Teresa A. Hestekin
Certified Animal Control Officer #236
4147 Soley Lane
715-832-9091
E-mail:
tar9091@aol.com
SURRENDERING YOUR PET
All
Veterinarian and transportation expenses up to this date have been the owners
responsibility.
Surrender fee: Animals under 20 lbs = $30.00; Larger Animals = $100.00; Other ________________
I, __________________________do hereby understand that I am completely giving up
ownership and all rights to this animal being surrendered.
He/she will be placed up for adoption as soon as possible, and will be
placed in a new home as soon as one is available, it may be an hour, a day, a
week, or longer. Once an animal is placed in a new home it is no longer
available to come back to you or any of your family members.
It is always helpful if the persons interested in adopting can call and speak to you personally. We understand if you are not willing, or maybe you just can't be available for this kind of assistance. Sometimes re-homing a loved pet is more then one can take and we want to help ease your pain.
_______Yes the new owner can contact me
_______No,
please keep my information confidential
To
the best of my knowledge, this animal has not bitten anyone within the last 15
days.
Dog ~
Cat ~ Horse
~ Bird
~ Or
other: __________
Pets
name is: _____________
Age
is: ___________________
Please
attach vaccination records if applicable.
Signature
_____________________________________ Phone#_____________________________
Proof
of Identification at the time the animal is surrendered:
Identification proof is required incase of discrepancy later on with
regards to ownership:
WI
Drivers license #___________________________________
or
other proof of
Identification:__________________________________________________________
_________________________________________________________
Todays
Date _________