| RESCUE CONTRACT RELINQUISHED TO OWNER MARY JUDITH JORDAN ADDRESS: 2453 BONNY DR. CITY,STATE & ZIP: COCOA, FLORIDA 32926 HOME: # 321-632-4148 CELL# 321-615-8878 RELINQUISHED OWNERSHIP INFORMATION |
| REGIATRATION #______________________DOB__________________ SEX_____________ PREVIOUS OWNER NAME: PREVIOUS ADDRESS: CITY,STATE,ZIP PHONE NUMBER: Home CELL THIS DACHSHUNDS WAS VOLUNTARILY TURNED OVER TO DACHSHUNDS AND DOXIES FOR PLACEMENT IN A HOME SUITABLE FOR THE DACHSHUND/S ATTITUDE AND NEEDS THIS DACHSHUND WILL BE CARED FOR TILL IT IS SOCIALIZED,TREATED FOR ANY DISORDERS BEFORE GOING TO A NEW HOME ALL NEW OWNERS WILL BE SCREENED TO INSURE PROPER CARE OF THE DACHSHUND(RESCUE) PREVIOUS OWNER SIGNATURE_______________________________DATED__________ RESCUES SIGNATURE________________________________________DATED__________ ANY OTHER INFORMATION ABOUT THE RESCUE DACHSHUND/ANIMAL THAT IS NEEDED TO BE KNOWN ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ |