ACAS Dog Owner Surrender Form

Athens City Animal Services (ACAS) Surrender Fee Policy ACAS subsidizes the surrender fee for the first two animals per household within a 365-day period. After these two animals, a surrender fee will apply for each additional animal surrendered within the same 365-day timeframe. Important Information for Animal Turn-Ins Please complete the surrender form with as much information as possible. This helps us reunite lost animals with their families and ensures they receive the best care. When turning in an animal to Athens City Animal Services, please be aware of the following requirements: • A valid photo ID is required. • Proof of residency within Athens city limits is required. Waitlist Policy Due to limited space, all animals being surrendered are placed on a waitlist in the order that applications are received. You will be contacted when space becomes available. Please note: • We cannot hold a space once it becomes available. • If you do not respond, the space will be offered to the next applicant on the list. City vs. County Reminder Athens City Animal Services and Limestone County Animal Care and Control (LCACC) are separate agencies. If you live outside Athens city limits, ACAS cannot accept the animal. Residents of Limestone County (outside the city limits) should contact LCACC at 256-233-6494 for assistance. Thank you for your understanding and cooperation!

Animal's Name *
First Name *
Last Name *
Address *
City *
State *
Zip Code *
What city/county do you reside in? * We do require current proof of residency and a current photo ID.	Athens City Limestone County Madison County Madison City Morgan County Lauderdale County
Phone Number *
Email Address *
Confirm email
Photo of your driver's license * Two current proof of residency are required for all surrenders, valid driver's license and utility bill with matching names and address.
Please attach a photo of your current utility bill. * Two current proof of residency are required for all surrenders, valid driver's license and utility bill with matching names and address.
Gender of the animal *
What breed/type of animal? *
Second breed if the animal is mixed breed.
Primary color? *
Secondary color
Color markings * Spotted, patches, etc.
Coat Length *	Short Medium Long Wire Corded
Age? *
Animal is good with * Please check all that apply. This will help us in placing the animal in the best environment.	Kids under 5 Kids over 12 Small dogs Medium dogs Large dogs Cats or small animals House-trained or litter box trained Walks well on leash
Has issues with * This information is necessary in order for us to help find the appropriate placement in either the shelter, foster home, rescue or forever home.	None Food or toy aggression Aggression towards people or other animals Separation anxiety Destructive behavior - chewing, digging Inappropriate bathroom usage Excessive barking or howling Jumping fence or running off
Please describe the animal(s) personality, etc in detail. *
Has the animal been spayed or neutered? *	Yes No Unknown
Veterinary Clinic *
Veterinary Clinic Phone Number *
What is the name on the account that the animal is registered under? * This will allow us to get your animal's most recent medical record so that you don't have to bring in a copy.
How did the animal come into your possesion *
Name of rescue or shelter that you adopted the animal from? * Name of the rescue or shelter that you adopted the animal from.
Please provide the name & contact information of the person that you got the animal from? * Name and contact information of the person that you got the animal from.
How long have you had the animal(s) *
Why are you wanting to turn in the animal? *
Photo #1 * Please attach a photo showing the face of the animal for identification.
Photo #2 * Please attach a photo showing the size of the animal. This is needed to ensure that we have an appropriate sized kennel or cage.
Photo #3 * Please attach a photo showing the size of the animal. This is needed to ensure that we have an appropriate sized kennel or cage.
Signature * I have been honest and truthful in all my answers above. If I have not be truthful, I understand that my Owner Surrender Application can not be processed. I understand that I am relinquishing all rights to above animal(s) and the animal(s) will not be returned to me, without going through the adoption process. Due to the constant state of the shelter being at max capacity, it is understood that Owner Surrender animals, are the first at risk of being euthanized for space as we are NOT a no-kill shelter. Our Intake Coordinator will be in contact with you once your form has been processed. This can take 3-5 business days and does not guarantee a space until an adequate kennel is available to house your pet.