To be signed by person accepting animal ________________________.org ph: ( ) --

ANIMAL ACCEPTANCE LIFETIME LEASE

The signatory of this agreement and contract, being of free will and sound mind, agrees to enter and follow all of the provisions of this agreement and contract herein contained.

1. I fully understand that ________________________ has incurred $ 1,500 in expenses to facilitate this arrangement. I further understand that any failure to abide with any of the material provisions of this contract on my part will subject me to liability for that breach and damages in the amount of $ 1,500 expended by ________________________, in addition to other costs as per Section 9 of this Agreement, if applicable.

Acceptor's initials: _________________.

2. This agreement does not transfer the property ownership rights of said animal to me and is given to me on a lifetime lease, provided I do not violate any of the provision of this Agreement.

3. I agree to provide love, care, and proper sustenance to the animal obtained through the services of the ________________________, as per the laws of the State_____________________________________.

4. I am obtaining possession of this animal for myself, as per the terms of this agreement. I agree not to materially violate any of the provisions of this agreement.

5. The identification tag provided by ________________________ and a collar will be kept on this pet continuously and at all times and will never be walked off leash unless in a closed 6ft fenced area with no holes or a City Park designated off leash area during off leash hours. I understand that this animal is not being bought, and that CAN reserves the right to repossess it upon demand.

6. I agree to a trial period of possessing the animal of seven (7) days, which is renewable by me until I am satisfied. If unsatisfied I have the right to return the animal at will but I will return the animal by transporting it back to the location it was residing before I took possession of it.

7. If, upon the termination of the seven (7) day trial period, all parties involved, ________________________, myself, and placing party are satisfied with the results, I agree to forthwith deliver a nominal contribution of __________ ($ ______) for an altered mixed breed animal, $____ for a full breed altered animal to ________________________ personally or by way of US Postal Service, in the form of cash, check or money order to be received by ________________________ within a period of five (5) days after the last trial day. If such contribution is not received within aforementioned schedule and time herein agreed to, a contract termination fee of $1500 shall be due to ________________________, payable immediately.

8. I agree to allow ________________________ and placing party reasonable telephone contact, up to a maximum of once per week for purposes of obtaining progress reports. Furthermore, I agree to allow ________________________, or their representatives, access and visitation rights to said animal up to a maximum of once per month, if requested.

9. In the event an accident or any harm befalls said animal, such as losing it, an accident, etc., I agree to immediately obtain veterinary care and authorize the release of all veterinary records to ___________________ and notify ________________________ within 24 hours of such event by telephone as to the name, address and telephone number of treating veterinarian or hospital and date, time, location, and nature of loss, or accident. In the event of any other changes such as behavioral issues of the animal or other household members or illness or loss of animal or any lifestyle changes, I agree to expand costs and efforts to treat and/or solve the issue(s) and/or retrieve said animal, including, but not limited to obedience training, veterinary care, searching, advertising, printing and posting of flyers, gasoline, and labor and other costs, up to a maximum of $1,500. My failure to abide with this paragraph's notification, veterinary care, obedience training and other requirements shall subject me to the expenses incurred by any party to provide the required services, as specified above, in addition to the liquidated damages agreed to in Section 1 of this Contract and Agreement, if applicable. If enforcement of this contract is required in court I agree to reimburse all court costs, fees, and collection costs.

10. I agree to notify ________________________ of any new residence address and/or telephone number which I may acquire within thirty (30) days of such acquisition.

11. I agree not to hold ________________________, nor placing party from whom animal was obtained, liable not responsible in any manner, for harm or damages which may result. I do not hold ________________________ responsible for error(s) in the information provided me about this pet.

12. If, at any time during the entire life span of this animal, I can no longer keep and provide for said animal, I agree to notify ________________________ a minimum of 90 days prior to being unable to keep said animal and keep it until another permanent home is found who will sign _____________________ adoption agreement. If I am unable to keep the animal until a new home is found I agree to board the animal with _______________________ at its kennel at the special low-cost rates I am entitled to under the terms and conditions specified in ______________________’s boarding agreement until a permanent home is found. Under no circumstances will I give this pet to a person, shelter or abandon it. I understand that the animal is not my property to transfer to any other person or entity.

______________________________ ______________________________

Signature of Accepting party Employer of Accepting party

______________________________ ______________________________

Printed name of Accepting party Employer's address

_____________________________

Employer's telephone

______________________________ ______________________________

Telephone of Accepting Party Family Reference Name

______________________________ ______________________________

Street Address of Accepting party Family Reference address

______________________________

Family Reference Phone Number

__________________________________ ______________________________

City State Zip Code Accepting Party's date of birth

______________________________ ______________________________

Printed name of witness Breed of animal being accepted

______________________________ _________________________ ______

Signature of witness Approximate age of animal Gender

______________________________ ______________________________

Street Address of witness Name of accepted animal

______________________________ ______________________________

Telephone of witness Microchip ID#

______________________________ ______________________________

Date of this agreement Accepting party's social security number

On this date of __________________________, I, ________________________________ obtained possession

of above mentioned animal from the placing party, __________________________________________.

_______________________________

Signature