Owner Release Form

This document provides for the transfer of ownership of the following Labrador Retriever/Labrador Retriever mix (dog):

Name: ________________________________________________,

Color: _______ Sex: ________ Age: _______ weeks/months/years (circle one)

Markings, if any: __________________________________ Weight: __________lbs.

This dog is spayed or neutered: YES / NO (if yes, attach copy of spay/neuter certificate)

This dog is up-to-date on vaccinations: YES / NO (if yes, attach copy of latest vaccination records)

This dog is currently owned by:

Name: __________________________________________________________

Street: _________________________________________________________

City/State/Zipcode: _______________________________________________

Phone Number with Area Code: ___________________________________________________

I certify that I am the owner* of the above named dog and that I have the authority to relinquish ownership of this dog to Southern California Labrador Retriever Rescue (SCLRR), Inc. I understand that the SCLRR will make all future decisions regarding the above named dog and I authorize them to make decisions about the welfare of the dog without my consent or knowledge. By signing this document I hereby relinquish my ownership and control of this dog to the SCLRR organization.

(Dog's Owner)	(SCLRR Representative)
Signed: __________________________	SCLRR:___________________________
Print Name: _______________________	Print Name: _______________________
Date: ___________________________	Date: ___________________________

* If I acquired this dog as a stray, I certify that I have followed California State Law by notifying the Animal Control Agency in the area where the dog was found not more than 24 hours after I found the dog. I further certify that I have done everything possible to try to reunite this dog with its rightful owners by (circle all that apply)

1. Placing an ad in the local newspaper in the area the dog was found.
2. Posting "found" notices in the area the dog was found
3. Posting "found" notices in local local feed stores or pet supply stores
4. Contacting local veterinarians in the area the dog was found
5. Posting notices in the local grocery and/or convenience stores in the area the dog was found.
6. Other: ___________________________________________________________________