APPLICATION FOR A Breeder Permit

Please be sure you have thoroughly and carefully read and understand Ventura County Ordinance 4425 before completing this application. Please note there is a cost associated with each permit for each pet. A Senior Animal Control Officer will review this application for completeness and accuracy to ensure you have met all of the qualifications as a breeder under Ordinance 4425. All required documentation can be sent via EMAIL, FAX or U.S. MAIL to the contact information below. If you prefer submitting this application via U.S. Mail or FAX, please print this application, complete it, and send to the contact information below. Smartphone photos of documents are accepted and can be sent to the email address below. Please do not send original documents if submitting required documents via U.S. Mail.

If you have any questions, please contact Senior Animal Control Officer Alina Hoffman at Alina.Hoffman@ventura.org or (805) 388-4397.

Ventura County Animal Services Approved Breed Registries:

Dogs

American Kennel Club (AKC)
American Canine Association Inc. (ACA)
American Purebred Registry (APR)
Continental Kennel Club (CKC)
National Kennel Club (NKC)
United Kennel Club (UKC)

Cat

Cat Fanciers’ Association
Cat Fanciers’ Federation

Breeder Permit Application

By checking this box, I hereby affirm that I have read Ventura County Ordinance 4425 and believe I am in compliance with the codes therein. I further understand there is a cost associated with each permit which must be paid prior to issuance.

Animal Owner's Name

Date of Birth

Phone Number

Address

City

State

Zip Code

Do you rent or own?

Rent Own

If renting, list landlord name:

Landlord phone number:

Total Number of dogs and cats on premises:

Animal #1 -- Name. Breed. Color. Sex and License Number:

Animal #2 -- Name. Breed. Color. Sex and License Number:

Animal #3 -- Name. Breed. Color. Sex and License Number:

Animal #4 -- Name. Breed. Color. Sex and License Number:

Animal #5 -- Name. Breed. Color. Sex and License Number:

Veterinarian's Full Name

Date last seen veterinarian:

Hospital/Clinic name:

Hospital/Clinic address:

City

State

Zip Code

Veterinarian Phone:

Veterinarian Email:

Veterinarian FAX:

REASON FOR BREEDING:

I CERTIFY THAT THE INFORMATION SUBMITTED ON AND WITHTHIS FORM IS TRUE TO THE BEST OF MY KNOWLEDGE.

TODAY'S DATE

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Breeder Permit Application

LOCATION AND HOURS OF OPERATION

CAMARILLO ANIMAL SHELTER

Simi valley Animal Shelter

Contact information

CLOSED HOLIDAYS*

pet licensing

TRANSLATE DISCLAIMER

I WANT TO...