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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 0 New ..yt Renewal Permit # Name: ( CLI "Vt t Ad 1 -4-Cv \\A-KA ; „-,c Vodei k Kennel Name: 7:1S °AA' D . Mailing Address: J iL. e 111 1 5 /6 U4 - Kennel Location: 3d11,, /4.) S t tet s la Or— City ?h(`1 t)t AZ ZIP C.7- (5-1 I -1 County Supervisorial District Home Phone: 4- e) 2 - Kennel Cele Phones.2 , - V5- ?6/‘ - 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 "operating a kennel" must obtain a permit issued by the Board of Supervisors where the kennel is located except if each individual dog is licensed. A.R.S. § 11- 1009 and MC Ordinance No. 13, Sec. 4. define a "kennel' as "an endosed, 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 require individual licensing of each dog under the provisions of ARS 11-1008. PLEASE ANSWER THE FOLLOWING QUESTIONS Initial Each 1. MilieriNVe assume complete responsibility for the kennel at the premises for which 1/we are making apPlieation 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- 100 OlfWe certify that the kennel has been approved by the local zoning authority (if applicable) at the es for which I/we are making application for a permit. NVe certify that I/VVe have dogs and that the kennel meets the definition in statute. Z z- 14 1/ ,/ e certify that INVe have not been convicted of a violation of A.R.S. §§ 13-2910 (cruelty to animals) or 1- 910.01 (dog fighting), or any other state, county or municipal animal welfare law. (Violations of license and leash laws DO NOT apply.) 4.. if /41 e certify that all dogs over the age of three (3) months that are kept, harbored or maintained on the pre ses 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 mai ined on the premises for each dog. S e certify that I/We are submitting a valid copy of the rabies vaccination certificate for each dog w th this application. Z., aik understand that a dog remaining within the kennel is not required to be licensed individually under ARS 11-1008. I/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 sectifaff. A , A understand that a person who fails to obtain a kennel permit under ARS 11-1009 is subject to a ty-five dollars in addition to the annual fee. 9ff/(iWe understand that a person who knowingly fails to obtain a kennel permit within thirty days after writ* notification from the county enforcement agent is guilty of a class 2 misdemeanor. 10M/ IC this WV kennel permit being obtained for the purposes of operating a business including but notJted to breeders, groomers or boarding establishments? (Please check one) YES 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,onswer question 10. above is "NO" please answer question 11. I certify that the kennel permit is being used solely for the purpose of licensing my own multiple common dogs in my household. I/VVe certify that all of the information INVe have provided is true and accurate under penalty of law. Applicant Signature Date: V- /-• 2 (9/3 Applicant Signature,. Date: 3-7- 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: R13-167047 Receipt Date: 08/2712013 Person ID: P1512726 Phone: 602 9731690 OHSONOTSO KENNELS 3202 W SIERRA VISTA DR 8/27/2013 3:01:57PM PHOENIX, AZ 85017 Item: Animal ID: Reference No: Price: Each: Amount: KEN PERMIT A7777777 K14-000038 $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.