Ownership Record Of Individual Dog Form
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1A. OWNERSHIP RECORD OF INDIVIDUAL DOG (MALE OR FEMALE)
BREED
REGISTERED NAME
AKC#:
RAT TERRIER
UKC#:
NAME & NUMBER OF SIRE
AKC#:
NAME & NUMBER OF DAM
AKC#:
UKC#:
UKC#:
DATE OF BIRTH
SEX
COLOR & MARKINGS
select
NAME OF PERSON FROM WHOM DOG WAS OBTAINED
DATE OBTAINED
ADDRESS OF PERSON FROM WHOM DOG WAS OBTAINED
BREEDER
FINAL DISPOSITION OF DOG –
DIED
TRANSFERRED
DATE
NAME OF PERSON TO WHOM TRANSFERRED
MARK (X) IN APPROPRIATE BOX AND GIVE DATE IN
W/ PAPERS
W/O PAPERS
SPAC PROVIDED
ADDRESS OF PERSON TO WHOM TRANSFERRED
DNA PROFILE NUMBER (IF AVILABLE)
PLACE AN X IN THE
REGISTRATION
REGISTRATION
BILL OF
CONTRACT
OTHER
DOG IDENTIFICATION TAG, TATTOO # OF MICROCHIP
BOX IF YOU PRIVIDED THE
CERTIFICATE
APPLICATION
SALE
PAPERS INDICATED TO THE NEW OWNER
NOTES
B. BREEDING RECORD OF ABOVE DOG
DATE OF MATING
NAME OF DOG MATED WITH ABOVE DOG
AKC#:
NAMES OF PESON HANDLING MATING
UKC#:
DNA PROFILE NUMBER (IF AVILABLE)
NAME OF OWNER OF DOG MATED
ADDRESS OF OWNER OF DOG MATED
LITTER DATE OF BIRTH:
# OF MALES:
# OF FEMALES:
NOTES:
DATE OF MATING
NAME OF DOG MATED WITH ABOVE DOG
AKC#:
NAMES OF PESON HANDLING MATING
UKC#:
DNA PROFILE NUMBER (IF AVILABLE)
NAME OF OWNER OF DOG MATED
ADDRESS OF OWNER OF DOG MATED
LITTER DATE OF BIRTH:
# OF MALES:
# OF FEMALES:
NOTES:
DATE OF MATING
NAME OF DOG MATED WITH ABOVE DOG
AKC#:
NAMES OF PESON HANDLING MATING
UKC#:
DNA PROFILE NUMBER (IF AVILABLE)
NAME OF OWNER OF DOG MATED
ADDRESS OF OWNER OF DOG MATED
LITTER DATE OF BIRTH:
# OF MALES:
# OF FEMALES:
NOTES:
This page was adapted from the American Kennel Club DOG OWNERSHIP and BREEDING RECORDS found on
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