United States Farm Dog Mail-In Litter Registration Form

Breed:  Breeder Name:   Breeder Address:

City:   State:   Zip:   Phone:   Mating Date: Litter Date Of Birth:   Number In Litter:  Males:  Females:

Breeder Signature: Breeder Email : *Dam's Name And Registration Number:  
*Sire's Name And Registration Number:    Owners Name: 

Owners Address: 

City:   State:  Zip:   Phone:    Date:  Email : 

Pup/Dog Name     Sex     Color      Coat
Pup/Dog Name     Sex     Color      Coat
Pup/Dog Name     Sex     Color      Coat
Pup/Dog Name     Sex     Color      Coat
Pup/Dog Name     Sex     Color      Coat
Pup/Dog Name     Sex     Color      Coat
Pup/Dog Name     Sex     Color      Coat
Pup/Dog Name     Sex     Color      Coat
Pup/Dog Name     Sex     Color      Coat
Pup/Dog Name     Sex     Color      Coat

By signing this Litter Registration Form, you as the breeder and owners of the sire and dam take full responsibility for the accuracy and truth of this litter Registration. You state that all information you have submitted is accurate and true, and that the Sire and Dam listed are the Parents of this whelping, and the Sire and Dam listed was the only dogs mated to produce this litter of pups.
  If The Sire Or Dam Is Not Registered With The United States Farm Dog Registry, You Must Include A Copy Of A 4 Generation Pedigree (ABC, CBCA, AIBC, ISDS, or NASD Papers). Of The Sire And Dam, Or Whichever One Is Not Registered With Us. No Added Charge For Sire And Dam Registration As Long As You Send A Copy Of The Pedigrees At The Same Time Of The Litter Registration. For Registration Of This Litter To USFDR, fill this form out online and print it, then mail it with a check or money order of $25.00 To:  Jeff Patterson 400 Eller Road Sparta, Tn 38583    Phone: 931-738-7716