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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 New Y4, Renewal Permit #_)1_11L 1 (.) 14 Name: lVa Kennel Name: m Mailing Address: ca e toydt; 1_.K1 Kennel Location: c9S-(9 -1 rtJi City x , AZ ZIP County Supervisorial istrict 3 Home Phone: <2 9 3 Kennel Phone: Cope 5 Co —3) Please complete and sign this application and return it to the above address with payment in the amount of three hundred twenty eight dollars ($328.00) within ten (10) days of receipt Pursuant to Arizona statute and county ordinance, a person "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 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 fora 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. I/VVe assume complete responsibility for the kennel at the premises for which I/we are making application 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. (r) INVe certify that the kennel has been approved by the local zoning authority (if applicable) at the premiges for which Itwe are making application for a permit I/VVe certify that I/VVe have < dogs and that the kennel meets the definition in statute. INVe certify that I/VVe have not been convicted of a violation of A.R.S. §§ 13-2910 (cruelty to animals) or 13-29 10.01 (dog fighting), or any other state, county or municipal animal welfare law. (Violations of license and leash laws DO NOT apply.) 5. 1 I/VVe certify that all dogs over the age of three (3) months that are kept, harbored or maintained on the premiss of the above named kennel have been properly vaccinated against rabies by a veterinarian licensed to practice in the state of Arizona and that a current vaccination certificate signed by a licensed veterinarian is maintained on the premises for each dog. 6. n'll I /We certify that I/We are submitting a valid copy of the rabies vaccination certificate for each dog w h this application. 7, lirJ INVe 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 section. 8. n/Ii() I/VVe understand that a person who fails to obtain a kennel permit under ARS 11-1009 is subject to a penaltyrof twenty-five dollars in addition to the annual fee. 9. I/We understand that a person who knowingly fails to obtain a kennel permit within thirty days after written notification from the county enforcement agent is guilty of a class 2 misdemeanor. 10. ' Is this kennel permit being obtained for the purposes of operating a business including but n 'limited to Ibyee°cIdHr inroOrnLrr bbaaitclirr ssttitII -iirrirrrtt )1..aass V 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 1-94 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. /,10 I/We certify that the kennel permit is being used solely for the purpose of licensing my own multiple compahion dogs in my household. I/We certify that all of the information I/We have provided is true and accurate under penalty of law. Applicant Signature 42- A---/ 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.gov Receipt Number: R13 -146976 Receipt Date: 07/2312013 Person ID: P1970707 Phone: 602 6204067 JOHNSON MARY KENNELS 2527 E TONTO LN 7/23/2013 2:03:49PM PHOENIX, AZ 85050 Item: Animal ID: Reference No: Price: Each: Amount: KEN PERMIT A7777777 K14-000047 $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 Other Signed: MFG MICROCHIP: WEIGHT: SEX: SPECIES: PATIENT: Patient THAT This is 3923 Indian VETERINARY Next Date of BY: I to 602-867-2992 Phoenix, E. Vaccination 06-12-12 Vaccinated Vaccinations... Bj, 0.00 Female Canine Trixie Information... HAVE certify... AZ Thunderbird Bend Vaccination: lbs 85032 Animal CLINIC on: RV By SERAL:1215372A, VACCINATED Road Hospital 07-22-16 07-23-13 THE CEEtIRMAIFIC' Rabies-Canine Vaccination EXPIRES: ANIMAL 1yr, #3 17/17114, DESCRIBED EOP - ADMIN: BELOW , R H (none) Next due Sq COLOR: AGE: BREED: TAG AGAINST (602) 2527 Mary OWNER Previous Certificate VACCINATION NO: Phoenix, OF RABIES. 