Application for the $20 Fix

Application for the $20 Fix



CARE’s Lillie’s Fund is dedicated to providing low cost spay and neutering services for dogs and cats that are at least 3 months old. To qualify, you must be a resident of Chatham County,


•Your annual household income is $40,000 or less


• You receive support from any of the programs listed on the next panel.

To apply, fill out this application and mail to:


P.O. Box 555

Pittsboro, N.C. 27312

A $20 co-pay for each dog/cat must be included with this application—this application will not be processed without it.

The co-pay amount (cost to you) is $20 for a cat and $20 for a dog. Puppies and kittens (four months old or less) can be fixed for $5 eachIF the mother is fixed at the same time.

If you are approved, you will receive a voucher and additional information. If you are not approved, your money will be returned to you.

Distemper and rabies shots (if needed) will be included along with pain medication for adult females. Rabies shots are required by law and will be given unless you provide proof of vaccination.

For questions, or help with this application, PLEASE contact us at or call 919-542-5757. To download additional applications, click on any Spay/Neuter link on our website.



Mailing Address:______

Street Address ______

(if different)
Phone-day: ______night: ______
What was your total household income last year from all household members:
Employment income last year? $ ______
Income from other sources last year (SSI, child support, alimony, unemployment, etc.): $______
What are your total monthly expenses now: $ ______
(mortgage/rent, utilities, groceries, clothing, etc.)
Proof of eligibility must be included. This application will not be processed without it.
Food Stamps
(card with photo ID and recent receipt) / Medicaid
for adult, not child / (SSI) Fed. Supp. Security Income
for adult, not child
Social Security Disability / (WIC) Women, Infants, & Children (with current date) / Social Security as your ONLY source of income
IRS form 1040 w/o soc sec # (not W-2 or pay stub) / Letter explaining special financial need if income over $40K
Please list all household members, including yourself, who rely on the income you have listed above:
First Name/Age / Occupation / Full/Part Time?


CARE reserves the right to limit the number of vouchers issued to any one household based on availability of funds.

Pet to be FIXed
Dog/Cat / Name / Sex
M/F / Voucher Number
Dog/Cat under 4 months / Name / Sex M/F / Voucher Number

Is your pet up-to-date on rabies shots? YESNO

If yes, you must bring the current rabies certificate to your appointment to avoid over vaccination.

How did you hear about Lillie’s Fund?______

I understand that Lillie’s Fund is for low income pet owners only and that information I provide will only be used to determine if I qualify for this program. I hereby attest to the accuracy of this information and that all pets listed are personally owned by me. CARE has my permission to verify this information to prove that I qualify. If any of the information I have provided about my income or eligibility is found to be false, I will be responsible for the payment of a standard rate of $200 for the procedure and vaccinations given to my pet.

Signature:______Date: ______

(Please allow two weeks for processing)

Spaying or Neutering is Good for you and Your Pet!

• Sterilized pets live longer, healthier lives.

• Sterilized pets make better pets, more

affectionate companions and are less

likely to roam or fight.

• Sterilized cats are less likely to spray and

mark territory

• Unsterilized animals exhibit more behavior problems, and may be more likely to bite. Females in heat often cry incessantly and attract unwanted males.

• Sterilization reduces pet overpopulation and the number of unwanted animals killed in

our animal shelters . . . 300,000 in

North Carolina in 2006 alone.

It’s easy to produce

80 million cats . . .

Allow two cats and their offspring to breed for 10 years, and you’ll produce 80,399,780 cats, assuming two litters per year and 2.8 surviving kittens per litter. Most of these cats will be killed in animal shelters because there just aren’t enough homes for them all.

Year 1: 12

Year 2: 66

Year 3: 382

Year 4: 2,201

Year 5: 12,680

Year 6: 73,041

Year 7: 420, 715

Year 8: 2,423,316

Year 9: 13,968,290

Year 10: 80,399,780

Do your part to stop the suffering.

Have your pets spayed or neutered.