SEIZING, IMPOUNDING, SURRENDER DETAILS
I declare that the dog/cat was seized by virtue of the Companion Animals Act 1998. I was not able to establish the owner of the dog/cat, prior to surrendering the animal to the pound.
I declare that the mentioned animal was impounded from a public place.
I surrender my dog/cat to the Authorised Officer, understanding that it MAY BE DESTROYED.
ANIMAL / OWNER DETAILS
- Tri Colour
- Am Staff
- German Shepherd
- Bull Terrier
- Cattle Dog
Is Animal Registered
Owners contact details
Other notes if required
TRANSPORTATION OF ANIMAL
Conveyed to RSPCA, Owner or Agent
Items Impounded With Animal
COMMENTS / WARNINGS
I am collecting the subject animal on behalf of the owner.
OFFICE USE ONLY
Date letter sent to last registered owner.
Number of Days Impounded
Total Amount of Fees Charged as per Pound Register
Microchip No. On Release
Animal Released to:- OWNER - AGENT (Circle)
Animal was :- TRANSFERRED TO RSPCA - DESTROYED - STOLEN - (circle)
RSPCA Pound Officers Name