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RELINQUISHING FORM

THIS IS TO CERTIFY THAT I AM THE LEGAL OWNER OF THE BOXER DOG/BITCH NAMED ...................................................................................... AND THAT I HAVE TODAY (DATE) ................ HANDED THE SAID BOXER DOG/BITCH AND ALL THE RELEVANT PAPERS (INCLUDING PEDIGREE) AND INOCULATION CERTIFICATE INTO THE CARE OF HOME COUNTIES BOXER WELFARE, AND I HEREBY RELINQUISH ALL CLAIM TO THE SAID BOXER DOG/BITCH

PEDIGREE YES/NO INOCULATION CERTIFICATE YES/NO DIET SHEET YES/NO MICROCHIP/TATTOO YES/NO INSURED YES/NO	SIGNATURE NAME IN CAPITALS WITNESS
ADDRESS POSTCODE	TELEPHONE NUMBER
VETERINARY SURGEON	TELEPHONE NUMBER
ADDRESS
(FOR OFFICIAL USE ONLY)
BOXER REHOMED WITH	DOG/BITCH COLOUR AGE SPAYED/CASTRATED
ON (DATE)	HISTORY (IF ANY)

HOME VETTED BY

REPRESENTATIVE(S) TRANSPORTING

FOSTERED/KENNELLED/STRAIGHT FROM HOME

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Home Counties Boxer Welfare

Completed form to: Ann Podmore, 89a High Street South, Stewkley, Leighton Buzzard, Beds LU7 0HU

QUESTIONS TO BE ASKED OF PERSON PARTING WITH DOG

NAME	TEL NO:
ADDRESS	BEST TIME TO MAKE CONTACT
DETAILS CONCERNING DOG TO BE HOMED
NAME	COLOUR DOG OR BITCH
SEX AGE (D.O.B.)	BREEDER ADDRESS
REASONS FOR WISHING TO PART WITH DOG	DATE BY WHICH TO BE REHOMED

DOG'S ATTITUDE TO	YOUNG CHILDREN TEENAGERS CATS OTHER DOGS OTHER ANIMALS (SHEEP) (HORSES)
USED TO TOWN OR COUNTRY	USED TO CAR
DISLIKES	LIKES
CLAUSTROPHOBIC OR NOT	CAN DOG BE LEFT FOR SHORT PERIODS
DEGREE OF LEARNING REACHED	ANY OTHER IDIOSYNCRASIES

WHERE DOES HE/SHE NORMALLY SLEEP	DIET
ANY OPERATIONS	ANY ILLNESSES
NAME, ADDRESS AND TEL. NO. OF VET WHO HAS TREATED DOG MICROCHIPPED YES/NO	INOCULATION CERTIFICATE YES/NO BOOSTER DUE INSURED YES/NO SPAYED/CASTRATED YES/NO

NOTIFIED TO WELFARE	(DATE)
NOTIFIED TO	(NAME AND TEL. NO.)
DOG HOMED WITH	ON





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	Under the Dangerous Dogs Act we are obliged to ask the following questions

	(The giving of wrong or misleading information could make the new owner or yourself liable)

	Dog's name .................................................... Colour......................................... Age................................ Has the dog ever bitten? YES ( ) NO ( ) If YES give full details..................................................................................... .................................................................................................................... ..................................................................................................................... If NO to the above question please sign the following statement. I certify that to the best of my knowledge the Dog to which this document refers has not bitten anyone. Signature .................................................................. Date ........................... ************************************************** This information is, to the best of my knowledge and belief, correct Signature .................................................................. Date ........................... Surname .......................................................... Mr/Mrs/Miss Intls ........... Address ........................................................... ............................................................. ............................................................. .............................................................