Fillable Printable AKC Registration Application for Open Registry of an Individual Dog
Fillable Printable AKC Registration Application for Open Registry of an Individual Dog
AKC Registration Application for Open Registry of an Individual Dog
Dog's Reg # Dog's Registry
Sire's Name
Dam's Name
Sire's RegistrySire's Reg #
Dam's RegistryDam's Reg #
Sex Date of Birth Breed Color Markings
//
Dog's Name
AKC Registration Application for Open Registry of an Individual Dog
Fee $50 (subject to change without notice). Please read the reverse side before completing this application.
Please print all information clearly and in ink.
Item Type 18 Do Not Write Above This Line
SECTION I: DOG INFORMATION
I hereby certify that to the best of my knowledge and belief the information given on this application and on all sup-
porting documents is true and accurate, and further that the dog is in compliance with all eligibility requirements given
on the reverse of this form. I agree to abide by all rules and regulations of the AKC.
SECTION IV: CERTIFICATION
signature of owner signature of co-owner
Name
Street Address
Name
Owner's AKC Customer Number
Write the owner's name and address below;
check here if a new address
Write the co-owner's name and address below;
check here if a new address
Co-Owner's AKC Customer Number
Address
State Zip
–
City
Zip
City
State
–
Name
Street Address
Zip
City
State
–
Breeder's AKC Customer Number Check here if a new address
When did the owner acquire the dog?
//
If the owner in Section II is not the breeder, complete this section.
SECTION II: OWNERSHIP INFORMATION
SECTION III: BREEDER INFORMATION
PAYING BY CREDIT CARD
If you wish to pay by credit card, please indicate which card you will be using and the number and expiration date; to authorize the debit, sign in ink.
Visa MasterCard American Express
Card Number Exp. Date
Card Owner’s Signature _________________________________________
ADOPEN(7/01) 7/13/01 8:54 AM Page 2
1. The dog is of a breed eligible for individual registration in the American
Kennel Club Stud Book.
2. The dog was born in the United States, or one of its possessions or territories.
3. The dog is individually registered with a registry organization whose
pedigrees are acceptable to the AKC for Open Registration.
4. The owner of the dog is a resident of the United States, or one of its
possessions or territories.
Note
A dog is not eligible for individual Open Registration if its litter has been
registered with the American Kennel Club. Normal procedures for
registering individual dogs must instead be followed.
1. The application completed and signed in ink. (Note that if an AKC
Customer Number is not known, it does not need to be included.)
2. The registration fee of $50, payable in U.S. funds. DO NOT SEND CASH.
3. An 8.5" by 11" photocopy of the original registration certificate issued by the
applicable registry identifying the applicant as the recorded owner of the dog.
DO NOT SEND THE ORIGINAL CER
TIFICATE.
4. An 8.5" by 11" photocopy of the original pedigree issued by the U.S. registry
containing at least three generations of ancestry, establishing that each dog
in the three generations was of the same breed, and registered with a
registry whose pedigrees are acceptable to the AKC.
DO NOT SEND THE ORIGINAL PEDIGREE.
If any of the dogs appearing in the ancestry are imported, the pedigree
must include the Stud Book initials and the foreign registration number
issued for the dog by the registry organization in the dog’s country of birth.
A dog will be ineligible for AKC registration if the pedigree issued by the
U.S. registry discloses that one or more dogs was recorded with the registry
on the basis of an affidavit.
5. Two color photographs, at least 3" by 4" in size, showing close-up front and
side views of the dog in a standing position.
6. If there are more than two owners of the dog, or more than one breeder,
please include a separate sheet which gives the name and address of each
additional owner or breeder.
Note
The AKC reserves the right to correct or revoke for cause the registration of
this dog. Any misrepresentation on this application is cause for cancellation
and may result in the loss of all AKC privileges. This application becomes
the property of the AKC when submitted.
Send this application, fee, and all supporting materials to:
American Kennel Club
5580 Centerview Dr.
Raleigh NC 27606-3390
ELIGIBILITY
REQUIREMENTS
FOR OPEN
REGISTRATION
WHAT TO SUBMIT
WHEN APPLYING
WHERE TO
SEND THIS
APPLICATION
ADOPEN (7/01)
ADOPEN(7/01) 7/13/01 8:54 AM Page 1
