Date of Purchase:_________________ Picked Up ______ Shipped ______

Breeders: Joe and Kelly Wilmes

P.O. Box 76 (4021 Highway H) Silex, MO 63377

Home: 573-384-5438 Cell: 636-358-1270

Email Address: cloverleaf@socket.net

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Breed: Great Dane Sex:________________ Color:________________

Price:______________ Deposit:____________ Balance:___________

Sire: Cloverleaf Creeks Blu Tatonka AKC #WR016772/03

Dam: Northwinds Blu Bella Jewel AKC # WR033080/17

Litter Date of Birth: April 30, 2003 AKC Litter #: WS047473

Wormed: 5/14, 5/28, 6/11, 6/25 with Pyrantel

Shots given: 6/11, 6/25 and 7/16 by Fort Dodge

Ears: ______Cropped ______Natural

Registration: ____Full _____Limited - Proof of Spay/Neuter - Rec’d_______

Breeders guarantee the general health of the puppy for 48 hours after purchase. Puppy is also guaranteed against congenital defects for 1 year after the sale of the puppy. If puppy is found to suffer from a congenital defect by a certified veterinarian, it may be returned to Breeder for replacement at the buyers expense. If no puppy is available at the time, buyer may select a puppy from a future litter. Under no circumstances will Cloverleaf Creek Great Danes or Breeders be responsible for any veterinary or medical bills incurred for the puppy after the date of sale to New Owner. Said Owner is responsible for proper maintenance of puppy. This includes continuing vaccinations, wormings, providing high quality dog food, water, and adequate shelter. Breeder prefers that all puppies be reared and raised indoors if at all possible. The puppy shall not be abused or neglected. At any time during the dogs life you are unable to care or provide for it you must contact the Breeder first and return the dog and all AKC registration information to us for permanent placement in a new home.

Breeders Signature:_____________________________ Date:_________________

Buyers Signature:_______________________________ Date:_________________

Buyers Address:_______________City:________________ST:____ Zip:_________

PHONE:_____________________ EMAIL:________________________________