569-3373 AZ E.Tonto Johnson Vaccination: No. Black 3 years 102 85050 Ln. ANIMAL . and Dachshund 0 Tan Other Signed: MFG MICROCHIP: WEIGHT: SEX: SPECIES: PATIENT: Patient THAT This is 3923 Indian VETERINARY Next Date of BY: I to 602-867-2992 Phoenix, E. Vaccination 06-12-12 Vaccinated Vaccinations... Bi, 0.00 Female Canine Molly information... HAVE certify... AZ Bend Vaccination: SER lbs 85032 Thunderbird Animal CLINIC on: RV By icense: L: 1 VACCINATED Road Hospital 07-22-16 07-23-13 A:1w , 15372A, THE mnrer Rabies-Canine Vaccination EXPIRES: ANIMAL CERZEITTOATE'OF 1yr, #0 07/17/14, DESCRIBED ADMIN: BELOW R H (none) Next due Sq COLOR: AGE: BREED: TAG AGAINST (602) 2527 Mary OWNER Previous Certificate VACCINATION NO: Phoenix, OF RABIES. 569-3373 AZ E.Tonto Johnson No. White 5 years West 101 85050 Lx. ANIMAL Vaccination: Highland 0 Terrier Other Signed: MFG MICROCHIP: WEIGHT: SEX: SPECIES: PATIENT: Patient THAT This is 3923 Indian VETERINARY Next Date of BY: I to 602-867-2992 Phoenix, E. Vaccination 06-12-12 Vaccinated Vaccinations... Bi, 0.00 Female Canine Sandy's Information... HAVE certify... AZ Thunderbird Bend CLINIC Vaccination: License: SERIAJf: lbs 85032 Animal on: RV By Westin VACCINATED Road Hospital 07-22-16 07-23-13 1215372A, THE Rabies-Canine Vaccination EXPIRES: ANIMAL 1yr, #8 17/17/14, DESCRIBED ADMIN: BELOW R H (none) Next due Sq COLOR: AGE: BREED: TAG AGAINST (602) 2527 Mary OWNER Previous Certificate AoCINATIO NO: Phoenix, OF RABIES. 569-3373 AZ E.Tonlo Johnson Vaccination: No. White 4 years West 104 85050 Lo. ANIMAL Highland 0 Terrier ANIMAL M49632 ANIMAL DOG STREET 2527 E LAST NAME JOHNSON VACCINE KILLED VACCB4E NOBIVAC /D TYPE ADDRESS TONTO TYPE PRODUCER ANIMAL LN SPAYED VETERINARIAN'S Dr. ANIMAL FRANCIE SEX RABIES Nancy NAME LICENSE Bradley VACC. 12 10 FIRST MARY NUMBER 3064 VACCZNE LENGTH Months VACCINATION AGE YEARS ANIMAL APT NAM OWNER Improving ARIZONA VETER SERIAL S279713E MICROCHIF9AHS 083257372 VACCINATION the !MARLINS lc NO CITY Live, of HUMANE K-12 ii(1 DATE 07/23/2013 TAG SIZE MED PHOENIX Arritnah SIGNATURE VACCINATED INFORMATION PERSON INFORMATION Since INFORMATION P320855 1957 SOCIETY ID PRIMAFtY RED PRIMARY DACHSHUND CERTIFICATE VACCINATION 07/23/2014 COLOR BREED TELEPHONE (602) (602) Phoenix, 1521 W. Arizona EXPIRES 620-4067 997-7586 AZ Dobbins Humane STATE AZ NUMBER 85041 Rd. Society SECONDARY SECONDARY PRINT 7/23/13 WHITE MIX ZIP 85050 DATE COLOR BREED CODE Other Signed: MFG MICROCHIP: WEIGHT: SEX: SPECIES: PATIENT: Patient THAT This is 3923 Indian VETERINARY Next Date of BY: I to 602-867-2992 Phoenix, E. Vaccination 06-12-12 Vaccinated Vaccinations... Bi, 0.00 Female Canine Jasmine Information... HAVE certify... AZ Thunderbird Bend Vaccination: igen' 71AL: lbs 85032 Animal CLINIC on: RV By : 1215372A, VACCINATED Road Hospital 07-22-16 07-23-13 THE Rabies-Canine Vaccination EXPIRES: .6i'ff-14!tIFIC.ATE ANIMAL 1yr, #9 07/17/14, DESCRIBED OF ADMIN: BELOW R H (none) Next due Sq COLOR: AGE: BREED: TAG AGAINST (602) 2527 Mary OWNER Previous Certificate VACCINATION NO: Phoenix, OF RABIES. 569-3373 AZ E.Tonto Johnson No. White 4 years West 103 85050 Ln. ANIMAL Vaccination: Highland 0 Terrier Other Signed: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT This is 3923 Next Date BY: I to 602-867-2992 Phoenix, E. Indian VETERINARY of 06-27-11 06-12-12 Vaccinated Vaccinations_ Relief -<-1, AAerial, 0.00 Female Canine Bella Information... HAVE certify... AZ Bend Vaccination Vaccination: lbs 85032 Thunderbird Animal CLINIC on: KJA RV By Veterinarian SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18156A, THE Rabies-Canine Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL 1yr, 3yr., .-3-)269 *A #2 12/16/12, DESCRIBED OF ADMIN: BELOW (none) 06-12-15 Next Sq AGE: TAG AGAINST due COLOR: BREED: NO: (602) 2527 Mary OWNER Previous Certificate VACCINATION RABIES. 569-3373 Phoenix, AZ E.Tonto Johnson OF No. Black 5 years 2 85050 Ln. ANIMAL Vaccination: and Dachshund Tan 0 Other Signed: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT is This 3923 Indian VETERINARY Next of Date BY: I to 602-867-2992 Phoenix, E. Vaccination 05-27-11 06-12-12 Vaccinated Vaccinations... Relief Medal, 0.00 Female Canine Belle information... HAVE certify... AZ Bend Vaccination: Veterinarian lbs 85032 Thunderbird Animal CLINIC on: KJA RV By SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18156A, THE Rabies-Canine Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL lyr 3yr., #0 12/16/12, DESCRIBED OF ADMIN: BELOW (none) 06-12-15 due Next Sq COLOR: AGE: BREED: TAG AGAINST OWNER Previous Certificate VACCINATION NO: (602) Phoenix, 2527 Mary RABIES. 