Please note:

I am
 
an individual
 
representing a rescue group

For individuals the total charge to surrender a cat is $5000. As a courtesy and only if you live in California, we will accept monthly payments toward this total, provided that you have first paid a non-refundable deposit of $500 (for cats under 8 years old) and $1000 for senior cats (8 years and older). The minimum monthly payment for non-senior cats is $60 per month until the entire balance is paid (up to 83 months) and $75 per month for senior cats (up to 67 months). If the cat's required vaccinations are not current or the cat is unaltered, there is an $80 fee in addition to the deposit.

Note: The full surrender fee is due and payable to The Cat House on the Kings even if the cat dies before full payment has been made. If the cat is adopted before all payments have been made, The Cat House on the Kings will consider the remaining debt to be paid in full and no further payments will be required.

Payment in full discount: If you pay the entire surrender fee at the time the cat is surrendered, the surrender fee will be discounted 10%. e.g. For a non-senior cat the discounted fee would then be $4500.

The surrender fee is NOT tax-deductible because we are providing the service of lifetime care for the surrendered cat in exchange for the fee.

Are you willing to pay the surrender fee?
 
Yes
 
No
First name: 
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Home phone:
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Address: 
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City: 
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Workplace:  black line
Work Address: 
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City: 
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Nearest Relative/Friend NOT LIVING WITH YOU #1:  black line Phone: black line
Address: black line
City:
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Nearest Relative/Friend NOT LIVING WITH YOU #2:  black line Phone: black line
Address: black line
City:
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Nearest Relative/Friend NOT LIVING WITH YOU #3:  black line Phone: black line
Address: black line
City:
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Nearest Relative/Friend NOT LIVING WITH YOU #4:  black line Phone: black line
Address: black line
City:
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Is this cat
 
Your pet?
 
Stray?
 
Other?
Why can't you keep this cat? black line
If not your pet, where did this cat come from? black line
Did you try to find the cat's owner?
 
Yes
 
No
Name of cat: black line
 Date of birth (est.)  black line Microchip ID: black line
Gender:
 
Male
 
Female
 
Breed: black line
 
Color: black line
Veterinarian (if your pet): black line
Spayed/neutered?
 
Yes
 
No
 
Don't know
All cats entering the sanctuary must be tested for the Feline Leukemia Virus (FeLV) and the Feline Immunodeficiency Virus (FIV). This is usually done with a single combination test.
Has this cat been tested for FeLV/FIV?
 
Yes
 
No
FeLV/FIV test used: black line (Important: Please ask the clinic if you are not 100% certain.)
FeLV/FIV test date:  black line
FeLV:
 
Positive
 
Negative
FIV:
 
Positive
 
Negative
Has the cat been outside since the FeLV/FIV test?
 
Yes
 
No
Has the cat had unsupervised contact with any FeLV+ / FIV+ cat since the FeLV/FIV test?
 
Yes
 
No

The following conditions apply when a cat is surrendered without first being tested for FeLV/FIV:

  1. The cat will be isolated until an FeLV/FIV test can be performed.
  2. There will be an additional charge to perform the test at the sanctuary. Contact us for the current cost.
  3. If the cat cannot be handled, he/she may need to be sedated to perform the test. Sedation carries an inherent risk to the cat.
  4. If the cat is FeLV+ you will be notified immediately. Acceptance of the cat is then dependent on the availability of space in our FeLV+ area.
  5. If the cat is FIV+, our acceptance of the cat will depend on the capacity of our FIV ward. If we cannot accommodate the cat in the FIV ward, you will be notified immediately. You will then have seven (7) days in which to make alternative arrangements.
  6. If the cat dies under sedation for the FeLV/FIV test, your deposit of $500 (for cats under 8 years old) or $1000 (for cats 8 years and older) will be forfeit.Therefore it is in your best interest to ensure that the test is performed before surrendering the cat.
 
I understand and accept these conditions for surrendering a cat not tested for FeLV/FIV.
 
Current on vaccinations? (PROOF REQUIRED)
4 in 1 (FVRCP & C):
 
Yes
 
No
 
Don't know
(All surrenders should have a 4 in 1 booster within 9 months of surrender if possible.)
Leukemia:
 
Yes
 
No
 
Don't know
Rabies:
 
Yes
 
No
 
Don't know

Please tell us as much as you can about this cat:

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I understand and agree that upon surrender I relinquish all rights and claims to this cat.
 
 
I confirm that I have contacted Lynea to obtain approval.
 
I understand that the surrender fee is not tax-deductible.
 
 
I understand that the deposit is non-refundable.
 
 
I understand that the surrender fee is due and payable even if this animal dies before full payment has been made.
 
I understand that if this animal is adopted before full payment has been made, The Cat House on the Kings will consider the remaining debt to be paid in full and no further payments will be required.
 
I understand and accept that not all cats will do well in the sanctuary environment.
 
 
I understand that given the number of cats and the size of the property, The Cat House on the Kings staff are not able to provide photos or updates on the condition of any surrendered cat on demand. However, I understand that I can schedule a visit to find the cat and check on him/her myself after his/her 30 day quarantine period.
 
 
I understand that The Cat House on the Kings may not accept this cat if the name and photo(s) I have provided are insufficient to distinguish this cat from similar cats.
 
May we add you to the mailing list for our quarterly newsletter and occasional announcements?
 
Opt In
 
Opt Out
Non-exchange surrender fee:$black line Monthly minimum payment:$black line
Non-exchange deposit :$black line Exchange requested:Y / N
Spay/Neuter:$black line Vacc/Shots:$black line
Flea Treatment:$black line Deworming Treatment:$black line
Vet/Other:$black line Describe:black line
Max. Amt. Owed this Surrender:$black line Total exchange points (or N/A):black line
Amt. Paid Today$black line Cash $black line Check #black line
Remaining Balance Due This Surrender:$black line
Amt. To Be Paid per Month:$black line
The monthly payment will begin (mon/day/year):black line / black line / black line and on the 1st of each month thereafter.

If you default on this agreement, we reserve the right to return your cat/cats either to your residence or to your relative/friend's residence or to take legal action against you.

By initialing all the boxes above and signing below, I affirm that I have read, understood and agree to the conditions set forth in this agreement.

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Signature Date
IN WITNESS WHEREOF the parties hereto have executed these presents the day and year above written.
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Signature Date
(For Office Use Only)
Microchip ID: black line
Intake housing: black line
Notes: black line