Arcadia
Dog License Application
NOTE: Before submitting this form, please call us at 626-792-7151 x115 to verify your address, as some sections of Arcadia are
unincorporated (not a part of the city of Arcadia) and are licensed through LA County Animal Control, 626-962-3577.
Print & submit a completed copy of this form and payment to:
Pasadena Humane Society, 361 S. Raymond Ave, Pasadena 91105 Attn. Licensing Dept
Questions? Call 626-792-7151 x115 or email [email protected]
Dog’s Name:
Pure Breed
Breed:
Mixed Breed
Markings:
Color:
Microchip #:
Age:
years
Size:
Small
months (must be 4 months of age to be licensed)
Medium
Please check one:
Large
Female (not spayed)
Female Spayed
Male (not neutered)
Male Neutered
DOG OWNER INFORMATION (Please use address where dog will be kept)
Owner’s First Name
Last Name
Address
City: Arcadia
State: CA Zip Code:
Telephone Number:
This is for a:
•
•
•
•
•
Renewal
or
New License
You must submit a copy of a current rabies certificate with this application. Rabies vaccination certificate must be valid throughout the license period. (AMC
4124.1.3,)
If applying for senior discount on a new license, you must submit proof of age (60+ years) (AMC 4124.2.5)
If applying for spay/neuter discount on a new license, you must submit certificate of sterility. (AMC 4124.2.5)
License period is 12 months from date of issue.
Licenses are issued only to individual persons. (AMC 4124.2.2)
Resident
Dog Unaltered $30
Spayed/Neutered $15
Dog Unaltered $15
Spayed/Neutered $7.50
Senior Citizen
(must show proof of 60 years+)
Late Renewal Charge (if not paid on or
before the expiration date)
$20
PLEASE MAKE CHECKS PAYABLE TO: PHS
Thank you!
$___________
$___________
$___________
Total $ ___________