Dog License Application (Page 4 of 4) in pdf

Dog License Application Page 4

License Now

Fee Schedule for Dog Licensing

Term Of License

If Spayed/Neutered

0-12 months

$40

$20

13-24 months

$60

$30

25-36 months

$80

$40

ID for Cats

$10

The rabies vaccination must be valid through the full license period. You may purchase

a license for as long as the rabies vaccine is valid. Please Note – Overpayments will be

neither returned or credited.

Pet’s Name_________________________ Color________________________________

Breed______________________________ Age________________________________

___Dog ___ Cat ___Male ____Female

___ Spayed/Neutered – Date: __/__/__ Veterinarian’s Signature: ___________________

Date Of Rabies Vaccination: __/__/__ Exp___Veterinarian’s Signature: _____________

Vaccine Manufacture: ______________ Type: _______________ Lot#_____________

_ Check Enclosed Use My MasterCard/Visa#____________________Exp Date______

Owner’s Name ___________________________________________________________

Address ________________________________________________________________

_______________________________________________________________________

Home Phone_____________________________________________________________

Alternate Phone __________________________________________________________

Dog Licenses may be

Complete the above information and either:

purchased up to the

Send with your check, or credit card number and

expiration date of the

expiration date to: Animals Services, 3281 E. Bayshore

rabies vaccination.

Road, Palo Alto, Ca 94303 Or if using a credit card, you

can fax applications to (650) 856-8591

Dog License Application Page 4