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Om For Office Use Only Tracking Number Amended Application Payment Information APPLICATION FOR ANIMAL CARE FACILITY LICENSE Instructions: Do not leave any item blank. Enter NA for non-applicable items. Submit the completed application and $75.00 application fee to the address above. Renewal applications and fees are due 45 days prior to license expiration. Checks should be payable to Brevard County Health Department. Payment with Visa and MasterCard are accepted via telephone at (321) 63.

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