EMAIL silverck@carroll.com

This is to certify Bitch _______________________________________________________________

AKC # _______________________ OFA # _________________ CERF #______________________

Owner/Leased By: __________________________________________________________________

Address ____ ____________________________________________________________

Phone ______________________ email _ ____________ Fax ______________

Is to be bred to Stud Dog _____________________________________ ______________

AKC ____________ OFA # ________ CERF #________ PRA/DNA _____ Copies Attached Yes__

Owned/Leased By ___Joanne & Stan Silver _______________________________

Fee to be paid as follows: *Cash $600.00 as follows: $100 When Bitch is delivered. Balance Due After Birth

And/Or Choice of Stud Fee or Puppy _____Stud Fee_______________________________________________

Stud fee is not refundable. If bitch fails to conceive, an additional stud service will be provided to this bitch by this dog. If this dog is not available, another of my stud dogs may be subbed at the consent of the bitch owner or lessee. If the bitch is not available, the service may be used for another bitch upon approval of the stud dog owner.

Two (2) puppies will be considered a litter and fulfillment of stud obligations. Bitch owner will be entitled to a repeat breeding if one (1) puppy if born.

No litter registration forms will be signed until full and all payments are made. If puppy is in place of the stud fee, litter registration form will be signed after agreement is made to take the puppy.

*In the event of an Artificial Insemination, all costs will be the responsibility of the bitch owner. If the bitch in not present and sperm is collected and shipped, all costs are the responsibility of the bitch owner. $300 of the stud fee is due upon receipt of the sperm, balance due after puppies are born. Litter registration papers will not be signed until payment is made in full. Transportation costs are the responsibility of the bitch owner.

A current Brucellosis test is required for all bitches. CERF for the eyes or eye clearance required dated with two years of the breeding. OFA#, equivalent, or clear hip x-ray required.

Signature Bitch Owner/Lessee, and Co-owners _____________________________________ DATE _______

____________________________________________________________________________ DATE _______

Signature Dog Owner/Lessee, or Co-owners ________________________________________ DATE _______

____________________________________________________________________________ DATE _______

Date of Matings ___________________________________ Date Due to Whelp _________________________

SPECIAL INSTRUCTIONS AND/OR COMMENTS ______________________________________________

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Copyright © 2005 Silvercreek CBR. All rights reserved.