Document ID: chunk:federal_register_of_legislation:F2018N00130:reg:13:p2
Version: federal_register_of_legislation:F2018N00130
Segment Type: reg
Provision Reference: reg 13 (pt 2/2)
Character Range: 31910–33937

OFFICE USE ONLY                                                  Remarks
Fees                                                  Total                                                                    Account no:515500
                                                           Paid                                                                Receipt no:
1.  Number of cat/s applied for                                  □ 1    □ 2    □  >2, How many _____
2.  Home visit required                                          □ No    □Yes, Date of visit ____________
3.  Sterilisation conducted                                      □ No, Complete agreement form (4)  □ Yes, proof provided ___
4.  Sterilisation agreement form completed                       □ Yes  □ No
5.  Cats identifiable, Please specify                            Cat 1                                                         Cat 2
        Tags, Collars, Micro chip
6.  Application approved                                         □ Yes  □ No, Letter sent □                                    Date:
7.  Registration number(s)                                       Cat 1.                                Cat 2.
8.  Registration valid until                                     1st July _______
9.  Permit Issued                                                □ Yes, Number:               Date:
10. Records updated                                              □ Yes  □ No
Issuing Officer                                                  Name:                                                         Signature:

 SCHEDULE 3

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                  Universal Mark of De-sexing via Neutering

Date [insert date]

The Common Seal of the Shire of Christmas Island was affixed under the authority of a resolution of the Council in the presence of –

Cr G. THOMSON, Shire President
D. NIELSEN, Acting Chief Executive Officer