Stud book of Cesky kynologicky svaz
U Pergamenky 3, 170 00 Prague 7 Czech Republic, email: petra.novotna@kynologie.cz
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QUESTIONNAIRE
About dog´s pedigree duplicate
APPLICANT’S DATA
Full name:..................................................................................................................................................
Address:.....................................................................................................................................................
E-Mail: ......................................................................................................................................................
DOG’S DATA
Breed:.................................................. Sex:............................. Date of birth.:..........................................
Name and the kennel:.................................................................................................................................
Registration number: CMKU/...................................................................................................................
Tatoo nr. / Chip:........................................................................................................................................
Date when was this dog obtained:...................................................... Name of the previous owner or the
breeder:.......................................................................................................................................................
WHY I ASK TO DUPLICATE (mark correct and add some informations about it)
1. I lost Pedigree of my dog:.......................................................................................................................
....................................................................................................................................................................
...................................................................................................................................................................
2. I found the dog:.......................................................................................................................................
....................................................................................................................................................................
...................................................................................................................................................................
3. Other reason:..........................................................................................................................................
....................................................................................................................................................................
....................................................................................................................................................................
In................................................. on......................................
Signature.................................................
Duplicate must go through process management and the issue therefore lasts 2 months.