Medway Council Stray dog collection form
Stray dog reference
Is this report for a lost or found dog
Date and time dog lost or found
Location where dog lost or found
- Unable to establish
- Puppy -Less than 1 year
- Older than 10
- As breed
- Half pricked
Chip number and details
Photo of dog collected by Community Warden.
Returned to owner
Dog claimed or returned to owner.
Dog placed in kennels
Any notes relevant to placing dog in kennels
Dog returned to owner
I agree to pay all Medway Council charges on receipt of invoice. I understand that if my dog strays on any subsequent occasion it will be taken straight to the kennels and that I will be liable for all costs.
Dog claimed by owner
Signature and address of purchaser or claimant
Retained on certificate
I declare that I have no ownership or other interest in the dog described above, which I have handed to Medway Council as a stray dog. I believe, to the best of my knowledge, that this information is true and I understand that making a false or misleading declaration may render me liable to legal action.
Print full name and date.