I the undersigned, do hereby certify that I am the owner of duly authorized agent for the owner of the animal described above, that I do hereby give the doctos of North Ogden Animal Hospital permission to euthanize and dispose of said animal in whatever humane manner the doctors of North Ogden Animal Hospital, their agents, servants or representatives deem appropriate. I also release the doctors, North Ogden Animal Hospital, their agents, servants and representative form any and all liability for so euthanizing and disposing of said animal.
I do also hereby certify that to the best of my knowledge the said animal has not bit any person or animal
during the last ten (10) days
and has not been exposed to rabies.