Sutherland Shire Council

Animal Impound/seizure log

IMPOUND FORM

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Title Page

IMPOUND

IMPOUND INFORMATION

Animal impounded
Impound reason
Location seized
Location Animal Found

ANIMAL INFORMATION

Animal
Gender
Breed
Colour
Desexed
Microchip No
Collar / Distinguishing Marks
Animal Photo

OWNER/RELEASE INFO

OWNER INFORMATION

Owner Details
Address
Phone Number
Date Contacted

RELEASE INFORMATION

Officer
Release Reason
Owner Name
Agents Name if dog not returned to owner
Date
Signature
Infringement Number
Other information or comment

Sutherland Shire Council

Animal Impound/seizure log

IMPOUND FORM

Use this Template

Print as PDF

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