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 munozd EBUSOFF RABIES VACCINATION CERTIFICATE Rabies Tag Number NASPHV Form #50 Owner's Name & Address Print - use ball point pen or type PRINT - Last First M.I. elephone 992/TO/Vgab 11021, No State to,sfr the44 71" gs-.0 12 Species: Sex: Age: Size: Predominant Breed: Colors: Dog Male tIEL. 3 mo. to 12 mo. U Under 20 lbs. 171( Cif/ , IC-itCrA Cat _ Female CI *12 m or older 20-50 lbs. , 0 4M,,,,,, tAy 141 W 7- Nan ie '701'''2711Vg55.41‘:.- Over 50 lbs. 0 , I x Vacc. Serial (lot) No. Producer. _ 13,1 yr. LIc.Nacc. (First 3 letters) 3 yr. Uc.Nacc. Other S o-s-gzi3 For Licensing Agency Use DATE VACCINATED: License No. Year Veterinetian's: # / Month Day Year SJ 1111, '1:701?1!11, " ' Other VACCINATION EXPIRES: 91 . 35th Ave_ Change U Add •Phoenbc, AZ 85051 Control No. 0-/ (602) 269-8969 Month Day Year RABIES VACCINATION CERTIFICATE Rabies Tag Number NASPHV Form #50 Owner's Name & Address Print - use ball point pen or type PRINT - Last First M.I. j Telephow /NY& e 0 4,m , . 773/4 7o szo,z. La) M eitat dc-r-,4:7f ,r • ktY io,"66( 15; z . State L§06.6 17 Species: Sex: Age: Size: Predominant Breed: Colors: Dog 70 Male -Xf. 3 me. to 12 mo. Under 20 lbs. g aki,# ArAmtiiv Cat U Female_ CI 12 mo. or older 20-50 lbs. freeigl- P44.41-) 0 Name Over 50 lbs. 0 W X, Vacc. Serial (lot) No. Producer. U 1 yr. LIc.Nacc: (First 3 letters) 1416/3 yr. UciVacc. Other For Licensing Agency Use DATE VACCINATED: License No. Year Veterinarian's: if_r_/1 Month Day Year Other VACCINATION EXPIRES: CATALINA VgIVNARY CENTER 9023 N. 35th Ave Change 0 Add U / cf. Phoenix, AZ 85051 Control No. / (602)269.8969 Month Day Year RABIES VACCINATION CERTIFICATE Rabies Tag Number IVASPHV Form #50 Owner's Name & Address Print - use ballpoint pen or type PRINT- Last First M.I. 'Telephone /flirC-ELC ?!73/4-5125 Street _ _ State IIP';511 'i Ias - 2 / Species: I Sex: Age: Predominant greed: Colors: Dog 1Male .1Er- 3 mo. to 12 mo. U Under 20 lbs. C761/12/Li-4 6,44 TA Cat U Female . 12 mo. or older- 20-50 lbs. 1-1 ; Over 50 lbs. U Vacc. Serial (lot) No. Producer. R I PI .,x I ca _1 _ yr. Lic.Nacc. (First 3 letters) %I" Irrr acc. Other S c9SYZt3 i4 For licensing Agency Use bATEtt:CCINATED: Veterina License No. Year No Month Day Year Signature Other VACCINATION EXPIRES: CATAUNA VETERINARY CENTER Change U Add U / 9023N. 35th Ave Control No. Phoenix, AZ 85051 Month Day Year (602) 269-8969 RABIES VACCINATION CERTIFICATE Rabies Tag Number NASPHV Form #50 Print - use ball poInt_pen or type Owner's Name & Address M.I. -nr17 3 PRINT: Last, IL-De 1(4 g- Fe fil / Size: Predominant Breed: / Colors: Age: 3 mo. to 12 mo. Under 20 lbs. 12 mo. or older a 20-50 lbs. U Over 50 lbs. Vacc. Serial (14\ No. Producer. PThr- I I U 1 yr.lic./Vacc. 615- (First 3 letters) $. 