Pet
Name
AWB:
Origin:
F
R
O
M
"
"
Via:
Microchip
Dest:
Name__________________________________________ Veterinary Information
Address________________________________________ Health Certificate Provided
Certificate of Acclimation Provided
_________________________________________________ Rabies Certificate Attached
Telephone_____________________________________
Food Instructions
Name__________________________________________
Address________________________________________
T
O _________________________________________________
Telephone_____________________________________
Shipper's Declaration
Animal(s) was last offered food and water at:
Yes
Yes
Yes
No
No
No
Under 16 weeks old - Feed 1x every 12
hours or upon arrival at comfort stop.
Over 16 weeks old - Feed 1x every 24
hours or upon arrival at comfort stop.
Water Instructions: Provide potable water at ALL times
a.m.
Time
p.m.
"I certify that the animal(s) being shipped have/has been offered food and water within
four hours prior to tender to Airline." All information provided herein is ture and correct.
Date
a.m.
p.m.
_____________________________________________________________________________________________________________________________________________________________________________
Shipper's Signature
Printed Name
Date
Time