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Pet Impound
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Dog Information
Name (If known)
Breed
*
Color/Markings
Gender
Approximate Age
Tag Number (if applicable)
Health Condition / Visible Injuries
Behavior Notes (e.g., aggressive, friendly, scared)
Impound Details
Date and Time of Impound
Date
Time
Location Found
Reason for Impound (stray, surrendered, seized, etc.)
Impounding Officer / Staff Name
Owner Information (if known or later retrieved)
Owner’s Full Name
*
First
Middle
Last
Contact Number
Address
Email Address
*
Proof of Ownership (file upload field for documents, photos, etc.)
Click or drag a file to this area to upload.
Shelter Details
Intake Number / Case ID
Kennel Number / Location
Vaccination Status
Intake Photos (multiple file uploads)
Click or drag a file to this area to upload.
Notes (medical treatments, quarantine status, etc.)
Fees and Release
Impound Fee
Daily Boarding Fee
Other Fees (e.g., medical treatment, licensing fines)
Total Due
Payment Status
Release Date and Time
Date
Time
Released By (staff)
documents, Breed /
Signature Fields (digital or printable)
Clear Signature
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