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Get AZ Dog License Application - Coconino County 2011

Ation Name of Dog Owner(s) Mailing Address Physical or Permanent Address (if different) City, State, and Zip City, State, and Zip Home Phone Work Phone Cell or Message Phone Dog’s Name Dog’s Breed Dog’s Date of Birth Dog’s Color Male □ Female □ Clinic/Veterinarian Rabies Tag Number Rabies Vaccination Date Dog License Fees Sterilized Dog □ $12 □ add $13 One Year License (per dog) Over 90 days late Check □ Visa □ Sterilized □ Unsterilized □ MasterCard .

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