3 yr. Lic.Nacc. °the For Licensing Agency Use DATE VACCINATED: License No. Year 7 3 / Month Day Year Signature ATALINA VD-ER:NARY CENTLA VACCINATION EXPIRES: a 9022 N. 35th Ave Other r3 Phoeniy, AZ V)51 Change 0 Add U 3/ 4 6 (602) 269-8969 Control No Month Day Year Pet name Keep with your Records Microchip ID #: 497 FOF 703F 111111111111111111011M11110 111110111 111111111 HOiriegAgairi For further assistance visit www.homeagain.com or call 1 888-IfOMEAGA N (1 -888-466 -3242) PARTNERING TO SAVE LIVES TEAR OFF HERE RABIES VACCINATION CERTIFICATE Rabies Tag Number NASPHV Form #50 Owners Name & Address Print - use ball point pen or type PRINT - Last First eiephone /7-7C-4(i-Z6 Atz !"2 3/140 No. 'Street CI 3 24- 44.) 6.42,44 /afoc SPeCieas:, 'Sex: ,AJti Predominant Ererelf Colors: D.69 . -XS Male00)3r ',woo rnrcor Iller 20 lbs: CP fie/ SA-43 Female U Jut- tu). JIJI.J,fr -J:01-30 lbs. U rrteo.ikeaof to HI- Naittihe Mr41. Over 50 lbs. U Producer: 4 1 yr. Lic.Nacc. Vacc. Serial (lot) No. (First 3 letters) id 3 yr. Lic.Necc. Other 0,5-8.2t3 4 For Licensing Agency Use DATE VACCINATED: Ucense No. Year VeterinEulan's: # . 1/ Month Day Year Other VACCINATION EXPIRES: ATALINA VEITVAERY CENTER Change U Add U 9023 N. 35th Ave Control No. Phoenix, AZ 85051 Month Day . Year (602) 269-8969 is/4::;7C 394B 11111111111 NMI 111111111111111111 _ ot I-InmeAaainID.com or fax to (3157634-9076), RABIES VACCINATION CERTIFICATE Rabies Tag Number NASPHV Form #50 laWrilff 5 PUSITICI 0. muuma. M.I. if•elephone PRINT- Lag} rst &/71/9/ S 0 q73/I: `la No. -, .., Streetal • V-5c7 1,7 .04. 0 91 %44...e. 4/2Feer> C ilY 4401.14-. Species: Sex: Age: Size: Predominant e : Colors: Dog pc Male zr 3 mo. to 12 mo. U Under 20 lbs. 43.' Cat 1=1 Female 0 . 12 mo. or older-er 20-50 lbs. Q ae.....d. Name 00 Over 50 lbs. U Vacc. Serial (lot) No. Producer: P PIT. U 1 yr. Lic.Nacc. 1/6 45--e,.. (First 3 letters) Cif 3 yr. Uc.Nacc. Other 5 / , For Licensing Agency Use DATE VACCINATED: Veteri n ans: ' it Mili-e -S License No. Year , . o - •I .4 Month Day Year Signature Other VACCINATION EXPIRES: ICATALINA VIETEPONARY CFNTEF-1 r 9023 N. 35th Ave Change CI Add U 7 3/ /.5 a Phoenix, AZ 85351 Control No. (602) 269-8969 Month Day Year Keep with your Records Pet name -Bie 0 29 it.5' Microchip ID #: 111111111111111111111111111111111111111111111111111111111111 4A2 872 0320 FiCiVigAgain* For further assistance visit www.homeagain.com o call 1 888 HOMEAGAIN 1 888-466-3242) PARTNERING TO SAVE LIVES TEAR OFF HERE RABIES VACCINATION VACCINATION CERTIFICATE Rabies Ta g Number NASPHV Form #50 owners Name e Ptuaress PRINT- Last First M.I.elephone 11,711G1-te -C=G. --47"---7 62 73/0° Street iqL. Die_ ,1-41)( tate is- o es; ''..42 6 Z t& -9/E k caif X.a-/29- Specie: r Sex Age: Size: Predominant Breed: Colors: Dog )171.. Male % 3 mo. to 12 rho. U Under 20 lbs. *4 Cat 4 Female U 12 mo or older?i 20-50 lbs. Li —Leiryii Name 75 50 lbs. 0 If eif,ft Vacc. Serial (lot) No. Producer: f' r .27 4,1 yr. Lic.Nacc. (First 3 