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Owned Dog Release Form to Shiba Inu Rescue
(S.O.S.- Save Our Shibas)

I, _______________________________________, release the Shiba Inu/Shiba mix

Named _______________________________________, age ________, sex ______, to

Shiba Inu Rescue (S.O.S.) representative (name) ______________________________.

I realize I will receive no payment for this dog and that I am voluntarily placing this dog with Shiba Inu Rescue (S.O.S.)

I relinquish all rights to the above named dog. I understand I have 48 hours to reclaim this dog, after which it becomes the permanent custody of Shiba Inu Rescue (S.O.S.) to be placed at their option.

I have included all records of inoculations and AKC papers, if available. I also certify that this dog has not bitten anyone in the last ten- (10) days.

Date: _____________

Time released to Shiba Inu Rescue (S.O.S.): __________________________

Name: ________________________________________________________

Address: ______________________________________________________

Phone: ( ) ___________________________(home)
( ) ___________________________(Work)

Owner signature: ____________________________________________________

Shiba Inu Rescue (S.O.S.) Representative
Signature: _________________________________________________________

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