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Dog License Form - City of San Gabriel Residents ONLY

Owner Information 
 
Name: ________________________________________________________________________________
 
Address: ______________________________________________________________________________
 
              ______________________________________________________________________________
 
Phone #: ______________________________________________________________________________
 
 
Dog Information
 
Name: ________________________________________________________________________________
 
Breed: _________________________________________________ Sex: __________________________
 
Color: ________________________________________________________________________________
 
Age (if under one year old): _______________________________________________________________
 
Rabies Expiration Date: __________________________________________________________________
 
Spayed or Neutered (Yes or No): ___________________________________________________________
 

Check List (you must include the following information):

 
____ Copy of Rabies Certificate (must span the entire license period - July 1 through May 31)
 
____ Copy of Certificate of Sterility (if your dog has been altered, proof must be included)
 
____ Check or Money Order (payable to San Gabriel Valley Humane Society)
                
        $30 One Year Altered/Sterilized            $50 One Year Unaltered/Unsterlized
                
                
 
          A 50% Late Fee and Penalty will be assessed on licenses renewed after August 31st.
 
 
Mail to San Gabriel Valley Humane Society, 851 E. Grand Ave, San Gabriel CA 91776
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