usbr usbr usbr usbr usbr usbr
USBR
USBR

Litter Information

* Breed
* Number of puppets
Male:
Female:
Total:
* Date of Breeding
/ /
* Litter Born
/ /

Sire Information

Name
USBR #
Owner Name
Owner Phone
() -
Owner Signature
Co-Owner Name
Co-Owner Phone
() -
Co-Owner Signature

Dam Information

Name
USBR #
* Owner Name
* Owner Email
Owner Signature
Co-Owner Name
Co-Owner Phone
() -
Co-Owner Signature

Payment Information

* Payment Type


Billing address is the
same as sire owner address?

* Card Holder Name
* Card Holder Email
* Card Holder Billing Address
* Card Holder City
* Card Holder State
* Card Holder Zip
* Card Number
* Card CVV
* Card Exp Date
/
* Cell Phone
() -
* Signature

Fees

 $30.00 US REGULAR REG

 $35.00 INTERNATIONAL REG

 $15.00 RUSH FEE

 $10.00 PRIORITY MAILING

 $25.00 RUSH PRIORITY

 $40.00 OVERNIGHT FEE

Total Due
$

PLEASE SUBMIT BOTH SIDES OF YOUR PEDIGREE FORM
(file size limit 10Mb)


FRONT OF PEDIGREE
INSIDE OF PEDIGREE

Comment

Once you click SUBMIT your registration
will be submitted to the office

if you are not the sire owner, USBR will call sire owner to verify

Your credit card will be charged when we process your registration