569-3373 AZ E.Tonto Johnson OF No. & Blk years 3 Long 85050 Ln. ANIMAL Vaccination: Tan Hair Dachshund Other Signed: BY: MEG WEIGHT: SEX: SPECIES: PAllENT: Patient THAT to is This Phoenix, 3923 Indian VETERINARY Next of Date 06-12-12 Vaccinated Vaccinations... Relief Medal, 0,00 Female Canine Cotton Information... HAVE I certify... 602-867-2992 AZ E. Bend Vaccination Vaccination: Veterinarian lbs 85032 Thunderbird Animal CLINIC on: RV By SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18156A, THE Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL 3yr #1 -7-Y7261- 12/16/12, DESCRIBED OF ADMIN: BELOW 06-12-15 due Next Sq COLOR: AGE: BREED: TAG AGAINST OWNER Previous Certificate VACCINATION NO: (602) Phoenix, 2527 Mary RABIES. 569-3373 AZ E.Tonto Johnson OF No. White years 8 West 1 85050 Ln. ANIMAL Vaccination: Highland Terrier Other Signed: MFG BY: WEIGHT: SEX: SPECIES: PATIENT: Patient THAT This is to Phoenix, 3923 Indian VETERINARY Next Date of 05-27-11 06-12-12 Vaccinated Vaccinations... Relief Medal, 0.00 Female Canine Lil Information... I HAVE certify... 602-867-2992 AZ E. Bend Vaccination Vaccination: lbs Misty 85032 Thunderbird Animal CLINIC on: KJA RV By Veterinarian SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18156A, THE Rabies-Canine Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL 1yr, 3yr., /A #2 12/16/12, DESCRIBED OF ADMIN: BELOW (none) 06-12-15 Next due Sq COLOR: AGE: BREED: TAG AGAINST 2527 OWNER Previous Certificate VACCINATION NO: (602) Phoenix, Mary RABIES. 569-3373 AZ E.Tonto Johnson OF No. White 6 years West 2 85050 Ln. ANIMAL Vaccination: Highland 0 Terrier Other Signed: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT This is to Phoenix, 3923 Indian VETERINARY Next Date of 05-27-11 06-12-12 Vaccinations... Relief BY: Medal, 0.00 Female Canine LuLu Information... I HAVE certify... 602-867-2992 AZ E. Bend Vaccination Vaccination: Vaccinated lbs 85032 Thunderbird Animal CLINIC on: KJA RV By Veterinarian SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18166C, THE Rabies-Canine Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL lyr 3yr., #8 5/4/13, DESCRIBED OF ADMIN: BELOW Sq (none) 06-12-15 Next due COLOR: AGE: BREED: TAG AGAINST (602) 2527 Mary OWNER Previous Certificate VACCINATION NO: Phoenix, OF 3 8 RABIES. 569-3373 AZ E.Tonto Johnson ANIMAL Vaccination: No. Cream years Dachshund 85050 Ln. 0 Other Signed: BY: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT to is This Phoenix, 3923 Indian VETERINARY Next of Date 05-27-11 06-12-12 Vaccinated Vaccinations... Relief Merial, 9.80 Female Canine Mystery information... HAVE I certify... 602-867-2992 AZ E. Bend Vaccination Vaccination: lbs 85032 Thunderbird Animal CLINIC on: KJA RV By Veterinarian SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18166C, Rabies-Canine Rabies-Canine Vaccination License: THE CERTIFICATE EXPIRES: ANIMAL 1yr 3yr., ,q1...\ #6 536 5/4/13, DESCRIBED OF ADMIN: BELOW Sq (none) 06-12-15 due Next COLOR: AGE: BREED: TAG AGAINST (602) 2527 Mary OWNER Previous Certificate VACCINATION NO: Phoenix, OF 5 6 RABIES. 569-3373 AZ E.Tonto Johnson ANIMAL Vaccination: No. Red years Dachshund 85050 Ln. Sable 0 Other Signed: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT is This 3923 Indian VETERINARY Next of Date BY: I to 602-867-2992 Phoenix, E. Vaccination 06-12-12 Vaccinated Vaccinations... Relief Meri4, 0.00 Female Canine Ruby information_ HAVE certify... AZ Thunderbird Bend Vaccination: Veteeinarian lbs 85032 Animal CLINIC on: RV By SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18156A, THE Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL 3yr., #4 3'7263- 12/16/12, DESCRIBED OF ADMIN: BELOW 06-12-15 due Next Sq COLOR: AGE: BREED: TAG AGAINST (602) 2527 Mary OWNER Previous Certificate VACCINATION NO: Phoenix, OF 5 4 RABIES. 