Pet owner's name: _____________________________________

Address: ____________________________________________

City: __________________ State: _______________ Zip: ______

Phone: ______________ E-mail: ____________________________

Purchase date: ______________________

Closest Airport For Shipping: ____________________________________

Breed purchased: _____________________________    

Date of birth: _____________ Sex: ___________ Color:__________

Puppy's Sire: ______________________

Puppy's Dam: ______________________

Exceptions to guarantee on this puppy, if any:

____________________________________________

____________________________________________

I agree to the above warrantee.

Signed: ______________________________ Date: __________