letters) la 3 yr. Lic.Nacc. Other S 6.58 z /Z3 A For Licensing Agency Use DATE VACCINATED: Veteri rlan's: / / Licenie No. Year Lice • r. . / / c-C // l i / Month Day Year A..111.1.a -IP gnature Other VACCINATION EXPIRES: . Change LI Add U e ; CATALINA VETERINARY CENTER Control No / / 4-S— / 11 9023 N. 35th Ave Month Day Year Phoenix, AZ 65051 MB% ?fill-R469 464D097115 I 464D@97115 raraigititti 464 D09 711 5 11101111111111111111 - Please enter the following information online at www.HomeA gainID.com or fax to (315-634-9076). or mail completed and detached form with payment in the envelope provided. Keep this part for your records. RABIES VACCINATION CERTIFICATE NASPHV Form ASO Rabies Tag Number Owner's Name & Address Print - use ball point pen or type PRINT - Last First Tr-feLL M.I. I Telephone No. itggf 64) aIIr 320.2) (43 E244 67:4- 20Z A z_Sta e Species: Sex: "hlx Dog rArk !Size: • Predominant Breed: Colors: Male U 3 mo. to 12 mo. Under 20 lbs. ki Cat U. era_ aleM 1 12 mo. or older>i 20-50 lbs. U elik/S` rstiMoift . 444"17 I tAl 4/25ffiratfe , Over 50 lbs. U .-z,. Producer: O 1 yr. Lic.Nacc. Vacc. Serial (lot) No. (First 3 letters) AI 3y. Uc.Nacc. Other Yo-5-1213,4 For Licensing Agency Use • DATE VACCINATED: Ucense No. Year Veterinadian's:# 45-- /1 Month Day Year Other VACCINATION EXPIRES: SIgriure Change U Add U CATAUNA VETERINARY CENTER Control No. 9023 N. 35th Ave Month Day Year Phoenix, AZ 85061 (602) 289-6969 arT1 464 D46 1 960 JP,CP.CII! 11111111111111111111111111111111111111111111111111111 Please enter the followin g information online at www.HomeA gainID.com or fax to (315-634-9076 ) , esr rn&I nesrnnle.f.-.4 _ , • , . . . RABIES VACCINATION CERTIFICATE Rabies Tag Number NASPHV Form #50 Owner's Name & Address Print - use ball point pen or type PRINT- Last First M.1. Telephone • I, • • wr 02 9711694D N9Z2 i), strrikiee4 1;s7,4- Aix Az. State Specivii Sex: Age: Size: Predominant Breed: Colors: Dog Male 17 3 mo. to 12 mo. Under 20 lbs. Cat 0 Female 12 mo. or older 20-50 lbs. 4 Name Over 50 lbs. ca Producer: Vacc. Serial (lot) No. _PI 1 yr. LIc.Nacc. (First 3 letters) A 3 yr. Lic.Nacc. Other S o 2/3 A For Licensing Agency Use DATE VACCINATED: License No. Year Veterinarian's: ; e N o Mont( Day Year Signature Other VACCINATION EXPIRES: Change 0 Add CI r CATAUNA VETERINARY CENTER Control No 9023 N. 35th Ave Month Day Year Phoenix, AZ 85051 46042690169 446 354 356F 11 Detach and keep this part for your records. !doll the part below with payment In the envelope prodded. RABIES VACCINATION CERTIFICATE Owner's Name & Address NASPHV Foml #50 Rabies Tag Number PRINT - Last Print - use ball point pen or type First ge.ZZ G4LA M.I. Telephone Street City 1.4.) 6 4/2 7 7-7/4 ra Species: Sex: State I Zip Dog Al Age: Size: PredbmInant 816—O/7 Male Z..' 3 mo. to 12 mo. Under 20 lbs. "If‘ Breed: Colors: Cat . female f,-J mo. or older$ 20-50 lbs. ‘9/#41de I SA g E Name ' Over 50 lbs. 41 4/ce," I L.