569-3373 AZ E.Tonto Johnson ANIMAL Vaccination: No. Red years Dachshund 85050 Ln. 0 Other Signed: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT This is 3923 Indian VETERINARY Next Date of Reli 6-7 BY: I to certify... 602-867-2992 Phoenix, E. Bend Vaccination 05-27-11 06-12-12 Vaccinated Vaccinations... Vete Medal, 0.00 Female Canine Tiger Information... HAVE AZ Thunderbird CLINIC Vaccination: lbs Lilly 85032 Animal on: KJA RV By SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18156A, THE Rabies-Canine Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL 1yr 3yr., 66 12/16/12, DESCRIBED OF ADMIN: BELOW (none) 06-12-15 Next due Sq COLOR: AGE: BREED: TAG AGAINST (602) 2527 Mary OWNER Previous Certificate VACCINATION NO: Phoenix, OF 3 6 RABIES. 569-3373 AZ E.Tonto Johnson ANIMAL Vaccination: No. Red years Dachshund 85050 Ln. Brindle Other Signed: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT This is to 3923 Indian VETERINARY Next Date of Vaccinations... Tre BY: I certify... 602-867-2992 Phoenix, E. Bend Vaccination 05-27-11 06-12-12 Vaccinated Medal, 68.00 Female Canine Fancy information._ HAVE AZ Thunderbird Vaccination: lIiet4rinarian lbs 85032 Animal CLINIC on: KJA RV By SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18156A, THE Rabies-Canine Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL 1yr, IA 3yr., 22-,7,6 #5 12/16/12, DESCRIBED OF ADMIN: BELOW (none) 06-12-15 Next due Sq COLOR: AGE: BREED: TAG AGAINST 2527 OWNER Previous Certificate VACCINATION NO: (602) Phoenix, Mary RABIES. 569-3373 AZ E.Tonto Johnson OF No. Fawn/Blk 9 years Boxer 5 85050 Ln. ANIMAL Vaccination: Mask 0 Other Signed: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT This is 3923 Indian VETERINARY Next Date of BY: I to 602-867-2992 Phoenix, E. Vaccination 05-27-11 06-12-12 Vaccinated Vaccinations... Relief Medal_ 0.00 Male Canine Zach Information... HAVE certify... AZ Thunderbird Send Vaccination: lbs 85032 Animal CLINIC on: KJA RV By Veterinarian SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18156A, THE Rabies-Canine Rabies-Canine Vaccination License: ANIMAL CERTIFICATE EXPIRES: 1yr 3yr., 3 3 DESCRIBED #7 6 12/16/12, OF ADMIN: BELOW (none) 06-12-15 Next due Sq COLOR: AGE: BREED: TAG AGAINST (602) 2527 Mary OWNER Previous Certificate VACCINATION NO: Phoenix, OF 5 7 RABIES. 569-3373 AZ E.Tonto Johnson ANIMAL Vaccination: No. Black/Cream years Dachshund 85050 Ln. 0 Other Signed: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT This is 3923 Indian VETERINARY Next Data of BY: I to 602-867-2992 Phoenix, E. Vaccination 05-27-11 06-12-12 Vaccinated Vaccinations... Relief Mena) 0.00 Female Canine Yukee information... HAVE certify... AZ Bend Vaccination: ibs 85032 Thunderbird Animal CLINIC on: KJA RV By eterinarian SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18156A, THE Rabies-Canine Rabies-Canine Vaccination License: ANIMAL CERTIFICATE EXPIRES: 1yr 3yr., 22—)26 #1 12/16/12, DESCRIBED OF ADMIN: BELOW (none) 06-12-15 Next due Sq COLOR: AGE: BREED: TAG AGAINST (602) 2527 Mary OWNER Previous Certificate VACCINATION NO: RABIES. Phoenix, OF 3 1 569-3373 AZ E.Tonto Johnson ANIMAL Vaccination: No, White years West 85050 Ln. Highland 0 Terrier Other Signed: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT This is 3923 Indian VETERINARY Next Date of BY: I to 602-867-2992 Phoenix, E. Vaccination 05-27-11 06-12-12 Vaccinated Vaccinations... Medal,' 0.00 Neutered Canine Toby information_ HAVE certify... AZ Thunderbird Bend Vaccination: RelieNeterinarian ibs 85032 Animal CLINIC on: KJA RV By SERIAL: Male VACCINATED Road Hospital 06-12-15 06-12-12 18156A, THE Rabies-Canine Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL 1yr 3yr., #4 12/16/12, DESCRIBED OF ADMIN: BELOW (none) 06-12-15 Next due Sq COLOR: AGE: BREED: TAG AGAINST OWNER Previous Certificate VACCINATION NO: (602) Phoenix. 2527 Mary RABIES. 