Deposit Receipt For Pup Under Nine Weeks Old

 Theresa Gilchrist (Breeder), RR 1, Pickardville, AB, T0G-1W0,  Phone# (780) 349-2868

    Email at ,

Receipt for Deposit

Should Purchaser decline to purchase above named dog, the $500.00 deposit will be held to cover expenses to locate a new Purchaser.  Deposit of $500.00 is non-refundable.

The Purchaser agrees if for any reason they cannot take care of below named dog that they will return below named dog to above named Breeder.  Purchaser agrees not to sell or give below named dog to any person or establishment except to above named Breeder without above named Breeder’s permission.

Received from:

Name: ___________________________________________

E-mail address: _____________________________________

Address: __________________________________________

Phone (home): _____________________________________

Alternate Phone: ___________________________________

Litter &  Dog Information

Breed:  ____________________________________________

Name of Reg. Dog: __________________________________

CKC Litter Reg. #: __________________________________

Date of Birth & Sex: _________________________________

Colour & Markings:  _________________________________

Tattoo #: __________________________________________

Sire’s Name & Reg. #: _______________________________

Dam’s Name & Reg. #: ______________________________

Total price of above named dog: $__________  Amount written _________________________

Amount owing $__________     Amount written________________________ ,

to be paid in full upon taking possession of above named dog on __(Date of Possetin)__.

Failure of Purchaser to take possession of said dog within two days of possession date will automatically begin boarding costs @ $21.00 per day and must be paid at the time the Purchaser takes possession of said dog.

Signature of Breeder (Seller): __________________________                Date: __________

I/We have read and understand the above and agree to all terms and conditions contained therein:

Signature of Buyer (Purchaser): ________________________               Date: _______________