Lisa Dunckley Horse Identification
Please fill out form with all details so law enforcement can identify the animal. One form per horse.
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
What is your horse's name?
What is your horse's age?
What is your horse's sex
Microchip number:
Registration number and association:
Tattoo number:
Brand and registry:
Description with specific markings, scars, locations of brands/tattoos:
Please upload photos of horse (left side, right side and face)
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If I am unable to be contacted, I give permission for the following person to act as my Agent: (insert contact details):
An agent will have full authority to act on your behalf.
I would like an independent DVM, at my own cost, to perform on my horse the following items:
Body score/condition evaluation
Lameness evaluation
Pregnancy
Dental
Fecal evaluation for deworming protocol
Coggins and health cert for intra/interstate travel
Update core vaccines
Other
If DVM, Law Enforcement, or Animal Control finds horse is not salvageable, and/or cannot survive given current state. I give permission to euthanize the animal.
Please type yes or no
I willingly give consent for any veterinarian evaluation or documentation to be shared to authorities.
Please type yes or no.
For law enforcement purposes, please declare dollar value on horse:
I certify that I am the true owner of this horse, and can provide documentation to authorities.
Please type yes or no
Please upload any relevant documentation to prove ownership (registration papers, contracts, emails, et all).
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I am willing to go on record with authorities and testify in any legal proceedings, civil or criminal against Lisa Dunckley.
type yes or no
I certify that the aforementioned form is true and my signature constitutes permission and consent on actionable items within this form:
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