Fill - Form 1: _ Foreign Dog Registration Application

ADIMPT (10/18) v1.7 EditPage 1 of 4

Date of Birth:

_ _

Month YearDayDog’s Foreign Registration Number

Dog’s Name

Sex:

Male

Female

Dog’s Registry Dog’s Country of Birth

Dog’s Color Dog’s MarkingsDog’s Breed

Dog Information:

Microchip

Tattoo

DNA Certicate Number

Microchip Type

Positive Identication (One Required)

Sire’s Registration Number

Sire’s Registry

Sire’s Name

Sire Information:

Dam Information: To Be Completed by the Importer of the Dog

Dam’s Name

Dam’s Registration Number

Dam’s Registry

Dam Information:

Breeder’s First Name Breeder’s Last Name

Street Address

City

Email Address

Telephone Number (do not include dashes, periods, or spaces)

Country

Foreign Postal Code

Breeder Information

Use this application to register a dog born in a foreign country. The dog must be of a breed eligible

for individual registration in the AKC

Stud Book. Please use black ink and capital letters to ll in the

boxes. Information you omit or print outside of the boxes will delay processing. Important information

Foreign Dog

Registration Application

and instructions are on page 3 of this form. Registration is not guaranteed. Processing fees are nonrefundable and all fees are subject to

change without notice.

— Do not send original documents. Please send only legible photocopies. —

Send the completed application and all required attachments to the address

specied on page 3 of this form.

Account Number (do not include dashes) Printed Name of CardholderExpiration Date

VISA AMEXCharge my:

Processing Fee $

2 5

Payment and Submittal Information See page 3 of this form for complete details

MasterCard

Discover

Check or money order made payable

to: The American Kennel Club.

* See Additional Requirements

section on page 3.

_ _

ADIMPT (10/18) v1.7 Edit

Page 2 of 4

_ _

Telephone Number Email Address

City

ZIP code + 4

Mailing Address

Date of

Sale:

1st Owner’s First Name 1st Owner’s Last Name

_ _

Month YearDay

This dog was sold DIRECTLY to the owner(s) listed below

State

2nd Owner’s First Name 2nd Owner’s Last Name

Sign here only if you are registering this dog in your name

1st New Owner’s Signature 2nd New Owner’s Signature

I (we) hereby certify that, to the best of my (our) knowledge and belief, the information contained in this application is true and accurate and that the

ancestors are of the same breed as the dog identied on this application. I (we) certify that the accompanying photographs are a true representation of the

dog identied on this application and supporting pedigree. I (we) agree to abide by American Kennel Club rules and regulations.

I (WE) AGREE THAT ANY

CAUSE OF ACTION, CONTROVERSY OR CLAIM ARISING OUT OF OR RELATED TO THIS REGISTRATION OR AS TO THE CONSTRUCTION, INTERPRETATION AND

EFFECT OF THIS AGREEMENT SHALL BE SETTLED BY ARBITRATION PURSUANT TO THE APPLICABLE RULES OF THE AMERICAN ARBITRATION ASSOCIATION.

HOWEVER, PRIOR TO ARBITRATION ALL APPLICABLE AKC BYLAWS, RULES, REGULATIONS AND PROCEDURES MUST FIRST BE FOLLOWED AS SET

FORTH IN THE AKC CHARTER AND BYLAWS, RULES, REGULATIONS, PUBLISHED POLICIES AND GUIDELINES.

Dog Information

Please reenter the dog’s number from page 1

Dog’s Foreign Registration Number

Owner Information: To Be Completed and Signed by the First U.S. Owner (Importer) or Foreign Owner

Email AddressTelephone Number

(do not include dashes, periods, or spaces)

Foreign Country

Foreign Postal Code

City ZIP code + 4State

Mailing Address

1st Owner’s Last Name1st Owner’s First Name

I (we) hereby certify that, to the best of my (our) knowledge and belief, the information contained in this application is true and accurate and that the

ancestors are of the same breed as the dog identied on this application. I (we) certify that the accompanying photographs are a true representation of the

dog identied on this application and supporting pedigree. I (we) agree to abide by American Kennel Club rules and regulations.

I (WE) AGREE THAT ANY

CAUSE OF ACTION, CONTROVERSY OR CLAIM ARISING OUT OF OR RELATED TO THIS REGISTRATION OR AS TO THE CONSTRUCTION, INTERPRETATION AND

EFFECT OF THIS AGREEMENT SHALL BE SETTLED BY ARBITRATION PURSUANT TO THE APPLICABLE RULES OF THE AMERICAN ARBITRATION ASSOCIATION.

HOWEVER, PRIOR TO ARBITRATION ALL APPLICABLE AKC BYLAWS, RULES, REGULATIONS AND PROCEDURES MUST FIRST BE FOLLOWED AS SET

FORTH IN THE AKC CHARTER AND BYLAWS, RULES, REGULATIONS, PUBLISHED POLICIES AND GUIDELINES.

