RELEASE OF

OWNERSHIP

This document provides for the transfer of ownership of the following Labrador Retriever (Dog):

Name: ________________________________________________,
Color: _______ Sex: ________ Age: _______ (weeks/months/years).
Markings, if any: __________________________________________
Height at shoulders: _______ inches. Weight: __________lbs.

This Dog is spayed or neutered: YES / NO (if yes, attach copy of spay/neuter certificate)
This Dog was last vaccinated on the date: ________________ (attach copy of vaccination record)

This Dog is currently owned by:

Name: __________________________________________________________
Street: _________________________________________________________
City/State/Zipcode: _______________________________________________
Phone Number: ___________________________________________________

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 the SCLRR. 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 Southern California Labrador Retriever Rescue, Inc. 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):

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

Southern California Labrador Retriever Rescue, Inc.
4654 East Ave S #108, Palmdale, CA 93552
Web: http://www.sclrr.org * Email: sclrr@sclrr.org * Message Line: 1-888-55-4ALAB
Revision: June 2005

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