2. Village of Merrionette Park
   11720 S Kedzie Avenue
   Merrionette Park, IL 60803
4. Animal
6. Pet Type

   1. Dog
   2. Cat
7. Sex

   1. Male
   2. Female
9. Pet Name
11. Breed
13. Color
15. Vaccination Number
    Must bring proof of vaccination with payment
17. Expiration Date
    Expiration Date
19. Tag Number
21. Cost
    $5.00 per dog tag.
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