AKC Compliant Ownership Change Form

Breed:

Registered Name:

Registration # or Litter # if not Registered:

Name of Sire:

Sire Registration #:

Name of Dam:

Dam Registration #:

Date of Birth (Of the dog being transferred):

Sex (Of the dog being transferred):

Color and Markings (Of the dog being transferred):

Name of person from whom dog was obtained:

First

Last

Date obtained:

Address of person from whom dog was obtained:

Address Line 1

Address Line 2

City

State

Zip Code

Email of person from whom dog was obtained

Phone of person from whom dog was obtained

Breeder (the person who bred the dog being transferred):

Final disposition of dog

Name of person to whom transferred:

Address of person to whom transferred:

Address Line 1

Address Line 2

City

State

Zip Code

Email of person to whom transferred:

Phone of person to whom transferred:

AKC DNA Profile # (If applicable):

Please check all that apply for documents given at the time of transfer:

Dog Identification Tag. Tattoo number or microchip:

Approval of AKC registrable litters:

The person to whom the dog is being transferred to; agrees to approve AKC registration for litters that are not yet born but confirmed breedings by the person from whom dog was obtained.

Disclosure by the person from whom dog was obtained of litters that will need to be approved by the person to whom transferred (if applicable):

Signature of person to whom transferred:

Signature of person from whom dog was obtained: