Pro Rata Invoice Template (Page 3 of 3) in pdf

SECTIONS MARKED IN RED ARE FOR OUR OFFICE USE ONLY

PRO RATA INVOICE:

______

SURNAME:

INITIALS:

VAT Registration No. 4100126277

EMERGENCY CELL CONTACT

(MR/MRS)

E-MAIL:

OTHER EMERGENCY CONTACT DETAILS:

POSTAL ADDRESS:

DOGS

NAME

BREED/TYPE

COLOUR

SEX

AGE

5:1

D/W

K/C

SPECIAL INSTRUCTIONS/ DIET: Please clearly indicate by circling Sharing/Non-Sharing accommodation required.

CATS

NAME

BREED/TYPE

COLOUR

SEX

AGE

3:1

D/W

(SHD; MHD; LHD Etc.)

SPECIAL INSTRUCTIONS/ DIET:

OTHER PETS

NAME

BREED

COLOUR

SEX

AGE

SPECIAL INSTRUCTIONS/ DIET:

ANY PHYSICAL PROBLEMS IN LAST SIX MONTHS?

YES/NO

DETAILS

TREATED BY

BOARD

Cages, Leads, Collars Etc.

DATE OF ENTRY

GROOMING

EXTRAS

DATE RETURNING

DISCOUNTS

COLLECTION/DELIVERY

DATE COLLECTED

VET FEES

TRAINING

NO. OF DAYS BOARDED

SUB TOTAL

LESS DEP/ADV PAYMENT

PAID CASH

SUB TOTAL

PAID CARD

ACCOUNTS

PAID CHEQUE

TOTAL VAT INCL.

TERMS & CONDITIONS OF ACCEPTANCE: (1) The management will not be held responsible for loss of, damage to, injury, sickness or death of pets howsoever arising. (2) All dogs

to have been immunized against distemper, rabies, hepatitis and parvo-virus within 12 months of entry. (3) All cats to have been immunized against feline enteritis and rabies

within 12 months of entry and against pneuminitis and sniffles within 6 months of entry. All vaccinations to have been carried out at least 2 weeks prior to entry. (4) Accounts

must be paid in full before animals will be released from the kennels. (5) Accounts must be paid monthly for animals boarding longer than 30 days. (6) The management has at

their discretion, the right to dispose of animals unclaimed 10 days after due date. The owner of the animals will remain liable for all charges incurred. (7) Veterinary treatment, if

required, will be an extra and the owner will be liable for the veterinary fees and disbursements.

Dr:

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(8) In cases on illness I would prefer the kennel to call my vet

but I authorize you to use any other vet of your

choice if deemed necessary. By my signature hereto, I agree to and accept the terms and conditions above.

SIGNATURE: (ON ADMISSION TO KENNELS)