2nd Owner’s Last Name2nd Owner’s First Name

2nd Owner’s Signature

1st Owner’s Signature

_ _

Month

Date of

Purchase:

YearDay

Foreign Dog

Registration Application

AmericAn Kennel club

If the owner listed above has transferred ownership of this dog they must complete the section below:

_ _

ADIMPT (10/18) v1.7 Edit

Page 3 of 4

AmericAn Kennel club

Foreign Dog

Registration Application

General Information and Instructions Tear off this sheet before you submit your application

You must pay the registration fee in U.S. funds. Do not send cash. Processing fees are nonrefundable and all fees

are subject to change without notice.

Fees

Note:

Use this application to register a dog born in a foreign country. The dog must be of a breed eligible for individual

registration in the AKC Stud Book. AKC rules and regulations may be viewed on our

Web site: www.akc.org. Once submitted, this application becomes the property of the American Kennel Club.

Purpose

Signatures of persons other than the owner(s) will be accepted only if a properly completed authorization form has

been led with the AKC.

Authorizations

These forms are available on our Web site: www.akc.org

Required

Attachments

The following items must accompany the completed, signed application:

Certicate of Registration. Attach a clear, legible photocopy of the original unrestricted (not a Limited

Breeding) Certicate of Registration indicating the dog’s registry and owner of record. Do not send the

original certicate. The AKC application and the foreign registration must reect identical ownership.

Pedigree. Attach a clear, legible photocopy of the complete foreign three-generation Certied Pedigree from the

registry in the dog’s country of birth (Export Pedigree if dog has been Imported to the US). Acceptable registries

are listed in Section IV of the Special Registry Services pamphlet available on our Web site: www.akc.org. Do

not send original pedigree.

For Canada, Bermuda and Mexico: See additional instructions below.

Bescheinigung. Attach a German certicate of transfer in letter form, if applicable. Do not send original

Bescheinigung.

Photographs required for all dogs. Attach two (2) color photographs of the dog in a standing position: one front

view; one side view. Print the dog’s name and registration number on the back of each photograph.

Send the completed application and attachments to:

The American Kennel Club

P.O. Box 900058

Raleigh, NC 27675-9058

Mailing

Information

Email AKC at foreign@akc.org or call 919-233-9767 to speak to an AKC Customer Service Representative,

Monday – Friday, 8:30 AM – 8:00 PM. Information about the registration process and downloadable forms

are available on our Web site: www.akc.org.

Assistance

The American Kennel Club reserves the right to correct or cancel for cause the registration of this dog and its

descendants. Any misrepresentation on this application is one example of for cause cancellation and may result

in loss of AKC privileges. By supplying your email address and/or telephone number, you consent to receive com-

munications from AKC and third parties. Registration is not guaranteed. Processing fees are nonrefundable

and all fees are subject to change without notice.

Notice

• The owner who applies to register the dog is either a resident of Bermuda (for a BKC-registered dog), of

Canada (for a CKC-registered dog), or of Mexico (for an FCM-registered dog).

Additional

Instructions for

the Registration

of a Dog Owned

by a Resident of

Bermuda,

Canada, or

Mexico

Please verify the following information before submitting your application:

• The dog is of a breed eligible for individual registration in the AKC Stud Book.

• The dog was registered with the Bermuda Kennel Club (BKC), the Canadian Kennel Club (CKC), or the

Federacion Canola Mexicana (FCM) BEFORE submission of the application for AKC registration.

• Do not submit the original pedigree. Please submit a clear, legible photocopy.

• The pedigree issued by the BKC, CKC, or FCM for a dog registered in Bermuda, Canada, or Mexico contains at

least three (3) generations of ancestry and establishes that each dog in these three (3) generations was of the

same breed and registered in its country of birth with one of the registry organizations recognized by the AKC.

• The person who applies to register the dog is identied as the recorded owner of the dog on the unrestricted

(not a Limited Breeding) BKC Registration Certicate, the unrestricted CKC Certicate of Registration, or the

unrestricted FCM Pedigree.

If BOTH the sire and dam of the dog identied on the application are AKC registered, print the AKC registration

number of the sire and dam in the appropriate spaces on the front of the application. In the case of Canada and

Bermuda, you may omit the copy of the Certied Pedigree. However, the Registration Certicate is still required.

If the dog identied on the application has been shown in AKC-member and/or AKC-licensed

events under its foreign registration number for more than thirty (30) days, write to Event Operations,

P.O. Box 900051, Raleigh, NC 27675-9051, and request an extension to continue showing the dog.

Additional

Requirements

Note: Eective for foreign dogs registered on or after March 1, 2006, any foreign dog registered with the AKC must

have an AKC DNA prole prior to registering its rst litter whelped in the United States.

These forms are available on our Web site: www.akc.org

•

If there are more than two (2) owners of the dog, contact the AKC for an Additional Signature form.

•

A Supplemental Transfer Statement must accompany this application for each intermediate transfer (that is, any

transfer other than the rst transfer occurring in the U.S. that is documented on this form).

• The dog must be registered with the name that appears on the Foreign Registration Certicate/Certied Pedigree.

Foreign titles will not appear on any AKC documentation.

ADIMPT (10/18) v1.7 Edit

Page 4 of 4

AmericAn Kennel club

Foreign Dog

Registration Application

Information that you provide on this side of the form, in any format, will not be processed.

Please refer to the General Information and Instructions section on page 3

of the form for guidance if you need to provide additional information.

Come. Sit. Stay. Shop.

www.akc.org

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