Agreement to Transfer Ownership of Dog


This Agreement to Transfer Ownership of Dog ("Agreement") is entered into on this __________ day of ___________, 201__.


I, _____________________________ owner of the below described Dog, do hereby permanently and irrevocably transfer ownership of the dog to Small Paws® Rescue, Inc. By executing this Agreement, I acknowledge that I am irreversibly relinquishing to Small Paws® Rescue, Inc. any and all right, title, and ownership that I had or may have had with respect to the Dog. I further acknowledge that I am the owner of the Dog and that I am fully authorized to enter into this Agreement.

Description of Dog:

Breed: __________________Registration #:________________

Tattoo #_________________Microchip #: _________________

Other identifying characteristics:

Name:____________________ Age:__________________

Color:__________________

Sex:________________Neutered? ________Spayed?_________

Name and address of breeder if known:_______________________________________________

_____________________________________________________

Diet Dog has been receiving:_____________________________________________

Has Dog Ever Bitten Anyone?______________________________

Housebroken?_______________ Noisy?_____________________

Jumper?__________________ Destructive?__________________

Good with children?_____________________________________

Good with cats?____________ Good with other dogs?__________

Health history?______________________________________________

_____________________________________________________

Date of last rabies immunization?____________, heartworm test:____________, DHLPP:_______

Name and telephone number of Veterinarian who has cared for this dog?_________________________________________________

_____________________________________________________

Reason for release of Dog to Small Paws® Rescue, Inc. _____________________________________________________

_____________________________________________________

Other comments:








Amount of donation, if any, coming with Dog into rescue, to help defray costs for care, until adoption $____________.

By signing this Agreement, I acknowledge that I have read the Agreement and that it is a binding legal agreement.

Printed Name:_______________________________________

Printed Name:_______________________________________

Address:______________________________________

__________________________________________________

Signature: _____________________________

Signature: _____________________________



I, a representative of Small Paws® Rescue Inc., hereby do accept responsibility for the above named and described Dog on behalf of Small Paws® Rescue, Inc.


_________________________________
Signature of Small Paws® Rescue Volunteer or Staffer