I hereby certify that I am the rightful owner/keeper/caretaker/custodian of the animal(s) that is/are the subject(s) of this Animal Surrender Form, hereinafter referred to as “the animal[s].” I hereby surrender any and all property rights to the animal(s). I certify that no other person has a right of property to the animal(s). I understand that by surrendering my property rights to the animal(s), the animal(s) may be transferred into the custody of an animal shelter. I also hereby certify that the animal has/has not or that the animals have/have not bitten or scratched a human or another animal within the past 10 days.
I understand that once I relinquish the animal(s), the animal(s) will not be available to be returned to me. I further certify that I have read and understood the terms of this Animal Surrender Form.