AKC Compliant Ownership Change Form

Breed

Registered name

Registration # (or litter # if not registered)

Name of sire

Sire registration #

Name of dam

Dam registration #

Date of birth (of the dog being transferred)

Sex (of the dog being transferred)

Colour and markings (of the dog being transferred)

Obtained from — first name

Obtained from — last name

Date obtained

Obtained from — address line 1

Obtained from — address line 2

Obtained from — city

Obtained from — state

Obtained from — ZIP code

Email of person from whom dog was obtained

Phone of person from whom dog was obtained

Breeder (the person who bred the dog being transferred)

Status of the dog's papers

Name of person to whom transferred

Transferred to — address line 1

Transferred to — address line 2

Transferred to — city

Transferred to — state

Transferred to — ZIP code

Email of person to whom transferred

Phone of person to whom transferred

AKC DNA profile # (if applicable)

Documents given at the time of transfer — check all that apply

Dog identification tag, tattoo number or microchip

The person to whom the dog is being transferred agrees to approve the transfer of ownership with the AKC

Disclosure by the person from whom the dog was obtained of litters that will affect this registration

Signature of person to whom transferred

Or draw your signature

Sign here with your mouse or finger

Signature of person from whom dog was obtained (typed)

Date