Owner Surrender Form

Owner Surrender Form

for Bossy Paws Rescue Inc
Name of pet parent

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please Complete the section below (include all animals)
Animal Type
Name if known: blanks* Animal Age(s): blank*
Animal Breed:  blank*  Color/description:  *

Litter information if applicable:
Number of females:     Number of males:
I hereby certify that I am the rightful owner/keeper/caretaker/custodian of the animal(s) who is/are the subject of this Animal Surrender Form, hereinafter referred to as “the animal.”

I hereby surrender any and all property rights to the animal.

I certify that no other person has a right of property to the animal. I understand that by surrendering my property rights to the animal, the animal may be transferred into the custody of an animal shelter.

I also hereby certify that the animal has not bitten or scratched a human or another animal.

I understand that once I relinquish the animal, the animal will not be available to be returned. I further certify that I have read and understand the terms of this Animal Surrender Form.
Upload a picture of the animal(s)

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Please upload a picture of the front of your drivers license or state issued ID.

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Please upload a picture of the back of your drivers license or state issued ID.

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Todays Date*

MonthDayYear
Date
Signature*

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