569-3373 AZ E.Tonto Johnson OF No. Black 5 years Yorkshire 4 85050 Ln. ANIMAL Vaccination: and 0 Tan Terrier Other Signed: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT This is 3923 Indian VETERINARY Next Date of BY: I to 602-867-2992 Phoenix, E. Vaccination 05-27-11 06-12-12 Vaccinated Vaccinations... Relief Melia/ 10.70 Male Canine Tiger Information... HAVE certify... AZ Thunderbird Bend Vaccination: lbs 85032 Animal CLINIC on: KJA RV By Veterinarian SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18156A, THE Rabies-Canine Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL 1yr 3yr., 3'2-7o #6 12/16/12, DESCRIBED OF ADMIN: BELOW (none) 06-12-15 Next due Sq COLOR: AGE: BREED: TAG AGAINST 2527 OWNER Previous Certificate VACCINATION NO: (602) Phoenix, Mary RABIES. 569-3373 AZ E.Tonto Johnson OF No. Red 2 years 6 85050 Ln. ANIMAL Vaccination: Brindle Dachshund 0 Other Signed: MFG BY: WEIGHT: SEX: SPECIES: PATIENT: Patient THAT This is 3923 Indian VETERINARY Next Date of / BY: I to 602-867-2992 Phoenix, E. Bend Vaccination 05-27-11 06-12-12 Vaccinated Vaccinations... Relief Mall, 24.00 Female Canine Tamarah Information... HAVE certify... AZ Thunderbird Vaccination: Veterinarian 11 SERIAL: lbs 85032 Animal CLINIC on: KJA RV By VACCINATED Road Hospital 06-12-15 06-12-12 18156A, Rabies-Canine Rabies-Canine Vaccination License: THE CERTIFICATE EXPIRES: ANIMAL 1yr 3yr., #6 12/16/12, DESCRIBED OF ADMIN: BELOW (none) 06-12-15 Next Sq COLOR: AGE: BREED: TAG AGAINST OWNER Previous Certificate VACCINATION due NO: (602) Phoenix, 2527 Mary RABIES. 569-3373 AZ E.Tonto Johnson OF No. Black 2 years Labrador 6 85050 Ln. ANIMAL Vaccination: and 0 White Retriever Mix Other Signed: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT This is 3923 Indian VETERINARY Next Date of BY: I to 602-867-2992 Phoenix, E. Vaccination 05-27-11 06-12-12 Vaccinated Vaccinations... Relief MedAl, 0.00 Male Canine Skipper information_ HAVE certify... AZ Bend Vaccination: lbs 85032 Thunderbird Animal CLINIC on: KJA RV By Veterinarian SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18156A, THE Rabies-Canine Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL 1yr 3yr., #2 6 12/16/12, DESCRIBED OF ADMIN: BELOW (none) 06-12-15 Next due Sq COLOR: AGE: BREED: TAG AGAINST OWNER Previous Certificate VACCINATION NO: (602) Phoenix, 2527 Mary RABIES. 569-3373 AZ E.Tonto Johnson OF No. White 2 years West 2 85050 Ln. ANIMAL Vaccination: Highland 0 Terrier Other Signed: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT This is to 3923 Indian VETERINARY Next Data of Vaccinations... Relief BY: I certify... 602-867-2992 Phoenix, E. Bend Vaccination 05-27-11 06-12-12 Vaccinated Medal, 0.00 Female Canine Sienia Information— HAVE AZ Thunderbird CLINIC Vaccination: Veterinarian lbs 85032 Animal on: KJA RV By SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18156A, THE Rabies-Canine Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL 1yr 3yr., #9 12/16/12, DESCRIBED OF ADMIN: BELOW (none) 06-12-15 Next due Sq COLOR: AGE: BREED: TAG AGAINST (602) 2527 Mary OWNER Previous Certificate VACCINATION NO: Phoenix, OF 3 9 RABIES. 569-3373 AZ E.Tonto Johnson ANIMAL Vaccination: No. White years West 85050 Ln. Highland 0 Tenier Other Signed: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT This is to Phoenix, 3923 Indian VETERINARY Next Date of 05-27-11 06-12-12 Vaccinated Vaccinations... Relief BY: Medal, 0.00 Male Canine Scooby information... I HAVE certify... 602-867-2992 AZ E. Bend Vaccination Vaccination: ibs 85032 Thunderbird Animal CLINIC on: KJA RV By Veterinarian SERIAL: Doo VACCINATED Road Hospital 06-12-15 06-12-12 18156A, THE Rabies-Canine Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL 1yr 3yr., 3,..726 #3 12/16/12, DESCRIBED OF ADMIN: BELOW (none) 06-12-15 Next due Sq COLOR: AGE: BREED: TAG AGAINST (602) 2527 Mary OWNER Previous Certificate VACCINATION NO: RABIES. Phoenix, OF Red 6 3 569-3373 AZ E.Tonto Johnson ANIMAL Vaccination: No. years Dachshund 85050 Ln. Other Signed: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT This is 3923 Indian VETERINARY Next Date of BY: I to 602-867-2992 Phoenix, E. Bend Vaccination 05-27-11 06-12-12 Vaccinated Vaccinations... Relief Merial, 0.00 Female Canine Little Information_ HAVE certify... AZ Thunderbird CLINIC Vaccination: lbs Lily 85032 Animal on: KJA RV By Veterinarian SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18156A, THE Rabies-Canine Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL 1yr, 3yr., 95220 ft9 12/16/12, DESCRIBED OF ADMIN: BELOW (none) 06-12-15 Next due Sq COLOR: AGE: BREED: TAG AGAINST (602) 2527 Mary OWNER Previous Certificate VACCINATION NO: Phoenix, OF 2 9 RABIES. 