Forms, Permits, and Applications

Departments

Forms, Permits, and Applications Table
Title	Attachments	Submit Online
Staff Shout Outs		Submit Online
Adult Protective Services	Report of Suspected Dependent Adult/Elder Abuse Form Report of Suspected Dependent Adult/Elder Financial Abuse Form Adult Protective Services Brochure Adult Protective Services Rack Card
Air Quality Forms & Information	Baghouse Supplemental Boiler Supplemental Code Violation Complaint Concrete Batch Plant Supplemental Cyclone Supplemental Device Information Supplemental Diesel Engine - Timing Certification Dry Cleaner Supplemental Fuel Storage Tank Supplemental Internal Combustion Engine (diesel-fired) Internal Combustion Engine (gas-fired or propane-fired) List and Criteria Mineral Processing Plant Supplemental Paint Spray Booth Supplemental Paint Spray Booth Guidelines Polyester Resin Operations Tune-Up Checklist Smoke Management Plan Title V Application Forms Public Records Request Vapor Recovery Testing Companies, Updated Oct. 13, 2023 Application for Authority to Construct/Permit to Operate
ALERT FM Request Form		Submit Online
Assessment Appeals
Assessor Forms
Bad Check Enforcement Program Details	NSF Check Report Form Suggested Shasta County Check Policy Supplemental Check Report Form
Bees	2023 Apiary Registration Form 2013 Apiary Ordinance Shasta County Swarm List
Birth & Death Registration	Birth Certificate Application Death Certificate Application Funeral Director Application
Body Art Facility & Practitioners	Body Art Facility COVID-19 Guidance Body Art Facility COVID-19 Safe Reopening Plan Safe Body Art Act Body Art Facility Permit Application Practitioner Registration Form Mechanical Stud and Clasp Ear Piercing Notification Form Bloodborne Pathogens Exposure Control Training Program Evaluation Bloodborne Pathogen Exposure Control Training Classes Infection Prevention Control Plan Template Hepatitis B Declination Statement Body Art Facility Pre Opening Checklist Body Art Facility Plan Review Checklist Body Art Facility Plan Check Guidelines Body Art Facility Infection Prevention and Control Plan Requirements Body Art Self-Inspection for Facilities and Practitioners Body Art Facility Plan Review Application
Building Forms & Applications
California Accidental Release Prevention Program (CalARP)	CalARP Regulations Seismic Walkdown Shasta CUPA CalARP Submission Process CalARP Registration Form
CCW Information	Personal Firearms Record Sheriff's Office CCW Policy Approved Instructor List
Certified Farmers' Markets	Certified Producer Application 2023 Shasta County Certified Farmers' Markets (See map for locations) Egg Handlers Registration Interested in Starting a New Farmers' Market? FAQ Assembly Bill 1871 Notice To Roadside Vendors
Change Address	Address Change Request Form
Child Abduction Unit	Child Abduction Good Cause Form Child Abduction Contact Form Family Law Facilitator Brochure
Citizen Complaints	Citizen Complaint Form Citizen Complaint Form (Spanish) Citizen Complaint Form (Lao)
Civil Forms	Request for Sheriff to Serve Court Papers: SER-001 Instructions Special Instructions for Writs and Levies - Attachment: SER-001A Earnings Withholding Order Supplement to Wage Garnishment Form WG035 Instructions for Claim of Exemption Real Property Levy
Civil Prosecution	New Consumer Complaint Form
Commercial Agriculture/Livestock Access Pass	Commercial Agriculture/Livestock Access Pass Information Letter Commercial Agriculture/Livestock Access Pass Application
Consumer Protection	Consumer Complaint Form
Contact Fire Department		Submit Online
Contact Public Works		Submit Online
Contact Tax Collector		Submit Online
Contact Us		Submit Online
Coroner
Criminal Justice Forms	Certificate of Rehabilitation Form Expungement Form Pardon Form
Criminal Prosecution	New Consumer Complaint Form
Disaster Relief	Disaster Relief Claim Form
Email Recorder		Submit Online
Email the Assessor		Submit Online
Emergency Job Matching Signup		Submit Online
Employee Appreciation Day Vendor Form		Submit Online
Encroachment Permits	Encroachment Permit
Environmental Crimes Unit	Illegal Dumping Reporting Form
Fictitious Business Name	FBN Application Withdrawal Application Abandonment Application
Firearms Relinquishment Fillable Forms	BOF 1022 Prohibited Persons Relinquishment Form Rev.01.2018 BOF 1023 Defendant Supplemental Form BOF 1024 Designee Supplement Form BOF 1025 Firearm Disposition Receipt
Grand Jury	Grand Juror Application Form
HHSA Privacy & Security - Your Privacy Rights	Notice of Privacy Practices Aviso de Prácticas de Privacidad Attestation: Questionnaire and Confidentiality Statement Authorization to Use or Disclose Protected Health Information Form (Release of Information - ROI) Autorización Para User o Divulgar Información de Salud Protegida Attachment A Anexo A Instructions - Authorization Form Revocation of Authorization to Use or Disclose Health Information Email and Text Communication Consent Email and Text Messaging Communication Consent Form Instructions for Managers
Housing - Hotels, Motels, and Organized Camps	Housing Application
IHSS Advisory Committee Minutes & Agendas	Speaker Request Form
IHSS Provider Orientation	426-A Recipient Designation of Provider Form W-4 Form Direct Deposit Enrollment Form Change of Address Form IHSS Rack Card Brochure
In-Home Supportive Services	Application for In-Home Supportive Services IHSS Rack Card Health Care Certification Form Applicant Questionnaire
In-Home Supportive Services	Application for In-Home Supportive Services IHSS Rack Card Brochure
In-Home Supportive Services	Application for In-Home Supportive Services
Inmate Visitation Request		Submit Online
Job Center Survey		Submit Online
Marriage Services
Medical Marijuana State Identification Card Program	Medical Marijuana Application Form Medical Marijuana Application Directions
Noxious Weed Survey		Submit Online

Forms, Permits, and Applications

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