Request Form

Please complete this form for assistance in providing you a record or documentation. Your payment is an admin fee and is non-refundable even in the event we can't find or provide the record. Depending on the record type we may not be able to provide any records. If it has been more than 12 month past the date of pick up we may not have access to the records. If there are any additional fees associated with the records request you will be invoiced prior to sending them. Records will be emailed unless requested otherwise. Payment for mailed items will be invoiced prior to sending any documents. We will not mail international.

We will only provide the records or documentation to the OWNER on the BILL OF SALE. If you do not have a completed BILL OF SALE we will send a bill of sale to the person listed on the purchase agreement. If the purchase agreement is not completed we will establish the owner as the first person listed in the deposit or application. There is only one owner per dog sold and we can't list co-owners.

We reserve the right to service or deny records to non-owners.

All payments must be sent via ZELLE. Any requests we are able to fill will be done within 30 days.

When sending ZELLE use our email

iheartminiaussies@gmail.com

Account Holder : iheart mini aussies LLC

Legal Owner Owner Name

First NameLast Name

Legal Owner Owner Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Legal Owner Owner Email (must provide the email address used on application/bill of sale)

example@example.com

Legal Owner Phone Number

Please enter a valid phone number.

Name of Dog

Breed of Dog

Male or Female

Dog color

Dog Date of Birth

Who are the parents of the Dog?

Date of puppy pick up or transport

Please let us know what you are requesting. Add as much information as possible. If you state "health record" or "vaccine record" we will automatically assume you mean a HEALTH CERTIFICATE from the 8 week old vet visit / sale visit.

I, blanks confirm that I am the legal owner of the dog listed in this form and am requesting a record for this dog. I understand that the records request fee is non-refundable ADMIN fee and will not be returned if records are unable to be provided. I am responsible for any additional fees associated with records.

Legal Owner Signature

Date of Signature

Request Form

RECORD REQUEST FEE IS : $25 VIA ZELLE