Owner Surrender Form – REFURBISHED PETS OF SOUTHERN MICHIGAN

Owner Surrender Form

Owner Surrender Form

***THIS FORM IS ONLY TO BE COMPLETED AFTER A REPRESENTATIVE OF REFURBISHED PETS OF SOUTHERN MICHIGAN HAS AGREED THAT THE DOG ON THIS FORM WILL BE TAKEN INTO OUR CARE. PLEASE FILL OUT AS MUCH INFORMATION AS YOU KNOW SO WE CAN PLACE THE DOG IN AN APPROPRIATE FOSTER HOME.

Surrendering Owner Information

Name(Required)
Address(Required)

Canine Background

Best Guess if Mix
Spayed Or Neutered(Required)
Dogs Gender(Required)
Cropped Ears?
Docked Tail?
Has the Canine been breed or had litters?
Does the Dog get along with other dogs?
Is the Dog good with kids?
Does the Dog get along with cats?
Age or age range of children dog is known to be good with.
Max. file size: 512 MB.
Max. file size: 512 MB.
PHOTO OF DRIVER’S LICENSE OR STATE ID OF THE PERSON 18 YEARS OR OLDER THAT IS SURRENDING THE ABOVE-DESCRIBED CANINE TO REFURBISHED PETS OF SOUTHERN MICHIGAN

Surrender Consent

I, the undersigned, attest and guarantee that I am the legal owner of the canine named below and have all rights to ownership. It is my understanding that with this instrument the canine becomes the sole property of Refurbished Pets of Southern Michigan. By my signature below, I waive all rights of ownership and claim to the canine named below. In addition, I agree to turn over all medical records and AKC records to Refurbished Pets of Southern Michigan. I understand that Refurbished Pets of Southern Michigan has no obligation to inform me of this canine’s final disposition or to provide any information on the canine’s adoptive home. I understand that Refurbished Pets of Southern Michigan will do what is best for the dog, including alteration. Furthermore, by my signature, I attest that no one has been bitten or scratched by this animal in the past thirty (30) days.(Required)

 

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