Philadelphia Dog License Form
This form is for 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.
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
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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