Ica Litter Registration Form – Fill Out and Use This PDF

International Canine Association, Inc

Increasing the value of your “Designer-Breed” puppies!

Information About Litter (Please print clearly)

I certify the above information to be true and correct to the best of my knowledge.

Sire’s Owner Signature

Information About Dam

(Please print clearly)

Dam’s Registered Name:

Dam’s Registered Number:

Dam’s Owner Name:

Address:

City:

State:

Country:

Zip Code:

Phone Number:

Email:

I certify the above information to be true and correct to the best of my knowledge.

Dam’s Owner Signature

Because ICA wishes to ensure the integrity of its registration process, all persons or entities are advised that the International Canine Association is not responsible for any error, omission, or misrepresentation regarding the accuracy of information contained on forms submitted by the breeder. We must depend on the information supplied to ICA and can therefore make no express or implied warranty concerning the accuracy of that information. ICA stands responsible for any error our office may commit during the registration process and will take steps immediately to correct such errors once they are brought to our attention. However, the faulty document must be returned to us with the error circled. Please be aware that an application may be revoked for good or sufficient cause and that deliberate misrepresentations thereon may result in cancellation of your application and any attendant privileges customarily extended by the International Canine Association. Please inspect all registration document(s) for accuracy upon receipt. Any errors (or items not received) must be reported to ICA within 90 days from the date of registration. Corrections requested after 90 days will be subject to a reissue fee. The International Canine Association, Inc. reserves the right to make changes or corrections to this document, including prices on any service without notice.

Additional Services

Express Delivery (Fee: $21.00)

(Continental US Only)

Shipping & Handling

Delivery 1 to 3 business days

Information About Payment

Please make check or money order payable to International Canine Association, Inc.	Mail this form to International Canine Association
	P.O. Box 121107, Clermont, FL 34712
	Phone: 1-800-651-8332 Fax: 1-800-422-1864

Check Policy

When you send a check as payment, you authorize ICA to convert the check into a one-time Electronic Funds Transfer (EFT). This will automatically debit the check amount from your bank account---please note that this may occur as soon as the same day we receive your payment. Also, because of EFT you will not receive a paper copy of your cancelled check from your bank. Any Check returned will be charged a $20.00 fee and orders will be cancelled until payment is received. The International Canine Association is not responsible for overdraft fee charges.

CREDIT CARD AND CHECK BY FAX OR EMAIL ORDERS MAY BE VERIFIED 24 HOURS AFTER SUBMISSION.

FAX ORDERS TOLL FREE TO 1(800)422-1864 OR EMAIL TO REGISTRATIONS@ACADOGS.COM.