Basenji Rescue and Transport, Inc.
TRANSFER CONTRACT
For official use only.
Basenji
Name: __________________________________ Age:________
I.D.
Type/No.: ______________________________________________
Color: ( )Red/White (
)Black/White ( )Tri-Color ( )Brindle
Sex: ( )Male ( )Female
Basenji Rescue And Transport, Inc., a Texas non-profit
corporation (BRAT), has established this Contract to detail the specific requirements to
which the Transferor must comply as a condition of the Adoption/Transfer of the pet
Basenji whose name and description appear above.
TRANSFER
Transferor represents that he/she is the only owner of the
Basenji herein described ("the Basenji"), and hereby transfers all of his/her
ownership right, title and interest in said animal to Basenji Rescue And Transport, Inc.
(BRAT). Transferor represents that the Basenji has never caused or been alleged to cause
injury to a person except as follows:
Transferor appoints BRAT as its agent, with all rights and
privileges thereof, to attempt to place this Basenji in a new home on behalf of
Transferor. BRAT will use its best efforts to place said Basenji in a new home pursuant to
the requirements as stipulated in the Adoption Contract, including mandatory neutering.
However, Transferor understands and acknowledges that BRAT may not be able to place the
Basenji and that this transfer is without any recourse. All adoption fees for the Basenji
will be paid directly to BRAT and Transferor will not be entitled to any portion of such
fees. Transferor releases and agree to hold harmless BRAT from all claims or causes of
action regarding this transfer of ownership, including any claims by a third party to
ownership of the dog.
Veterinarian Records and AKC records must be turned over to
BRAT at time of surrender, for verification of ownership, vaccinations and heartworm
prevention.
I certify that all representations contained herein are true
and correct and that I have read, understand and agree to the stipulations contained in
this Contract.
Signed by Transferor: ______________________________on this day
of:______________
Printed
Name:_______________________________________________________________
Address:___________________________________________________________________
City:______________________________ State:________ Zip
Code:_________
Phone Numbers: (H) (____)____________________(W) (____)______________________
Agent's Name(s):___________________________________________
Phone Number: (____)________________________
Basenji RESCUE AND TRANSPORT, INC.
By: __________________________________
Printed Name: ____________________________________________
Title: __________________________________
After this Contract has been executed, both
the Transferor and the BRAT Representative should keep a copy for their
records and return the original to:
B. Ann Hageman
321 W View St
Lombard IL 60148-1515 Email:
b.ann321@comcast.net
. Web Site:
http://www.Basenjirescue.org
Revised August 18 2010 |
