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Pet Owner Information
First Name*
Last Name*
Address*
Apt #
City*
State
Zip*
Email*
Phone*
Description of Animal
Name of Dog*
Breed
License Number*
The six-digit number engraved on your dog's tag and also found on the receipt provided to you when you licensed your dog.
Reason for Error
Reference Number*
Please enter the Reference Number on your coupon
What is the error?*
1. Dog is currently licensed (number above)
2. No longer own dog
3. Dog is deceased
4. No longer resident of Maricopa County
5. Other
Please Explain