569-3373 AZ E.Tonto Johnson ANIMAL Vaccination: No. While years West 85050 Ln. Highland 0 Terrier Other Signed: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT This Is to Phoenix, 3923 Indian VETERINARY Next Date of 05-27-11 06-12-12 Vaccinated Vaccinations... Relief 7,1 I, BY: 0.00 Female Canine Lil information_ HAVE I certify... 802-867-2992 AZ E. Bend Vaccination Vaccination: lbs Tosha 85032 Thunderbird Animal CLINIC on: KJA RV By Veterinarian SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18156A, Rabies-Canine Rabies-Canine Vaccination License: THE CERTIFICATE EXPIRES: ANIMAL 1yr, 3yr., /A 319 12/16112, DESCRIBED OF ADMIN: BELOW (none) 06-12-15 Next due Sq COLOR: AGE: BREED: TAG AGAINST 2527 OWNER Previous Certificate VACCINATION NO: (602) Phoenix, Mary RABIES. 569-3373 AZ E.Tonto Johnson OF No. Cream years 4 9 85050 Ln. ANIMAL Vaccination: Dachshund 0 Other Signed: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT This is to Phoenix, 3923 Indian VETERINARY Next Date of 05-27-11 06-12-12 VacLII Relief BY: Medal, 0.00 Male Canine Lil Information_ I HAVE certify... 602-867-2992 AZ E. Bend Vaccination Vaccination: Vaccinated lbs Red 85032 Thunderbird Animal CLINIC on: KJA RV By Veterinarian SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18156A, THE Rabies-Canine Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL 1yr, 3yr., #\ #5 12/16/12, DESCRIBED OF ADMIN: BELOW (none) 06-12-15 Next due Sq COLOR: AGE: BREED: TAG AGAINST (602) 2527 Mary OWNER Previous Certificate VACCINATION NO: Phoenix, OF 4 5 RABIES. 569-3373 AZ E.Tonto Johnson ANIMAL Vaccination: No. Red years Dachshund 85050 Ln. 0 Other Signed: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT This is to Phoenix, 3923 Indian VETERINARY Next Date of 05-27-11 06-12-12 Vaccinations... BY: Merle), 0.00 Canine Lii Information... I HAVE certify... 602-867-2992 AZ E. Bend Vaccination Vaccination: Vaccinated ReliefVeterinarian lbs Female Gracie 85032 Thunderbird Animal CLINIC on: KJA RV By SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18156A, THE Rabies-Canine Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL 1yr, 3yr., *A #4 12/16/12, DESCRIBED OF ADMIN: BELOW (none) 06-12-15 Next due Sq COLOR: AGE: BREED: TAG AGAINST (602) 2527 Mary OWNER Previous Certificate VACCINATION NO: Phoenix, OF 12 4 RABIES. 569-3373 AZ E.Tonto Johnson ANIMAL Vaccination: No. Choc./Cream months Dachshund 85050 Ln. 0 Other Signed: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT This is 3923 Indian VETERINARY Next Date of BY: I to 602-867-2992 Phoenix, E. Vaccination 05-27-11 06-12-12 Vaccinated Vaccinations... Relief <- Medal, 0.00 Female Canine Jojo Information... HAVE certify... AZ Thunderbird Bend CLINIC Vaccination: lbs 85032 Animal on: KJA RV By eterinanan SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 — 18156A, THE Rabies-Canine Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL 1yr, 3yr., 336 #\ #4 12/16/12, DESCRIBED OF ADMIN: BELOW (none) 06-12-15 Next due Sq COLOR: AGE: BREED: TAG AGAINST 2527 OWNER Previous Certificate VACCINATION NO: (602) Phoenix, Mary RABIES. 569-3373 AZ E.Tonto Johnson OF No. Cream 4 years 4 85050 Ln. ANIMAL Vaccination: Dachshund 0 Other Signed: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient This is 3923 Next Date BY: THAT I to 602-867-2992 Phoenix, E. Indian VETERINARY of 05-27-11 06-12-12 Vaccinated Vaccinations... Relief MenAI, 0.00 Male Canine Ice Information... HAVE certify... AZ Bend Vaccination Vaccination: lbs Man 85032 Thunderbird Animal CLINIC on: KJA RV By Veterinarian SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18166C, THE Rabies-Canine Rabies-Canine Vaccination ucense: CERTIFICATE EXPIRES: ANIMAL 1yr, 3yr., 33 /A #5 5/4/13, DESCRIBED OF ADMIN: BELOW Sq (none) 06-12-15 Next due COLOR: AGE: BREED: TAG AGAINST (602) 2527 Mary OWNER Previous Certificate VACCINATION NO: Phoenix, OF RABIES. 