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Dog License California Form
Application
Microchip #:
BELOW TO BE COMPLETED BY ANIMAL SERVICES OR VETERINARIAN (or attach Rabies Certificate)
CERTIFICATE OF RABIES VACCINATION
Hospital:
Vacc Date:
Phone:
Vacc Exp:
Manufacturer:
Veterinarian’s Signature
Lot No.
Vet License No.
LICENSE FEES
3 Year
Altered
Unaltered
$ 40.00
$ 85.00
Rabies Vacc
Microchip
2 Year
Altered
Unaltered
$ 30.00
$ 60.00
Total $
Donation $
Altered
Unaltered
PDA-New
PDA-Renewal
$ 15.00
$ 30.00
$200.00
$100.00
Cash
Check No.
Late...
Show details
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