Transfer of Dog Ownership Form – Town of Cheektowaga

By signing and submitting this form you are declaring that the following information is true and accurate. The Current Owner must sign the document.

Current Name of Owner *

First

Last

Current Owner Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

Current Owner Phone Number *

Legal Name of Dog

Name of New Owner *

First

Last

New Owner Mailing Address (and where the dog will be housed) *

Address Line 1

Address Line 2

City

State

Zip Code

New Owner Email *

New Owner Contact Phone Number

I Certify this is the Date of Transfer of Ownership

Signature Current Owner *

I certify that the information above is true and accurate.