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2. Intact Animal
   -- Select One --1 Year $35.002 Years $70.00 3 Years $104.00
3. Altered Animal
   -- Select One --1 Year $16.002 Years $34.003 Years $47.00
4. Senior Citizen Discount
   -- Select One --1 Year $11.002 Years $23.003 Years $30.00

   Please note that the pet must be altered, and the owner MUST be 62+ years, and age verification of the owner will be required to qualify for the discount. 

5. Other Fees
   -- Select One --Duplicate Fee $5.00Transfer Fee $10.00Late Fee $25.00
7. Owner's First Name*
8. Owner's Last Name*
10. Address*
12. Address
14. City*
15. State*
16. Zip*
18. Mailing Address (if different)
20. Address
22. City
23. State
24. Zip
26. Primary Phone Number*
27. Phone Type
    -- Select One --CellHomeWorkOther
29. Email Address*
31. Animal Name*
33. Animals Sex*
    -- Select One --FemaleMale
34. Animals Age*
35. Color(s)*
37. Breed*
39. Mircochip #
41. Rabies Vaccine Record*
42. Identification (for Senior Citizen Discount only)
44. Payment Information*

    1. I understand that I need to submit a check or money order to the City of Citrus Heights Police Department to complete this pet license.

    By clicking this checkbox, and submitting this form, I acknowledge and understand that my pet license will be complete upon receipt of payment. Payments must be submitted at the front counter at CHPD or mailed to: 

    Citrus Heights Police Department
    Attn: Animal Services Unit
    6315 Fountain Square Drive
    Citrus Heights, CA 95621

    *** Make check or money order payable to the City of Citrus Heights. DO NOT SEND CASH. ***

    Attach a copy of the rabies certificate (photos of metal rabies tags will not be accepted). A copy of the spay/neuter certificate must be submitted for animals not previously licensed.

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45. 1. Receive an email copy of this form.
46. Email address

    This field is not part of the form submission.

47. Submit Submit and Print

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