569-3373 AZ E.Tonto Johnson No. White 8 years West 5 85050 Ln. ANIMAL Vaccination: Highland 0 Terrier Other Signed: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT is This 3923 Indian VETERINARY Next of Date BY: I to 602-867-2992 Phoenix, E. Vaccination 05-27-11 06-12-12 Vaccinated Vaccinations... Relief Myl, 0.00 Female Canine Gracie Information... HAVE certify... AZ Bend Vaccination: Veterinarian - MRIAL: lbs 85032 Thunderbird Animal CLINIC on: KJA RV By VACCINATED Road Hospital 06-12-15 06-12-12 18166C, THE Rabies-Canine Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL 1yr, 3yr., 7-""726 *A #3 5/4/13, DESCRIBED OF ADMIH: BELOW Sq (none) 06-12-15 due Next COLOR: AGE: BREED: TAG AGAINST (602) 2527 Mary OWNER Previous Certificate VACCINATION NO: RABIES. Phoenix, OF 5 3 569-3373 AZ E.Tonto Johnson ANIMAL Vaccination: No. Choe./Cream years Dachshund 85050 Ln. 0 Other Signed: MFG BY: WEIGHT: SEX: SPECIES: PATIENT: Patient THAT Is This 3923 Indian VETERINARY Next of Date Relief Medal, I certify_ to 602-867-2992 Phoenix, E. Bend Vaccination 05-27-11 06-12-12 Vaccinated 0.00 Female Canine Dimples Information... HAVE AZ Thunderbird CLINIC Vaccination: Veteftharian lbs 85032 Animal on: KJA RV By SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18166C, THE Rabies-Canine Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL 1yr, 3yr., (A #7 5/4/13, DESCRIBED OF ADMIN: BELOW Sq (none) 06-12-15 due Next COLOR: AGE: BREED: TAG AGAINST (602) 2527 Mary OWNER Previous Certificate VACCINATION NO: Phoenix, OF 2 7 RABIES. 569-3373 AZ E.Tonto Johnson ANIMAL Vaccination: No. Dapple years Dachshund 85050 Ln. 0 Other Signed: MEG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT This is 3923 Indian VETERINARY Next Date of BY: I to 602-867-2992 Phoenix, E. Vaccination 05-27-11 06-12-12 Vaccinated Vaccinations... Relief Merial, 0.00 Female Canine Cookie information... HAVE certify... AZ Thunderbird Bend Vaccination: Veterinarign lbs 85032 Animal CLINIC on: KJA RV By SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18156A, THE Rabies-Canine Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL 1yr, 3yr., '2772 #\ #1 6-9-- 12116/12, DESCRIBED OF ADMIN: BELOW (none) 06-12-15 Next due Sq COLOR: AGE: BREED: TAG AGAINST 2527 OWNER Previous Certificate VACCINATION NO: (602) Phoenix, Mary RABIES. 569-3373 AZ E.Tonto Johnson OF No. 4 years 1 85050 Ln. ANIMAL Vaccination: Piebald/Red Dachshund 0 Other Signed: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT This is to Phoenix, 3923 Indian VETERINARY Next Date of 05-27-11 06-12-12 Vaccinations... BY: Medal, 0.00 Male Canine information... I HAVE certify... 602-867-2992 AZ E. Bend Vaccination Vaccination: Vaccinated ilVdt"Hrl lbs Casper 85032 Thunderbird Animal CLINIC on: KJA RV By SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18156A, THE Rabies-Canine Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL 1yr, 3yr., #\ #8 12/16/12, DESCRIBED OF ADMIN: BELOW (none) 06-12-15 Next due Sq COLOR: AGE: BREED: TAG AGAINST (602) 2527 Mary OWNER Previous Certificate VACCINATION NO: RABIES. Phoenix, OF 5 8 569-3373 AZ E.Tonto Johnson ANIMAL Vaccination: No. White years West 85050 Ln. Highland 0 Terrier Other Signed: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT is This 3923 Indian VETERINARY Next of Date BY: I to 602-867-2992 Phoenix, E. Vaccination 05-27-11 06-12-12 Vaccinated Vaccinations... Relief Merial, 0.00 Male Canine Cash information... HAVE certify... AZ Bend Vaccination: VeteKnarian lbs 85032 Thunderbird Animal CLINIC on: KJA RV By SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18156A, THE Rabies-Canine Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL 1yr, 3yr., 3')20 #\ #0 12/16/12, DESCRIBED OF ADMIN: BELOW (none) 06-12-15 due Next Sq COLOR: AGE: BREED: TAG AGAINST 2527 OWNER Previous Certificate VACCINATION NO: (602) Phoenix, Mary RABIES. 