The Cat House on the Kings Surrender Form

Surrender a Cat

You must contact Lynea by phone at (559) 638-8696 (6am-11am / 1pm-4pm Pacific, Thu-Sun only) to obtain approval before submitting a surrender form.

Do not print this web page to fill out by hand!

You must submit this form online for a cat you wish to surrender. You will receive instructions afterwards for printing the paperwork to bring with the cat when you deliver him/her. If you need a copy of this form for someone else who does not have Internet access, please use the printer friendly version.

Please note:

We charge a surrender fee of $30 per cat per month. The maximum total per-cat surrender fee is $2000 (67 months). There is an additional upfront fee of $60 for an un-neutered, un-vaccinated cat/kitten. If the cat is adopted or passes away, our agreement is terminated.
We require evidence from a veterinarian that your cat has been tested for FeLV and FIV so that we can provide proper care. This test must be repeated if your cat has either been outside or exposed to other cats who are FeLV+ or FIV+ since this test was done.
The transition into the sanctuary is especially stressful for older, extremely timid and/or obese cats, to the extent that they may suffer significant health issues. We cannot guarantee their continued well-being. Therefore, the sanctuary should be the very last resort for these particular cats. We will gladly work with you to find an alternative which may be better for the cat.

Are you willing to pay the surrender fee?

Yes

First name:

Last name:

Email:

Home phone:

Cell phone:

Work phone:

Address:

City:

State:

Zip:

Workplace:

Work Address:

City:

State:

Zip:

Nearest Relative/Friend NOT LIVING WITH YOU #1:

Address:

City:

State

Zip:

Phone:

Nearest Relative/Friend NOT LIVING WITH YOU #2:

Address:

City:

State

Zip:

Phone:

Is this cat

Your pet?

Stray?

Other?

Why can't you keep this cat?

If not your pet, where did this cat come from?

Did you try to find the cat's owner?

Yes

Name of cat:

Date of birth (est.)

(Click icon)

Microchip ID:

Gender:

Male

Female

Breed:

Color:

Veterinarian (if your pet):

Spayed/neutered?

Yes

Don't know

FeLV/FIV test date:

(Click icon)

FeLV:

Positive

Negative

FIV:

Positive

Negative

Has the cat been outside since the FeLV/FIV test was done?

Yes

Has the cat had unsupervised contact with any FeLV+ or FIV+ cat since the FeLV/FIV test was done?

Yes

Current on vaccinations?

4 in 1 (FVRCP & C):

Yes

Don't know

(All surrenders should have a 4 in 1 booster within 9 months of surrender if possible.)

Leukemia:

Yes

Don't know

Rabies:

Yes

Don't know

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

We require a relatively recent digital picture of the cat to be surrendered. The picture must be in JPEG (".jpg") format and the picture file must not be larger than 100K bytes. Just click the Browse button and select the picture file.

Picture file:

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.

	I agree to these conditions and understand that I must sign a printed copy of this agreement when the cat is surrendered.
	I confirm that I have contacted Lynea to obtain approval.

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