-ti Producer: yr. UcJVacc. Vacc. Serial (lot) No. (First 3 letters) W...3 yr. Uc.Nacc. For Licensing Agency Use Other 9 4958' 2 i31Q License No. DATE VACCINATED: Year Veterl IM /5_ /1 Month e No. baj, Year Other Change 1:1 Add 1=1 VACCINATION EXPIRES: CATALINA:ftVRy CENTER Control No. 9023 k. atkkte • Month Phoenix, AZ 05051 Day Year (002) 269.8969' 493 35A 4F13 Fit IIit Keep with your Records Microchip ID #: 493 35A 4F13 14nmpArsadin the New . For further assistance visit www . .homeagain.com or call 1-888-HOMEAGAIN (1-888-466-3242) RABIES VACCINATION CERTIFICATE Rabies Tag Number NASPHV Form #50 Owner's Name & Address Print - use ball point pen or type PRINT - Last First M.I. I Telephone 16 oz. if'7_3 /4- 4?0 MiTC/41Z .hity uJ Nt2 02 to aelet e_ 441, ,iszi.... ie City ,444 10:11, 10 State Z lyr 1 7 Species: Sex: Age: Size: Predominant Breed: Colors: Dog Xi Male 10 3 mo. to 12 mo. CI Under 20 lbs. lat. Cie6 /7-44t "dee C #E1 C LU! / Cat 0 Female Xf 12 mo. or oiderN 20-50 lbs. 0 ri'Ce41 t,J 14 ha( Name Over 50 lbs. U Vacc. Serial (lot) No. Producer: .fi I it- —71 f=i 1 yr. Lic.Nacc. os.B. 3 /f (First 3 letters) )4. 3 yr. Lia/Vace. Other For Licensing Agency Use DATE VACCINATED: Veterinarian's: # License No. Year ( ) - Month Day Year r5thlwe Other VACCINATION EXPIRES: Phoenix, AZ 85051 Change (0 Add 0 45- (602) 269-8969 Control No. Month Day Year 462E110327 462E11_0327 ..... 462 E11 0327 111111 lull 111111 liii 11111111111111111111111111111 liii ICTIDC ';a4i-1‘71.07;a7 Please enter the following information online at www.HomeAgainID.com provided. Keep or fax this to (315 part for -634-9076), your records. • navmPnt in the envelope RABIES VACCINATION CERTIFICATE Rabies Tag Number NASPHV Form #50 Owner's Name & Address Print - use ball point pen or type 14) M.I. gel ephonier7 PRINT - Last /77 / re, fig 41. No. 67P-42-0 Ka+ ItY /6#,‹ 41.6 15-6-/ 3241a Lt.,) Size: Predominant Breed: Colors: Species: Sex: Age: e Dog Xs Male 3 mo. to 12 mo. CI Under 20 lbs. C4 61,1 Cat emale - 12 mo. or older lig 20-50 lbs. PYrio tty Name Cra, Over 50 lbs. 0 Vacc. Serial (lot) No. 'Producer n 1 vr. LIciVacc. 63-8.2/34 (First 3 letters) Other For Licensing Agency Use DATA(LCINATED: Veterin License No. Year _14 Month Day Year A / Signature Other VACCINATION EXPIRES: g CATALINA VETERINARY CENTER Change C-.1 Add LI 9023 N. 35th Ave Control No. Phoenix, AZ 85051 Month Day Year (602) 269-89R9 - - - RABIES VACCINATION CERTIFICATE Rabies Tag Number NASPHV Form #50 Owners Name & Aaaress tv M.I. Telephone PRINT- Last __, First b0 27I /14 /TC—(16ZZ C.-412., y Sta e Zip N g., . Street . City Ay r,r o 1 7 4 A. 0-2. tl) , S faso,gAt 4.57it DP— .09.. Colors: Species: Sex Age: Size: Predomlnant Breed: it/i Male 0 3 mo. to 12 mo. Li Under 20 lbs. X CAVtiv 1.0 id i 7? ' Dog Cat CI Female* 12 mo. or older Pt 20-50 lbs. U '-'4,1c /74.4 Li. Ld/ Bi.4- CA Name RA: 7ç Over 50 lbs. 1:11 Vacc. Serial (lot) No. Producer: r F 1 ID 1 yr. Lic.Nacc. (First 3 letters) iiIr 3 yr. LIcJVacc. Other S C95 1' 3 .4 For Licensing Agency Use DATE VACCINATED: Vetedna n' / License No. Year .„ • Iiipa . / 4.5— Month Day Year —014.-1 .