I hereby certify that I am the rightful owner/keep/caretaker/custodian of the animals) who is/are the subject of the Animal Surrender Form, hereinafter referred to as “the animal.” I hereby surrender any and all property rights to the animal. I certify that no other person has a right of property to the animal. I understand that by surrendering my property rights to the animal, the animal may be transferred into the custody of an animal shelter. I also hereby certify that the animal has/has not bitten or scratched a human or another animal within the past 10 days. I understand that once I relinquish the animal, the animal will not be available to be returned. I further certify that I have read and understand the terms of the Animal Surrender Form.