"Iowa Greyhound Dog Dam Information Report Form" - Iowa

Iowa Greyhound Dog Dam Information Report Form is a legal document that was released by the Iowa Department of Agriculture and Land Stewardship - a government authority operating within Iowa.

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  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Iowa Department of Agriculture and Land Stewardship.

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Download "Iowa Greyhound Dog Dam Information Report Form" - Iowa

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I
D
A
L
S
OWA
EPARTMENT OF
GRICULTURE AND
AND
TEWARDSHIP
Mike Naig, Secretary of Agriculture
Henry A. Wallace Building
www.IowaAgriculture.gov
502 E. 9th Street, Des Moines, IA 50319
IOWA GREYHOUND DOG DAM INFORMATION REPORT
Date____________________________
Enclose $25 Fee Make check payable to IDALS or IA Dept of Ag
Enclose front and back copy of original NGA certificate of registration and Breeders Acknowledgement
DAM NAME:_________________________________________________________________________
L.E. TATTOO:_____________________________R.E.TATTOO:_______________________________
EXPECTED DATE OF WHELPING: ______________________BREEDING DATE: ______________
OWNER INFORMATION:
(Owner of dam & litter at time of whelping)
NAME
______________________________________________________
ADDRESS
_____________________________________________________
CITY, STATE, ZIP
______________________________________________________
PHONE NUMBER
_____________________________________________________
WHELPING LOCATION INFORMATION
NAME OF PERSON IN CHARGE ______________________________________________________
ADDRESS
______________________________________________________
CITY, STATE, ZIP
______________________________________________________
COUNTY
______________________________________________________
PHONE NUMBER
_____________________________________________________
To qualify individual dogs in a litter for IOWA registration under The IOWA DOG BREEDING PROGRAM a dog
shall have been registered, whelped, inspected and raised for the first six months of its life in IOWA.
A dam information report must be postmarked ten (10) business days prior to whelping. Dam information report
SHALL include the original NGA Certificate of Registration and Breeding Acknowledgement.
I certify that all registered animals are maintained under conditions set by Iowa Animal Welfare regulations to
ensure that the animals are properly cared for. This facility shall be ANNUALLY INSPECTED and LICENSED to
be eligible for the Iowa Dog Breeding program.
ANY FALSE INFORMATION WILL BE GROUNDS FOR DENIAL OR WITHDRAWAL OF
ALL REGISTRATIONS OF IOWA WHELPED DOGS.
SIGNATURE______________________________________________________DATE______________
(Save a copy of the inspection slip for your records.)
Iowa Horse & Dog Breeding Program
Iowa Department of Agriculture and Land Stewardship
Wallace State Office Building
th
502 East 9
St
Des Moines, Iowa 50319
Telephone: (515) 281-4103 Fax: (515) 281-4282
Additional forms visit our website
www.iowaagriculture.gov
Code 93 - $25
The Iowa Department of Agriculture and Land Stewardship is an equal opportunity employer and provider.
I
D
A
L
S
OWA
EPARTMENT OF
GRICULTURE AND
AND
TEWARDSHIP
Mike Naig, Secretary of Agriculture
Henry A. Wallace Building
www.IowaAgriculture.gov
502 E. 9th Street, Des Moines, IA 50319
IOWA GREYHOUND DOG DAM INFORMATION REPORT
Date____________________________
Enclose $25 Fee Make check payable to IDALS or IA Dept of Ag
Enclose front and back copy of original NGA certificate of registration and Breeders Acknowledgement
DAM NAME:_________________________________________________________________________
L.E. TATTOO:_____________________________R.E.TATTOO:_______________________________
EXPECTED DATE OF WHELPING: ______________________BREEDING DATE: ______________
OWNER INFORMATION:
(Owner of dam & litter at time of whelping)
NAME
______________________________________________________
ADDRESS
_____________________________________________________
CITY, STATE, ZIP
______________________________________________________
PHONE NUMBER
_____________________________________________________
WHELPING LOCATION INFORMATION
NAME OF PERSON IN CHARGE ______________________________________________________
ADDRESS
______________________________________________________
CITY, STATE, ZIP
______________________________________________________
COUNTY
______________________________________________________
PHONE NUMBER
_____________________________________________________
To qualify individual dogs in a litter for IOWA registration under The IOWA DOG BREEDING PROGRAM a dog
shall have been registered, whelped, inspected and raised for the first six months of its life in IOWA.
A dam information report must be postmarked ten (10) business days prior to whelping. Dam information report
SHALL include the original NGA Certificate of Registration and Breeding Acknowledgement.
I certify that all registered animals are maintained under conditions set by Iowa Animal Welfare regulations to
ensure that the animals are properly cared for. This facility shall be ANNUALLY INSPECTED and LICENSED to
be eligible for the Iowa Dog Breeding program.
ANY FALSE INFORMATION WILL BE GROUNDS FOR DENIAL OR WITHDRAWAL OF
ALL REGISTRATIONS OF IOWA WHELPED DOGS.
SIGNATURE______________________________________________________DATE______________
(Save a copy of the inspection slip for your records.)
Iowa Horse & Dog Breeding Program
Iowa Department of Agriculture and Land Stewardship
Wallace State Office Building
th
502 East 9
St
Des Moines, Iowa 50319
Telephone: (515) 281-4103 Fax: (515) 281-4282
Additional forms visit our website
www.iowaagriculture.gov
Code 93 - $25
The Iowa Department of Agriculture and Land Stewardship is an equal opportunity employer and provider.