"Request for Animal Rescue" - Alabama

Request for Animal Rescue is a legal document that was released by the Alabama Department of Agriculture and Industries - a government authority operating within Alabama.

Form Details:

  • Released on November 1, 2006;
  • The latest edition currently provided by the Alabama Department of Agriculture and Industries;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Alabama Department of Agriculture and Industries.

ADVERTISEMENT
ADVERTISEMENT

Download "Request for Animal Rescue" - Alabama

1134 times
Rate (4.5 / 5) 79 votes
Request for
Animal Rescue
REPORTING SOURCE
REPORTING DATE:
TIME (include AM/PM):
INFORMATION TAKEN BY (PLEASE PRINT):
LOCATION FORM FILED:
PRIORITY STATUS
URGENT
2 DAY
3 DAY
OWNER REQUESTED
REPORTED BY OTHER PARTY
AGENCY REQUEST
REPORTING PARTY
NAME: (include agency if applicable)
ADDRESS:
CITY/STATE/ZIP:
HOME PHONE:
WORK PHONE:
CELL PHONE:
(
)
(
)
(
)
ALT. PHONE:
E-MAIL ADDRESS:
(
)
DOES THIS ANIMAL(S) BELONG TO THE REPORTING PARTY?
IF NOT, WHO DOES THIS ANIMAL BELONG TO? (provide name, address and phone number if known.)
YES
NO
ANIMALS TO BE RESCUED
#
TYPE
GENDER
BREED
COLOR
SIZE
AGGRESSIVE
CONFINED
1
YES
NO
YES
NO
2
YES
NO
YES
NO
3
YES
NO
YES
NO
4
YES
NO
YES
NO
5
YES
NO
YES
NO
ANIMAL LOCATION
ARE THERE PEOPLE WITH THE ANIMAL(S)? IF YES, WHO?
LAST TIME FED?
ANIMAL(S) LAST SEEN:
IS/ARE THE ANIMAL(S) BEING FED?
DATE:____________ TIME: ____________
YES
NO
NAME:_________________________________________
YES
NO
WHERE IS/ARE THE ANIMAL(S) LOCATED?:
ADDRESS:
CITY:
DIRECTIONS TO RESCUE AREA:
LANDMARKS:
LOCATION OF ANIMAL(S) ON PROPERTY:
PERMISSION TO RESCUE
The animal(s) listed above is/are legally mine and I can show proof of ownership.
I give permission to _____________________________________ volunteers to enter my property to rescue the animals I have listed above.
I do not hold the staff or volunteers liable if they are not able to save the animal(s) I have requested be rescued.
I understand that sometimes circumstances beyond control prevents this from happening.
I do not hold the staff or volunteers liable for any damage done to my property while attempting to rescue the animals listed above.
(Every effort will be made to leave the owner’s property in the same condition it was when the vounteer entered
the property.)
Key provided:
YES
NO
• Permission to force entry:
YES
NO
SIGNATURE: _____________________________________ DRIVER LICENSE #: _____________________________ DATE: ________________
VERBAL PERMISSION GIVEN
RESULT OF RESCUE EFFORTS
ACTION
ANIMAL NUMBER (as noted in “ANIMALS TO BE RESCUED” section) and DATE
RESTRICTED ENTRY INTO THE AREA
UNABLE TO FIND ANIMAL(S)
RESCUED
COULD NOT BE FOUND
COULD NOT BE CAUGHT
DECEASED
This form created by United Animal Nations, (916) 429-2457. Reprint and use by permission only. Revised 11/2006.
Request for
Animal Rescue
REPORTING SOURCE
REPORTING DATE:
TIME (include AM/PM):
INFORMATION TAKEN BY (PLEASE PRINT):
LOCATION FORM FILED:
PRIORITY STATUS
URGENT
2 DAY
3 DAY
OWNER REQUESTED
REPORTED BY OTHER PARTY
AGENCY REQUEST
REPORTING PARTY
NAME: (include agency if applicable)
ADDRESS:
CITY/STATE/ZIP:
HOME PHONE:
WORK PHONE:
CELL PHONE:
(
)
(
)
(
)
ALT. PHONE:
E-MAIL ADDRESS:
(
)
DOES THIS ANIMAL(S) BELONG TO THE REPORTING PARTY?
IF NOT, WHO DOES THIS ANIMAL BELONG TO? (provide name, address and phone number if known.)
YES
NO
ANIMALS TO BE RESCUED
#
TYPE
GENDER
BREED
COLOR
SIZE
AGGRESSIVE
CONFINED
1
YES
NO
YES
NO
2
YES
NO
YES
NO
3
YES
NO
YES
NO
4
YES
NO
YES
NO
5
YES
NO
YES
NO
ANIMAL LOCATION
ARE THERE PEOPLE WITH THE ANIMAL(S)? IF YES, WHO?
LAST TIME FED?
ANIMAL(S) LAST SEEN:
IS/ARE THE ANIMAL(S) BEING FED?
DATE:____________ TIME: ____________
YES
NO
NAME:_________________________________________
YES
NO
WHERE IS/ARE THE ANIMAL(S) LOCATED?:
ADDRESS:
CITY:
DIRECTIONS TO RESCUE AREA:
LANDMARKS:
LOCATION OF ANIMAL(S) ON PROPERTY:
PERMISSION TO RESCUE
The animal(s) listed above is/are legally mine and I can show proof of ownership.
I give permission to _____________________________________ volunteers to enter my property to rescue the animals I have listed above.
I do not hold the staff or volunteers liable if they are not able to save the animal(s) I have requested be rescued.
I understand that sometimes circumstances beyond control prevents this from happening.
I do not hold the staff or volunteers liable for any damage done to my property while attempting to rescue the animals listed above.
(Every effort will be made to leave the owner’s property in the same condition it was when the vounteer entered
the property.)
Key provided:
YES
NO
• Permission to force entry:
YES
NO
SIGNATURE: _____________________________________ DRIVER LICENSE #: _____________________________ DATE: ________________
VERBAL PERMISSION GIVEN
RESULT OF RESCUE EFFORTS
ACTION
ANIMAL NUMBER (as noted in “ANIMALS TO BE RESCUED” section) and DATE
RESTRICTED ENTRY INTO THE AREA
UNABLE TO FIND ANIMAL(S)
RESCUED
COULD NOT BE FOUND
COULD NOT BE CAUGHT
DECEASED
This form created by United Animal Nations, (916) 429-2457. Reprint and use by permission only. Revised 11/2006.