Sirius Canine Fertility, Inc
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| Sirius Canine Fertility, Inc
PO Box 741 Cedar Ridge, CA 95924 530-273-9123 ( phone ) 530-273-9128 (Fax) info@siriuscaninefertility.com ( email) FROZEN CANINE SEMEN OWNER RELEASE FOR DISPOSAL This document, when completed, signed, witnessed and dated, requests SCF to dispose of the frozen canine semen listed below. All Co-Owners of this frozen semen must sign this document in order for the semen to be destroyed. I____________________________________________________________________ Name of present owner, coowners of frozen semen Do hereby transfer all rights of ownership and interest in the following frozen semen to Sirius Canine Fertility, Inc. This request is for the frozen canine semen on the dog listed below to be destroyed/ disposed of: ________________________________________________ __________________________ Registered Name of Dog Registry _______________________________ ___________________________________ Registration Number Breed The following semen from the above dog is to be destroyed. Date of collection:_____________________ Number of vials:___________________ Date of collection:_____________________ Number of vials:___________________ All semen from the Above Dog:__________________________________________________________________________ Signature here if you wish to destroy all of the frozen semen on the dog I/ we do request that the specific frozen semen listed above be destroyed: ________________ ________________________________________________________ Date signature (s) of present semen owner and coowner Printed Name of Owners/Co Owners:________________________________________________ Address:_______________________________________________________________________ Telephone:___________________________ Email:____________________________________ witness signature:_________________________________________________ Directory: wp-content -> uploads -> 2017 2017 -> Leadership ohio 2017 -> Ascension Lutheran Church Counter’s Schedule January to December 2017 2017 -> Board of directors juanita Gibbons-Delaney, mha, rn president 390 Stone Castle Pass Atlanta, ga 30331 2017 -> Military History Anniversaries 16 thru 31 January Events in History over the next 15 day period that had U. S. military involvement or impacted in some way on U. S military operations or American interests 2017 -> The Or Shalom Cemetery Community Teaching on related issues of Integral 2017 -> Ford onthult samenwerking met Amazon Alexa en introduceert nieuwe navigatiemogelijkheden van Ford sync® 3 met Applink 2017 -> Start Learn and Increase gk. Question (1) Name the term used for talking on internet with the help of text messege? 2017 -> Press release from 24. 03. 2017 From a Charleston Car to a Mafia Sedan 2017 -> Tage Participants 2017 -> Citi Chicago Debate Championship Varsity and jv previews Download 7.55 Kb. Share with your friends:
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