Cocker Surrender Form
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DOG INFORMATION
*There are severe penalties regarding the rehoming of aggressive dogs
*If yes please provide date and details of last vaccination: (i.e. C3, C4, C5 etc.) 
Please provide and attatch the following original paperwork: 

Desexing Certificate:

Vaccination Certificate:

Microchip Number:


 
THIS FORM CONSTITUTES A LEGAL AGREEMENT:

Surrendering Owners Declaration:

I declare that I am the owner of the Cocker Spaniel referred to herein.   I declare that all information provided by me is true and correct.  I understand that there are severe penalties for rehoming aggressive dogs.  I hereby surrender my Cocker Spaniel into the care of English Cocker Spaniels Australia Incorporated (ECSA Inc). I understand that upon signing this declaration, that I relinquish ownership of, and any and all interest in the Cocker Spaniel referred to herein. 

Thanks for submitting!