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Monday, 12-Mar-2001 19:17:00 PST
PDF Translated to HTML
 


HTML Translation of http://www.akc.org/pdfs/literap.pdf

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g

ALITTA (8/00)
g
T
HE
A
MERICAN
K
ENNEL
C
LUB
Litter Registration Application
Use this application to register a litter of puppies
bred and whelped

in the USA
from an AKC-registered female and an AKC-registered male of the same breed.
Additional information and instructions are on the back of this form.
Submittal and Payment Information
o
Fee: $20.00
(Standard)
Litter registration applications must be received within six (6) months of the date of birth or an additional $60 penalty fee with
explanation and records will be required. Fee subject to change without notice. Do not send cash. Send the completed application and
a check (or credit card information) for all applicable fees to:
The American Kennel Club, P.O. Box 37901, Raleigh, NC 27627-7901.
o
Fee: $50.00
(Expedited)
Special restrictions apply. See the back of this form for additional information. Send the completed application and a check (or credit
card information) for all applicable fees to:
The American Kennel Club, P.O. Box 37912, Raleigh, NC 27627
-
7912.
If you use a credit card, you may complete this page and fax it to: AKC, (919) 233-3627.
Charge my:
o
VISA
o
AMEX
o
MasterCard
0
Account Number (do not include dashes)
Expiration Date
Signature of Cardholder
Litter Information
Breed:
Number of living puppies in this litter:
0
0
o
This litter is the result of artificial insemination.
Males
Females
Date of Birth
See requirements on the back of this form.
Registered Name of Sire (Male)
AKC Number of Sire (Male)
Registered Name of Dam (Female)
AKC Number of Dam (Female)
Section A: To Be Completed and Signed by Owner/Co-Owner of Sire (Male) on Date of Mating
I
certify
that the identified Dam (Female) was mated to the identified Sire (Male) and that the Sire was owned/co-owned by me on the date of
mating. I understand that if the identified Sire has sired six (6) or more litters in a lifetime or three (3) or more litters in a calendar year, an AKC
DNA profile is required to register this litter.
Owner's First Name
Owner's Last Name
Sire Owner or Co-Owner Signature (required)
0
0
Telephone Number
Email Address
Section B: To Be Completed and Signed by All Owners or Lessees of Dam (Female) on Date of Birth
All owners and co-owners read and sign the following statement:
I (we) apply to register this litter and
certify
that I (we) are the owner(s) or
lessee(s) of the identified Dam (Female) on the date of birth of the litter and that this Dam was not mated to any other dog during her season. I
(we) further
certify
that all of the representations on this application are true. I (we) agree to comply with AKC rules and regulations.
Owner's First Name
Owner's Last Name
Owner's Signature (required)
2
nd
Owner's First Name
2
nd
Owner's Last Name
2
nd
Owner's Signature

(required)
3
rd
Owner's First Name
3
rd
Owner's Last Name
3
rd
Owner's Signature (required)
AKC will send the litter kit (one registration application for each puppy) to the owner below.
Name
Street Address
0
City
State
Zip Code
0
0
Telephone Number
Email Address
Section C: To Be Completed Only If Ownership of Dam (Female) Changed or Lease Terminated while Dam Was in Whelp (Pregnant)
I (we)
certify
that I (we) was (were) the owner(s) or lessee(s) of the identified Dam (Female) on the date the Dam was mated to the identified Sire
(Male). I (we) certify that the Dam, while in my (our) possession, was not mated to any other dog during her season.
Owner's First Name
Owner's Last Name
Signature of Owner/Lessee (required)


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