPEC 12 Months 1_ 7/30/2013 7/30/2014 7/30/13 VACCINE PRODUCER VACC. LENG TH DATE VACCINATE II VACCINATION EXPIRES PRINT DATE ----Vrvi 4,--.....--/ 7:5--- KILLED Maricopa County Animal Care 8z Control VACCINE TYPE VETERINARIANS SIGNATURE 2500 S 27th Avenue, Phoenix, AZ 85009 (602) 506-7387 VACC. SERIAL NO. VETERINARIAN'S LICENSE NUMBER