AUSTRALIAN NATIONAL KENNEL CONTROL APPLICATION FOR REGISTRATION OF SEMEN (SEMEN COLLECTED IN AUSTRALIA) ANKC Form Semen 2 (Dogs ACT form Semen_2) IMPORTANT - Semen collected inside of Australia will require the following documentation: (i) OFFICE: Certificate of Collection of Semen (ANKC form Semen #1). DETAILS OF SEMEN Frozen or Chilled: Batch No. (Please indicate) No. of Straws: Storage & Location: Name of Dog: Registration No. Breed: Sire: Reg No. Dam: Reg No. Markings/Colour: Date of Birth: Microchip/Tattoo No. Owner/s Name: 2nd Owner/s Name: These names will appear on the registration certificate. If you want individual owners on individual certificates then that semen needs to be registered individually. OR an individual member registers the batch then transfers individual straws/bead as per the rear of this document. Address: 2nd Address: DECLARATION BY OWNER/S I/We hereby certify I/We are the registered owner/s of the above mentioned semen and apply to have the semen registered in my/our name. I/We attach the Certificate of Semen and in the case of non resident semen an Export Pedigree of the dog issued by the Canine Controlling Body in the Country of origin of the semen, the necessary import/quarantine documentation and in the case of a non resident dog, the completed Re-registration application and fee. Signature/s (Note: All owners are to sign this statement) Date Dogs ACT - Registration of Semen. Forward to - PO Box 815, Dickson, ACT, 2602 See next page for schedule of costs for registration of semen. Please complete where further information is required. SCHEDULE OF COSTS FOR REGISTRATION OF SEMEN COLLECTED IN AUSTRALIA. @1 January 2013 Semen Re-registration (Overseas dogs) please use Dogs ACT form ANKC Semen 2A Re-registration of semen. Semen Initial Registration (Australian dogs) within 90 days of collection - $38.00 Semen Initial Registration (Australian dogs) over 90 days upto 18 months from collection - $70.00 Then registration certificate for subsequent individual straw/beads - (related to the same application for registration of semen) - $10.00 Example – If you want all semen related to this application registered on the one certificate - $38.00. If you want individual registration certificates per straw, combination of straws or beads then $38.00 and $10 for subsequent registration certificates. ie 5 straws on individual certificates will cost $78.00. The benefit of this is when using or selling the semen, each amount of semen will have it’s own registration certificate. Transfer of registration of that semen will be as per transfer of any animal by completion of the declaration of the rear of each registration certificate. Each certificate will be clearly marked “Semen Only”. Transfer of semen – within 28 days of transfers No.straws/beads per registration certificate $29.00 Straw/Beads Identification numbers Fees Initial Registration $38.00 Subsequent Certificate 1 $10.00 Subsequent Certificate 2 $10.00 Subsequent Certificate 3 $10.00 Subsequent Certificate 4 $10.00 Subsequent Certificate 5 $10.00 Subsequent Certificate 6 $10.00 Total certificates Total straw/beads Office Use Only Date completed: / (Office Only) Registration Number Registration fees. / Return to Dogs ACT – PO Box 815, Dickson, ACT, 2602 $