Type Full Name :
Sign With Hand
Last Name
City
Rabies Vaccine Period
New Tag #
If Other Breed, specify
Required Documents
Serial # of Rabies Vaccine
Vaccination Information
Owner Information
Sex
Age
Phone #
Rabies Vaccination Exempt?
Color
{[PNAME]}
State
Phone #
  • Proof of alter or unaltered.
  • Proof of service dog certification.
  • Proof of rabies vaccination or exemption.
  • Proof of senior if age 65+ (If applicable)
  • Proof of disabled (If applicable)
Address 2
Address
License Fee
Donation
Applicant Signature
First Name
Vaccination Expiration Date
ZIP
Old Tag #
Are you a senior 65+/disabled?
First Name
City
Is Rabies Vaccination Valid?
If applicable, provide details of another owner for this dog that resides at the same address.
Veterinarian Information
ZIP
Manufacturer of Rabies Vaccine
Last Name
Dog Name
By submitting this form, I am confirming that all of the information I have entered is accurate, according to the best of my knowledge. I understand that failure to provide correct information will result in revocation of my pet’s license.
Phone #
Dog Tag Replacement?
License Type
Altered or Unaltered
City of Grand Terrace Animal Care and Control
22795 Barton Road
Grand Terrace, CA 92313
(909) 954-5200
Application Type
Note that payment must be received in full before a Dog License and Registration Tags can be issued.

License Fee
Vaccination Date
State
Email
Address
Microchip #
Dog Information
Name
Certification
Breed
Address 2
City of Grand Terrace
Service Dog?
Email
Specify Address where BOTH Dog and Owner reside
Tag Replacement Fee