OWNER SURRENDER FORM
I
certify that I am the legal owner and represent all other owners of the
animal
described below since ___________________________________
I
hereby relinquish all ownership rights to The Sweet Water Ranch Inc. Adoption 911 program.
Owner’s
Name (print):_________________________________________
Co Owner's name_____________________________________________
Address:____________________________________________________
City:___________________________________County:______________ State:__________________________________Zip:_________________
Home phone:___________________ Work phone:__________________
Driver’s
License Number:_______________________________________
Expiration date___________________State:_______________________
Animal’s Name: _________________________________ Age:________
Equine / Canine / Feline / Other :________________________________
Breed:_____________________________________________________
Markings / Color:_____________________________________________
Registered ID #______________________________________________
This animals temperament is: Very Gentle / Mild / Average / Some Issues
Hard to Handle / Wild or Feral / Other _____________________________
This animal is: Neutered: yes - no / Spayed: yes -
no
Gelding: yes - no / Stud: yes - no / Currently in Foal : yes - no
Micro chipped : yes - no / Chip ID#_______________________________
Has
this animal bitten, scratched or hurt anyone in the past ten days?
Was it reported to an Animal Control Agency or any medical facility?
If so, what date did this incident occur and to whom was it reported to?
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
Your reason
for relinquishment:__________________________________
___________________________________________________________
___________________________________________________________
Where
did you originally obtain the animal? ________________________
___________________________________________________________
___________________________________________________________
I
understand that I am surrendering my animal(s) to The Sweet Water
Ranch Inc. / Adoption 911 program. If the animal(s) deemed un-adoptable
by SWR Adoption 911 because of health issues or behavioral, I understand
that it may be humanely euthanized. I
certify
that I am the legal owner and I have no contractual obligation with any agency,
organization
or individual concerning the animal(s) described herein.
Please Sign__________________________________________________
Owner's signature Date
Please Sign__________________________________________________
Co Owner's Signature Date
___________________________________________________________
*Please copy and complete this form, then send it in by e-mail or fax.
* E-mail it to: sweetwaterranch@sbcglobal.net
*Fax it to: (818) 992-6657
___________________________________________________________
*Please include a photocopy of your drivers license and or a picture ID.
*Please also include any type of registration paperwork on this animal.
*Please include a photo of the animal to be surrendered.
*If you are surrendering multiple animals, please use an
additional form for each animal.
___________________________________________________________
