Consent to Inspect

CONSENT TO INSPECT

O.C.G.A § 4-11-9., ET SEQ.: THE COMMISSIONER OR HIS DESIGNATED AGENTS ARE AUTHORIZED TO ENTER UPON ANY PUBLIC OR PRIVATE PROPERTY AT ANY TIME FOR THE PURPOSE OF INSPECTION THE BUSINESS PREMISES OF ANY PET DEALER, ANIMAL SHELTER, KENNEL, OR STABLE AND THE DOGS, CATS, EQUINES, OR OTHER ANIMALS HOUSED AT SUCH FACILITY TO DETERMINE IF SUCH FACILITY IS LICENSED AND FOR THE PURPOSE OF ENFORCING THIS ARTICLE AND THE RULES AND REGULATIONS ADOPTED BY THE COMMISSIONER PURSUANT TO THIS ARTICLE.

PLEASE PRINT THE FOLLOWING INFORMATION:

OWNER / ESTABLISHMENT ______LICENSE # ______

PHYSICAL ADDRESS ______COUNTY ______

CITY ______STATE ______ZIP ______

PLEASE PRINT THE FOLLOWING INFORMATION:

I, ______, ATTEST THAT I AM THE OWNER AND/OR LICENSE HOLDER OF

THE ABOVE REFERENCED PREMISES; I, ______, HAVING BEEN INFORMED

THAT MY ABOVE REFERENCED PREMISES AND/OR ALL RECORDS PERTAINING TO THE ANIMAL(S) AND THE BUSINESS ARE

SUBJECT TO INSPECTION BY THE GEORGIA COMMISSIONER OF AGRICULTURE OR HIS DESIGNATED AGENT(S) UNDER

O.C.G.A. § 4-11-9, ET SEQ., AND THAT I CAN REFUSE TO VOLUNTARILY CONSENT TO HAVE SUCH PREMISES AND/OR ALL

RECORDS PERTAINING TO THE ANIMAL(S) AND THE BUSINESS INSPECTED WITHOUT AN INSPECTION WARRANT, HEREBY

AUTHORIZE ______AS DESIGNATED

AGENT(S) OF THE GEORGIA COMMISSIONER OF AGRICULTURE, TO CONDUCT A COMPLETE INSPECTION OF MY ABOVE

REFERENCED PREMISES AND/OR ALL RECORDS PERTAINING TO THE ANIMAL(S) AND THE BUSINESS; THIS COMPLETE

INSPECTION INCLUDES BUT IS NOT LIMITED TO INSPECT, OBSERVE AND/OR PHOTOGRAPH THE ABOVE REFERENCED

PREMISES; COPY AND/OR OTHERWISE DOCUMENT ANY RECORDS, LETTERS, PAPERS, MATERIALS, OR OTHER DOCUMENTS

PERTAINING TO THE ANIMAL(S) AND THE BUSINESS; THIS WRITTEN PERMISSION IS BEING GIVEN BY ME TO THE ABOVE

NAMED DESIGNATED AGENT(S) VOLUNTARILY AND WITHOUT THREATS OR PROMISES OF ANY KIND; I UNDERSTAND

THAT THE USE OF ANY ITEMS COVERED UNDER THIS CONSENT WILL BE USED IN ACCORDANCE WITH THE PROVISIONS OF

THE ABOVE REFERENCED GOVERNING LAW.

OWNER / LICENSE HOLDER SIGNATURE ______DATE ______