Relinquishment of Ownership Form

Relinquishment of Ownership Form

I request the Siberian Husky Welfare Association (UK) to take unconditional possession of my/our Siberian Husky, detailed below:

Pet name of Dog
KC Registered Name / KC Reg No
Date of birth / Sex
Coat colour / Eye colour
Vaccination details (The dog must be vaccinated up to date before we can accept it.)
Tattoo/Microchip details
Is the dog/bitch neutered/spayed
Reason for Rehoming and Owner’s Declaration
Reason for Giving Up Dog (please give full details of all reasons)

I have read through the whole of this form and relinquish all ownership of the above Siberian Husky forthwith
Signed (type name if using e-mail) / Date
OWNER’S DETAILS
Full Name / E-Mail address
Address
Home Phone No. / Mobile Phone No.
Breeders Details (where known)
Name
Address
Telephone Email
Donations/Charges
No charge is made for accepting a dog into our care for assessment and rehoming. Donations are always welcome however.
If the dog is not already neutered/spayed, a contribution towards the cost of this operation would be gratefully received.
If the assessment and collection of the dog involves our staff travelling more than 5 miles, then the owner giving up the dog will be expected to cover the costs of that travel at a rate of 15p per mile for the first 25 miles and 30p per mile thereafter.
If you are submitting this form by e-mail – e-mail it to – the email carries the same legal weight as a personally signed form.
IMPORTANT NOTICE
To all those considering giving up your dog for adoption
If you relinquish your dog to us for whatever reason, please understand that this is a PERMANENT arrangement. We cannot foster, kennel or look after your dogs on a temporary basis. Once your dog is collected by us, the dog will be assessed and rehomed to a suitable permanent home as soon as possible. It is important that you realise this and do not come back to us months later asking for your dog to be returned. This will not happen - the dog has already suffered the trauma of being rehomed the first time. It would never be in the dog’s interests for that to happen again—and it is the dog’s interests which concern us, not the humans.
I accept the above Siberian Husky into our welfare Scheme (SHWA use only)
SHWA(UK)
Representative / Date / ___ / ___ / ___

Please Note: Please be completely honest about your reasons for giving up your dog. We cannot take on dogs which are aggressive towards humans, or which are very dog-aggressive. If we find that we have been misled about the dog’s behaviour and/or temperament, the relinquishing agreement will be null and void and the owner of the dog will be responsible for any medical, veterinary or material costs incurred while in the care of SHWA(UK).

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Note to Staff: A copy of this form must be sent to the National Rehome Co-ordinator at the following address :

Karen Johnson, 35 Glenallen Gardens, North Shields, Tyne & Wear,NE30 3TE

Email: