SERVICE CERTIFICATE (To be completed by the owner of the Sire or Frozen Semen and counter signed by the owner of the Dam) BEING FINANCIAL MEMBER/S OF: I/WE Being the Sire’s Owner/s MEMBERSHIP NUMBER: Being the Owner of the Frozen Semen (cross out which is not applicable) ADDRESS: POSTCODE: CERTIFY THAT THE BITCH: BITCH REGISTRATION NUMBER: WAS SERVED BY SIRE REGISTRATION OR SEMEN REGISTRATION NUMBER: (Insert Sire’s Name): ON DATE OF MATING: SIGNATURE OF SIRE/SEMEN OWNER/S: All must sign unless prior arrangements have been made and lodged with the Owner’s Controlling Body SIGNATURE SIGNATURE OWNER/S OF DAM COUNTER SIGNATURE/S: SIGNATURE SIGNATURE ARTIFICIAL INSEMINATION: NOTE: If the dogs to which this application relates have been subject to “AI” it is necessary An application of registration may be lodged at any time within eighteen (18) calendar months of the date of whelping. for the Veterinary Surgeon who performed the AI to sign the following declaration: An application received must accompany the current fees. Fees are available on the DogsNT website I__________________________________________________________________ The owner/s of the sire or the owner of the frozen semen should complete all details of the Service Certificate and this must be countersigned by the owner/s of the bitch. (Veterinary Surgeon) Certify that I artificially inseminated the above mentioned bitch with semen taken Overseas registered sires or dams must be re-registered on the Australian Canine Computer (ANKC) system before the from the above mentioned sire. litter can be registered. Imported semen or semen from non-Australian resident sires must be re-registered on the Australian Canine Computer SIGNATURE: (ANKC) system before the litter can be registered. All dogs in the litter must be registered. Any dogs not included in this application may cease to be eligible for registration. DATE:
SERVICE CERTIFICATE (To be completed by the owner of the Sire or Frozen Semen and counter signed by the owner of the Dam) I/WE Being the Sire’s Owner/s Being the Owner of the Frozen Semen (cross out which is not applicable) BEING FINANCIAL MEMBER/S OF: MEMBERSHIP NUMBER: ADDRESS: POSTCODE: CERTIFY THAT THE BITCH: BITCH REGISTRATION NUMBER: WAS SERVED BY (Insert Sire’s Name): SIRE REGISTRATION OR SEMEN REGISTRATION NUMBER: ON DATE OF MATING: SIGNATURE OF SIRE/SEMEN OWNER/S: All must sign unless prior arrangements have been made and lodged with the Owner’s Controlling Body SIGNATURE SIGNATURE OWNER/S OF DAM COUNTER SIGNATURE/S: SIGNATURE SIGNATURE NOTE: An application of registration may be lodged at any time within eighteen (18) calendar months of the date of whelping. An application received must accompany the current fees. Fees are available on the DogsNT website The owner/s of the sire or the owner of the frozen semen should complete all details of the Service Certificate and this must be countersigned by the owner/s of the bitch. Overseas registered sires or dams must be re-registered on the Australian Canine Computer (ANKC) system before the litter can be registered. Imported semen or semen from non-Australian resident sires must be re-registered on the Australian Canine Computer (ANKC) system before the litter can be registered. All dogs in the litter must be registered. Any dogs not included in this application may cease to be eligible for registration. ARTIFICIAL INSEMINATION: If the dogs to which this application relates have been subject to “AI” it is necessary for the Veterinary Surgeon who performed the AI to sign the following declaration: I__________________________________________________________________ (Veterinary Surgeon) Certify that I artificially inseminated the above mentioned bitch with semen taken from the above mentioned sire. SIGNATURE: DATE: