PIMA ANIMAL CARE CENTER
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ANIMAL LICENSE
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APPLICATION FORM
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FIELDS IN RED ARE REQUIRED FOR PROCESSING
Please fill out one form per animal
If you have problems trying to license online or have questions regarding the process, please contact us at
(520) 724-5969 Monday through Saturday 8am to 5pm or by email at licensingpacc@pima.gov.
Altered: Yes
(attach proof)
Animal Name:
Age: Date of Birth
OR
years
months
Male
Female
Service Dog: Yes:
(attach proof)
Color:
Breed:
________________________________________________________________________________________________________
Owner Name:
Physical Address:
(within Pima County where licensing pet)
AZ
City:
State:
Zip Code:
Mailing Address:
(if different from above)
City:
State:
Zip Code:
Telephone Number(s):
Primary:
Secondary:
Email Address:
Please indicate which proofs you are attaching and be sure to include them with this form.
See our Fees page for discount eligibility requirements.
Select one of the following discount types that is
______ Rabies vaccination
______ Senior discount (age 65 or older)
the best option for you:
______ Alteration
______ Disabled discount
______ Service dog
______ Low income discount
(licensingpacc@pima.gov) --OR-- Fax to (520) 791-6627 --OR--
US Mail to Pima Animal Care Center, 4000 N Silverbell Rd, Tucson AZ 85745
email to PACC
When this form and the necessary attachments have been processed, PACC Licensing will send you the
login information you will need to purchase your new license online.