Return to Owner Form

Home » Return to Owner Form

**This information is kept confidential**

Return to Owner/Guardian
Animal Information
Animal's Name*
Today's Date*
MM slash DD slash YYYY
Animal's Age or Date of Birth*
Gender*
- Male
- Female
Spayed/Neutered?*
- Yes
- No
Species*
- Cat
- Dog
- Other
Breed(s)
Owner/Guardian Information
Owner or Agent's Name (as it appears on Drivers License)*
First Last
Drivers License Number*
Issuing State*
Email*
Physical Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Mailing Address (if different)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Alternate Phone
Upload photo of your Drivers License or ID
Max. file size: 64 MB.
If you are not the owner, what is your relation to the owner?
By signing below, I attest that I am the owner or am acting as an agent of the owner with the owner's permission to reclaim the above listed animal.
Signature*
Date*
MM slash DD slash YYYY
CAPTCHA

Return to Owner/Guardian