-I6' S ig nature Other VACCINATION EXPIRES: 1 CATALINA VETERINARY CENTER Change U Add C.1 9023 N. 35th Ave Control No / 1-C _f_q Phoenix, AZ 85051 Month Day Year (602) 289-8989 462F565928 462F565928 arisw-vkra,--xmce,monezi LtratiT,1 a —.Atat-',0 111111111 1111 111111111 11111 111 11 i°411516 59-27— — . . ..P..vo.,v9947-6.-r""'-' RABIES VACCINATION CERTIFICATE Rabies Tag Number NASPHV Form OM Owner's Name & Address Print - use ball point pen or type PRINT-Last First Mi. Telephone 41/ra 1/6iz Gi A 12-. y 14) 02r7.3/L7.0 No. 0 , LtjSttreettl . 4/4. 467..4. ikty /0/44 4 z.. State 5firs,4, i 7 Species: "A' Sex: _ ° f- Age: . ' Size: Predominant Breed: 1 e_, Colors . Dog .12i, Male ID 3 mo. to 12 mo. 0 Under 20 lbs. a V ///4 4th(44 1 if<E2c LA/ Cat ra Female* 12 mo. or older4 20-50 lbs. whe/ru t Name 7;9 Over 50 lbs. 0 Vacc. Serial (lot) No. Producer 1 yr. LicNacc. (First 3 letters) 3 yr. Lic.Nacc. Other 048" z 13 /9 For Licensing Agency Use DATE VACCINATED: License No. Year Veterin Mon‘ Day Y ear Other VACCINATION EXPIRES: Change ID Add U ATALINA VETERINARY CENTER Control No. 9023 N. 35th Ave Mo n th Day Year Phoenix, AZ 85051 (602) 260 8980 7-; ii 4630336E55 1 4630336E55 J Iii 463 033 6E55 111111 111 11111 11111 11111 11111 1111 11111 Iffi II , kl! RABIES RABIES VACCINATION CERTIFICATE Rabies Tag Number NASPHV Form 050 Owner's Name & Address Print - use ball point pen or type PAINT- RINT- A i First M.1. fo,'" 01 I (•, /C7 Ata-0/1 - P.,i1 A-4e State NQ,3 0 Str ati 5,5 d 11 Size: Predominant Bre : Colors : €, Species: Sex: Age: Dog lg. Male 0 3 mo. to 12 mo. L3 Under 20 lbs. 4. Cat CI F ale fid 12 mo. or older 21. 20-50 lbs. C-.) 64,66. Name 1.-/4- Over 50 lbs. Ca v. Vacc. Serial (lot) No. Producer: 1 yr. LieNacc. (First 3 letters) j2 3 yr. Lic.Nacc. (C.ththiunt For Licensing Agency Use DATE VACCINATED: Veterlfarian's:.# License No. Year 7 3/ / Month Day Year Si_gnature CATALINA \gT•ETINARY CENTER Other VACCINATION EXPIRES: 902. N. 35a, Ave Change 0 Add phoonik, AZ 85051 Control No. (602) 269-8969 Month Day Year — - Keep with your Records I Pet name Miaochip ID #: 11111111111111111111111111111111 111111111111111111111111111 4A2 53B 6D22 (1-888-466-3242) assistance visit www.homeagain.com or call 1-888 HOMEAGAIN H8inlvAgairl For further PARTNERING TO SAVE LIVES TEAR OFF HERE Rabies Tag Number RABIES VACCINATION CERTIFICATE NASPHV Form r750 Yaw Racua r •••• -••• f j) M.I. Ilelephonl 91 owner's Name et PI001.055 First Oz Y73/4 PRINT - Last 1W TIF/sy 1 7 If/If c-,•17 Street Die PeNc rs-0 tc 1 g a /2.4 4 4.Sfijil- Predominant Breed: Colors: N 2,(92, Wa Age: Size: 'ELIA. Species A : r Sex: 3 mo. to 12 mo. CI Under 20 lbs. X... S''#.i "44 LI 4644 ity W Air Dog Male XIC ., 12 mo. or older 20-50 lbs. CI Cat p Female Over 50 lbs. Cil tagerr::.:1 Vacc. Serial (lot) No. NE411:0-. d I f 0 1 yr. Uc.Nacc, Other I1 65: Z / 3 Producer. (First 3 letters) )iir..3 yr. Uc.Nacc. DATE VACCINATED: Veterinarian's: # For Licensing Agency Use ,A11 License No. Year /45- //' ..41I_,. .. .. _ -,/ Day Year _____' ature Month CATALINA VETERINARY CENTER VACCINATION EXPIRES: 9023 N. 35th Ave . . _ Other Reek, AZ 85051 Change CI Add 0 7 / i3- - & i (802) 269-8969 Control No. Month / Day ' Year „„„„ a 444z. 6,we9e2x, 11S 0 ad.)4. 