569-3373 AZ E.Tonto Johnson OF No. Cream years 4 0 85050 Ln. ANIMAL Vaccination: Dachshund 0 Other Signed: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT is This 3923 Indian Next Date BY: I to 602-867-2992 Phoenix, E. VETERINARY of 05-27-11 06-12-12 Vaccinated Vaccinations... Relief Medal, 0.00 Female Canine Bubbles Information_ HAVE certify... AZ Bend Vaccination Vaccination: lbs 85032 Thunderbird Animal CLINIC on: KJA RV By Vet&inian SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18156A, THE Rabies-Canine Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL 1yr, 3yr., /A #9 12/16/12, DESCRIBED OF ADMIN: BELOW (none) 06-12-15 due Next Sq COLOR: AGE: BREED: TAG AGAINST OWNER Previous VACCINATION NO: (602) Phoenix, 2527 Mary Certificate RABIES. 569-3373 AZ E.Tonto Johnson OF No. Blue 22 9 85050 Ln. ANIMAL Vaccination: and months Dachshund Tan 0 Other Signed: MFG BY: WEIGHT: SEX: SPECIES: PATIENT: Patient THAT This is to Phoenix, 3923 Indian VETERINARY Next Date of 05-27-11 06-12-12 Vaccinated Vaccinations... Relief Medal, 0.00 Female Canine Blanca information... I HAVE certify... 602-867-2992 AZ E. Bend Vaccination Vaccination: lbs 85032 Thunderbird Animal CLINIC on: KJA RV By Veterinarian SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18156A, THE Rabies-Canine Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL 1yr, 3yr., #1 #0 12116/12, DESCRIBED OF ADMIN: BELOW (none) 06-12-15 Next due Sq COLOR: AGE: BREED: TAG AGAINST OWNER Previous Certificate VACCINATION NO: (602) Phoenix, 2527 Mary RABIES. 569-3373 AZ E.Tonto Johnson OF No. Cream 4 years 0 85050 Ln. ANIMAL Vaccination: Dachshund 0 Other Signed: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT This is to Phoenix, 3923 Indian VETERINARY Next Date of 05-27-11 06-12-12 Vaccinated Vaccinations... Relief BY: Medal, 0.00 Female Canine Betty Information... I HAVE certify... 602-867-2992 AZ E. Bend Vaccination Vaccination: lbs Lou 85032 Thunderbird Animal CLINIC on: KJA RV By Veterinarian /— SERIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18156A, THE Rabies-Canine Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL 1yr, 3yr., .27.720 #1 #5 12/16/12, DESCRIBED OF ADMIN: BELOW (none) 06-12-15 Next due Sq COLOR: AGE: BREED: TAG AGAINST (602) 2527 Mary OWNER Previous Certificate VACCINATION NO: Phoenix, OF 4 5 RABIES. 569-3373 AZ E.Tonto Johnson ANIMAL Vaccination: No. Choc years Dachshund 85050 Ln. 0 Other Signed: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT to is This Phoenix, 3923 Indian VETERINARY Next of Date 05-27-11 06-12-12 Vaccinations... Relief Medal, BY: 0.00 Male Canine Information... HAVE I certify... 602-867-2992 AZ E. Bend Vaccination Vaccination: Vaccinated lbs Bambaki 85032 Thunderbird Animal CLINIC on: KJA RV By VeMaharian URIAL: VACCINATED Road Hospital 06-12-15 06-12-12 18156A, THE Rabies-Canine Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL 1yr, 3yr., #\ #3 12/16/12, DESCRIBED OF ADMIN: BELOW (none) 06-12-15 due Next Sq COLOR: AGE: BREED: TAG AGAINST (602) 2527 Mary OWNER Previous Certificate VACCINATION NO: RABIES. Phoenix, OF 5 3 569-3373 AZ E.Tonto Johnson ANIMAL Vaccination: No. Cream years Dachshund 85050 Ln. 0 Other Signed: MFG WEIGHT: SEX: SPECIES: PATIENT: Patient THAT is This 3923 Indian VETERINARY Next of Date Vaccinations... Reli BY: I certify... to 602-867-2992 Phoenix, E. Bend Vaccination 06-12-12 Vaccinated Merial, 0.00 Female Canine Jasmine information_ HAVE AZ Thunderbird CLINIC Vaccination: lbs 85032 Animal on: RV By eferinarian SERIAL: VACCINATED Road Hospital 06-12-13 06-12-12 18166C, THE Rabies-Canine Vaccination License: CERTIFICATE EXPIRES: ANIMAL 1yr, #9 5/4/13, DESCRIBED OF ADMIN: BELOW Sq 06-12-13 Next due COLOR: AGE: BREED: NO: TAG AGAINST (602) 2527 Mary OWNER Previous Certificate VACCINATION RABIES. 569-3373 AZ Phoenix, E.Tonto Johnson OF No. White years 3 West 9 85050 Ln. ANIMAL Vaccination: Highland 0 Terrier