Transcription of Request for a Duplicate Dog Registration Application
1 ADD201 (5/15) 2015 The American Kennel ClubLitter date of birth:__Month YearDayDam s AKC Registration NumberDam s AKC Registered NameSire s AKC Registration NumberSire s AKC Registered NameIf the AKC litter number is unavailable, please provide the following information:Requirements, Instructions, and General Information See the bottom of this form for submittal informationSend the completed Application to the address specified on the bottom of this Name of CardholderAccount Number (do not include dashes) VISAAMEXC harge my: _Processing Fee$51 Expiration DateFeesMasterCardDiscoverRequirementsTh is Request must be completed and signed by the owner of the litter as shown on AKC records. To Request a Duplicate litter kit, please use the Request for a Duplicate Litter Kit InformationSend this form and all appropriate fees to: The American Kennel Club8051 Arco Corporate Drive, Suite 100 raleigh , NC 27617-3390 Signatures of persons other than the owners will be accepted only if a properly completed authorization form has been filed with the AKC.
2 AuthorizationsNote: These forms are available on our Web site: AKC at or call 919-233-9767 to speak to an AKC Customer Service Representative, Monday Friday, 8:30 AM 5:00 PM. Information about the Registration process and downloadable forms are available on our Web site: American Kennel Club reserves the right to correct or cancel for cause the Registration of this litter and its descendants. Any misrepresentation on this Application is one example of for cause cancellation and may result in loss of AKC privileges. By supplying your email address and/or telephone number, you consent to receive communications from AKC and third parties. Processing fees are nonrefundable, and all fees are subject to change without notice. Once submitted, this Application becomes the property of the American Kennel : This form is available on our Web site: Owner InformationFirst NameLast NameOwner s SignatureMailing Address_City ZIP code + 4 StateTelephone Number__Email AddressCA1 AARequest for a Duplicate Dog Registration ApplicationAKC Litter NumberNumber of Duplicate Dog Registration applications neededBreed:Litter InformationCheck or money order made payable to: American Kennel ClubUse this form to Request a Duplicate Dog Registration Application .
3 Detailed instructions and submission requirements are at the bottom of this form. Please use black ink and capital letters to fill in the boxes. Information you omit or print outside of the boxes will delay processing. Processing fees are nonrefundable, and all fees are subject to change without Kennel clubRequest for a Duplicate Dog Registration ApplicationInformation that you provide on this side of the form, in any format, will not be refer to the Requirements, Instructions, and General Information section on page 1 of the form for guidance if you need to provide additional Sit. Stay.
