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May we be OBSERVICE to you?
 
Monday, 12-Mar-2001 19:02:08 PST
PDF Translated to HTML
 


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

[Page 1] [Page 2]


Page 1 of 2

Name of
NEW OWNER____________________________________________
Address _________________________________________________
City _______________________State__________Zip____________
Phone (_____) _____________________
Name of
NEW CO-OWNER ________________________________________
Address _________________________________________________
City _______________________State___________Zip___________
Phone (_____) _____________________
I (we) transferred the dog identified above directly to the New
Owner(s) listed above on the date of transfer indicated. I am (we are)
in good standing with the American Kennel Club.
Signature of Former Owner
Signature of Former Co-Owner
I (we) apply to the American Kennel Club to have a Registration
Certificate for this dog issued in my (our) name (s) and certify that I (we)
acquired this dog on the date stated above directly from the Former
Owner(s). I (we) agree to abide by all rules and regulations of the
American Kennel Club. I (we) understand that if the Limited box in Section
A of the Dog Registration Application has been checked by the Litter
Owner(s) or if the dog already has Limited Registration I (we) will receive
a Limited Registration Certificate.
Signature of NEW OWNER
(Note any address corrections in Section A)
Signature of NEW CO-OWNER
(Note any address corrections in Section A)
This statement must be attached to an AKC Dog Registration Application or
Certificate. All applications become the property of the AKC. $10.00 fee per Transfer
Statement, subject to change without notice.
SECTION
B
The New Owner(s) listed above MUST sign this section if they
are applying for this dog to be registered in their name(s).
OTHERWISE, THIS SECTION IS TO BE LEFT BLANK.
NEW
OWNER(S)
SIGN
HERE
FORMER
OWNER(S)
SIGN
HERE
SUPPLEMENTAL TRANSFER STATEMENT
BEFORE COMPLETING, READ INSTRUCTIONS ON REVERSE.
Please TYPE or PRINT with Pen. Do NOT use Pencil.
Alterations on this form (except for address changes) require an explanation.
Dog Information
(as shown on the Registration Application or Certificate)
AKC Registration
or Litter Number: ______________________________Sex: ________
Dog's Name: _____________________________________________
Breed: ___________________________Color:__________________
Date of Transfer: __________________________________________
Owner(s) transferring the dog identified below must complete
and individually sign this section. The name(s) of New Owner(s)
should be printed below as they are to be registered.
SECTION
A
AKC Customer # (if known)
AKC Customer # (if known)
month / day / year


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