6 //ei ET NAME 43 1F7F7 54D 1 111101111110111111111111111 111111111111111111 ICROCHIP ID T FORM ()LIME erovIded. RABIES VACCINATION CERTIFICATE Rabies Tag Number NASPHV Form #50 Owner's Name & Address Print - use ball point pen or type PRINT - Last First Ilelepho py l 7C3, ile-Z C lAj 44P ea- 3/ 2P No. , j ICAIL4Ixilic ity .,., State -a2 az 1A), nu/ v/sfn xi4 P 27-3-O i Species: Sex: Age: Size: Predominant Breed: Colors: Dog Male 3 mo. to 12 mo. Under 20 lbs. 131' 431. Cat femaie_0 12 mo. or olderXL 20-50 lbs. U e 1°44 44 1,J/if/Ws- Over 50 lbs. 1=2 fr". Vacc. Serial (lot) No. Producer I 1 yr. M./WI= (First 3 letters) eK 3 yr. Uc./Vacc. Other SC, 58. zj For Licensing Agency Use IAT VACCINATED: License No. Year /,5-- )1 Month Day Year Signature Other VACCINATION EXPIRES: Change U Add U CATAUNA VETERINARY CENTER Control No. 1-5" /g 9023 N. 35th Ave Month Day Year Phoenix, AZ 85051 PET NAME 011 PC.60170: MICROCHIP ID 11110 1111 11111 11111 111E131 43 6 1 0 3 5AS 9 RABIES VACCINATION CERTIFICATE Rabies Tag Number NASPHV Form #50 Owner's Name & Address Print - use ball point pen of type M.1. Vele hone PRINT ,>Laspi First Tei4/ State "7 44t °3Aea edomlnantl Colors: Species: 1Sex: Age: Size: Dog ID Male 0 3 mo. to 12 mo. Under 20 lbs. at41 Cat 1:11 Female CI 12 mo. or older 21- .20-50 lbs. Over 50 lbs. Name Avgdid Vacc. Serial (lot) No. CPI= :1 3 yr. Llc./Vacc. Producer 4 yr. Uc./Vacc. Othe / 6-3 (First 3 letters) For Licensing Agency Use DATE VACCINATED: fot. Veterinarian's: # License No. Year No 7 Month Day Year Signature . ICATALINA VETERINARY CFNTER Other VACCINATION EXPIRES: 9023 N. 35th AVO Change U Add U /5". • Phoenix, AZ -85051 Control No. Year • (602) 269-8969 Month Day ir-- Keep with your Records Pet name lii7/97/1 Microchip ID #: 11111111111111111111111 1111111111111111111111111111111111111 497 160 2D38 HOVievAgairf Forfiirther assistance visit www.homeagain corn or call 1-888 HOMEAGAIN (1-888-466-3242) Rabies Tag Number RABIES VACCINATION CERTIFICATE NASPHV Form #50 Print - use ball point pen or type M.I. Telephone Owner's Name & Address irst 4 en 'tee:, - 7/73 44- /7 Pe PRINT - Last 4 zstate rChi lt Cit,_. "A‘ No. Street t-Yi&eZ4 Predominant Breed: Colors: 32oz, Age: Size: it ‘b 4 LOT Species: Sex: 3 mo. to 12 mo. Under 20 lbs. 47/6 ..es, Dog Male Id— or olderXi 20-50 lbs. CI f-f Cat Female C.) 12 mo. Over 50 lbs. CI Name S Vacc. Serial (lot) No. P I U 1 yr. Lic/Vacc. Other Producer: (First 3 letters) yt 3 yr. Lic./Vacc. Agency Use DATE VACCINATED: Veterinarian's: # For Licensing Year IL License No. /-s— Month Day Year Sigrtatetre ATALINA VETERINARY CENTER VACCINATION EXPIRES: 9023 N. 35th Ave Other Phoenix, AZ 85051 Change U Add (602) 269-8969 Control No. Month Day Year 45461A1946 1 1 1 1 riiii,...... , 45461A1946 .. i 11111111 II 111.1,411 II 111111111111 752 as 454 61A 1946 111111 mini 212 1 45461A1946 9vrtwa.14:14:4q6r.' EiWffirRaf V,411%.F.: ,Ter*.tvea hole Rabies Tag