Philadelphia Dog License Form
This form is only for dog owning residents of Philadelphia, PA. License fees are non-refundable. If you live outside of Philadelphia you must purchase your dog license for your county at licenseyourdog.pa.gov.
Your Contact Information
ACCT Philly will never share or sell your personal information.
Kindly select 'Yes' to continue if you are a resident of Philadelphia.
*
Yes
Name:
*
First Name
Last Name
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Is this a renewal?
*
Yes
No
Animal Sex
*
Neutered Male
Non-neutered male
Spayed Female
Non-Spayed Female
Dog's Name
*
Animal Age (in years)
*
Breed, Colors, and Markings
*
Is the dog a service animal required because of a disability?
Yes
No
What work or task has the dog been trained to perform?
Does your dog have a current rabies vaccine?
*
Yes
No
What veterinary office gave your dog's most recent rabies vaccine?
*
Rabies Tag Number
*
Proof of vaccination
*
See attached
Please contact my veterinarian
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Spayed / Neutered License
Please choose this selection if your dog has been spayed or neutered.
$
16.00
Spayed / Neutered License (Senior Citizen 65+)
Please choose this selection if your dog has been spayed or neutered.
$
8.00
Non-Spayed / Non-Neutered License
Please choose this option if your dog has not been spayed or neutered.
$
40.00
Non-Spayed / Non-Neutered License (Senior Citizen 65+)
Please choose this option if your dog has not been spayed or neutered.
$
20.00
Service Dog License
Please choose this option if your dog is a service animal required because of a disability.
$
Free
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
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