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(To be completed by person presenting dog for microchipping)
1. Name and address of person presenting dog for identification:
2. Relationship to the dog (delete as appropriate):
owner of the dog;
person authorised to represent the owner of the dog.
3. I confirm that the dog I am presenting for microchipping today is the same dog whose tail was docked on [DATE] and in relation to which Parts 1 to 3 of this certificate were completed.
4. I am aware that it is an offence knowingly to give false information to a veterinary surgeon in connection with the giving of a certificate for the purposes of section 6 of the Animal Welfare Act 2006.
Signature of owner of the dog or of the person authorised to represent him:
Name
Date:
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Original (As Enacted or Made) - English:The original English language version of the legislation as it stood when it was enacted or made. No changes have been applied to the text.
Original (As Enacted or Made) - Welsh:The original Welsh language version of the legislation as it stood when it was enacted or made. No changes have been applied to the text.
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