Number RABIES VACCINATION CERTIFICATE NASPHV Form *50 Print - use ball point pen or type M.I. npia? Owner's Name & Address P,neqf 73 PRINT 7 1..rxiire,,644. State tSil, /7 .e4 Act-- Colors: 3122 Species: Sex: Age: 3 mo. to 12 mo. Under 20 lbs. Dog 2f Male C3 12 rno. or older kia 20-50 lbs. 1.3 Cat fa Female fff•-- Over 50 lbs. C3 Serial (lot) No. Name 5. Vacc. 6' I 7q- / 6-3 yr. Lic.Nacc. Producer: (First 3 letters) 3 yr. LiciVacc. DATE VACCINATED: Veterinarian's: Lice e No. For Licensing Agency Use License No. Year 7 Month Day Year Signature L'ITALiN VT.TEP. CENTLFs" VACCINATION EXPIRES: 902;: r , Ave Other 3/ Phoeuth:, k51 Change U Add U -2 mu) 2-669 Control No. Month Day Year Keep with your Records Pet name g Microchip ID #: 75C 1D31 1111111 1111111111111111111111111111111111110 1111111111 492 assistance visit www.homeagain corn o call 1 -888-HOMEAGAIN (1 -888-466-3242) LI"dmutillirt=i11. the New For further CERTIFICATE Rabies Tag Number RABIES VACCINATION NASPHV Form #50 ,I171,011 0 11•10.11,, ZlIJuru00 M.I. lephone d11 3'./ a PRINT - Last i z State frpo..6 17 aie-,e-4. Street 14s7:4- 2).9 "friA.96, Breed: Colors: 326-a, tAi-, Sex: Age: Size: Predominant ' e• lloc iitt/ Species:., A Male /4 3 mo. to 12 mo. C3 Under 20 lbs. 11 till /1144 iht A- Dog Female U 12 mo. or olderX 20-50 lbs. ID Cat U Over 50 lbs. CI Name vAgiterxrieg'..'• ._ a- Vacc. Serial (lot) No. P F 1 1 ___, fa 1 yr. Uc.Nacc. ace a 1..3 n- Producer: (First 3 letters) 7a 3 yr. Lic.Nacc. Other g - For Licensing Agency Use DATE VACCINATED: 1 i Veterinarian's: # i Licensi o. A License No. Year ~ AC - Aisadmie 0 / Year • - - Month Day SInature ATALINA VETERINARY CENTER VACCINATION EXPIRES: 9023 N. 35th Ave Other Change U Add 121 / .5-- / t7/ e s Phoenix, AZ 85051 / (602) 269-8969 Control No. Month Day Year a .:::-...;;-......azzaipseeparegarraosea2-=-.- - • _ Fieffriter. (!?) 6 f 465 1 3F 6511 111111111111111111111111111111111111111111111111 Lt NT FORM Diaocn gantar thp iollowina information online at www.HomeAgainID.com or fax to (315-634-9076), RABIES VACCINATION CERTIFICATE Rabies Tag Number NASPHV Form #50 Owner's Name & Address Print - use ball poInt_pen or type • PRINT - Last m 1/24/ ".l. Z11.17 3-/4 ?so ' State go Street e 4 57:1. Pite' c a' Ks-6/ 7 1.2 62, 0.91 Predominant Breed: Colors: Species: Sex: Age: Size: riiii/Ai .4i Dog Male U 3 mo. to 12 mo. Under 20 lbs. 14. Hi Hu n4 0 Lel an-- Cat U Female Zr 12 mo. or older/4 20-50 lbs. CI d rizzimyy. Over 50 lbs. U Name Vacc. Serial (lot) No. Producer: 1 , D 1 yr. Ucacc. .N 2. 134 (First 3 letters) -yo 3 yr. LIc.Nacc. Other For Licensing Agency Use DATE VACCINATED: Veterina License No. Year - Month Day Year 'CATALINAsaglINARYICENTER Other VACCINATION EXPIRES: 9023 N. 35th Ave Change CI Add a Phoenix, AZ 85051 Control No. _L / NC (602) 269-8969 Month Day Year Keep with your Records Pet name iXAAJDy Microchip ID #: 4A1 52D 1 23F 111111111111111111111111111111111111111111111111111111111111 11C`)ItrevAgain. For further assistance visit www.homeagain.com o call 1 888-HOMEAGAIN (1-888-466-3242)