IMPOUND

IMPOUND INFORMATION

Pen Number

Animal impounded
Date available

Impound reason

Location seized

Publish on the Internet

Available to rehome

ANIMAL INFORMATION

Animal

Breed

Colour

Age

Gender

Desexed

Registration tag

Microchip No

Collar / Distinguishing Marks

Animal Photo

OWNER/RELEASE INFO

OWNER INFORMATION

Owner Details

Address

Phone Number

Date Contacted
RELEASE INFORMATION

Officer

Release Reason
Date
Fraser Coast Regional Council, and its consultants, partners, agents and employees shall not be held liable for any and all claims, losses, expenses, injuries or damages arising by reason of any act or omission, including negligence not amounting to a wilful or intentional wrong during the period of time within which the above described animal was not in your custody or under effective control.

Owner Name

Signature

Receipt Number

Infringement Number

Euthanising Vet Signature
RELEASED/REHOMED/EUTHANISED
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.