LITTER REGISTRATION APPLICATION

Please allow 4 to 6 weeks for processing. UKC® is not responsible for errors caused by illegible handwriting. Incomplete applications may result in processing delays.
The litter must be registered before it reaches one year of age. Both the Sire and Dam must be permanently registered with UKC in order to register a litter.
You can register this litter online at UKCdogs.com
Step 1 - Litter Information
Total # Males _____________ Date of Breeding / /
month day year
Breed Total # Females ___________ Date of Birth / /
Normal Gestation Period is 63 days. month day year

Step 2 - Sire Information Step 3 - Dam Information

UKC #
UKC #
Was Frozen Semen Used? q Yes q No Date Collected for Freezing
Registered Name of Dam
Registered Name of Sire
Dam Registrant/Sole Signatory (Please print)
Sire Registrant/Sole Signatory (Please print)
Dam Registrant/Sole Signatory Signature (Required)
Sire Registrant/Sole Signatory Signature (Required)
Dam Co-Registrant (if applicable, please print)
Sire Co-Registrant (if applicable, please print)
Dam Co-Registrant Signature (Required, if applicable)
Sire Co-Registrant Signature (Required, if applicable)
Current Address
Current Address
City State/Province
City State/Province
Postal Code Country
Postal Code Country
Phone # ( )
Phone # ( )
Email Address (Required for Expedited Service)
Email Address
Complete Step 4 ONLY if the Litter Registrant/Sole Signatory is not the Registrant/Sole Signatory of the

Dam.

Step 4 - Litter Registrant Information - Complete this Step ONLY if the Litter Registrant/Sole Signatory is not the Registrant/Sole Signatory of the Dam.

Print the name of the Registrant/Sole Signatory to whom the litter is being registered.
Registrant/Sole Signatory (Only one indiVidual may be listed as the Registrant/Sole Signatory) Continue to Step 5
Signature of the Registrant/Sole Signatory (Required)

Current Address
For Permanent
UKC is NOT responsible for undeliVerable mail due to incomplete mailing addresses. Registration of pups, see
City State/Province Postal Code Country Step 5.

Phone # ( ) Email Address (Required for Expedited Service) For fees and additional
services, see Step 6
)))))))))))
“By signing this application all the aboVe parties agree to abide by all UKC® rules, regulations, and policies; also understand that each are responsible for all information contained herein.”
All applications become the property of UKC® and are not returned. UKC® reser Ves the right to refuse an application as well as correct or reVoke any registration at any time.
 Step 5 - Permanent Registration of Pups By choosing to permanently register, you must name the puppy, proVide the color, sex, and the Registrant/Sole Signatory’s name and contact information.
Flat Fee Discount: Up to 6 months - $100 / 6 months to 1 year - $150.
(Includes Permanent Registration of 5 pups with 3-generation pedigree of each. Each additional 3-generation registration $10 - includes Litter Registration
Fee.)
Sex Color Variety Tattoo# / Chip Number 3-Gen Pedigree ............................$24 q

Name 4-Gen Pedigree ............................$29 q

Print the name of the Sole Signatory to whom pup is being registered. 6-Gen Pedigree ............................$45 q
Address City State/Province Postal Code Country 7-Gen Pedigree ............................$60 q
Additional
(If more than one indiVidual is being listed on this
Phone ( ) Email Date of Sale / / dog’s record, a Sole Signatory Form is required) Easy EntryTM Card ........................$10
q
Sex Color Variety Tattoo# / Chip Number 3-Gen Pedigree ............................$24 q

Name 4-Gen Pedigree ............................$29 q

Print the name of the Sole Signatory to whom pup is being registered. 6-Gen Pedigree ............................$45 q
Address City State/Province Postal Code Country 7-Gen Pedigree ............................$60 q
Additional
(If more than one indiVidual is being listed on this
Phone ( ) Email Date of Sale / / dog’s record, a Sole Signatory Form is required) Easy EntryTM Card ........................$10
q
Sex Color Variety Tattoo# / Chip Number 3-Gen Pedigree ............................$24 q

Name 4-Gen Pedigree ............................$29 q

Print the name of the Sole Signatory to whom pup is being registered. 6-Gen Pedigree ............................$45 q
Address City State/Province Postal Code Country 7-Gen Pedigree ............................$60 q
Additional
(If more than one indiVidual is being listed on this
Phone ( ) Email Date of Sale / / dog’s record, a Sole Signatory Form is required) Easy EntryTM Card ........................$10
q
Sex Color Variety Tattoo# / Chip Number 3-Gen Pedigree ............................$24 q

Name 4-Gen Pedigree ............................$29 q

Print the name of the Sole Signatory to whom pup is being registered. 6-Gen Pedigree ............................$45 q
Address City State/Province Postal Code Country 7-Gen Pedigree ............................$60 q
Additional
(If more than one indiVidual is being listed on this
Phone ( ) Email Date of Sale / / dog’s record, a Sole Signatory Form is required) Easy EntryTM Card ........................$10
q
Sex Color Variety Tattoo# / Chip Number 3-Gen Pedigree ............................$24 q

Name 4-Gen Pedigree ............................$29 q

Print the name of the Sole Signatory to whom pup is being registered. 6-Gen Pedigree ............................$45 q
Address City State/Province Postal Code Country 7-Gen Pedigree ............................$60 q
Additional
(If more than one indiVidual is being listed on this
Phone ( ) Email Date of Sale / / dog’s record, a Sole Signatory Form is required) Easy EntryTM Card ........................$10
q
Step 6 - Additional Services (Fees are in addition to Registration Fees and are subject to change without
Step 7 - Payment Information - Select one box below
notice)

Next Day Air (Available for physical mailing addresses in Continental US / Fee for delivery outside the Continental US
Litter Registration
Up to 6 months - $30 q 6 months - 1 year - $60 q...............$
will be higher. / Saturday delivery not available / No P.O. Box addresses.)
...................................................................$60 q Flat Fee Discount (Includes 3-generation with Permanent Registration for 5 pups)
Expedited Service (Upon receipt at UKC, processed and returned within five business days, with tracking
number.
Available in continental US only.).....................................................................................................................$40 q Up to 6 months - $100 6 months - 1 year - $150 q..............$
q
Rush Service (Processed within five business days of receipt at UKC® / does not include time in transit.)...........
$30 q
 GRAND TOTAL................................................................... $
When requesting an accelerated serVice,write RUSH, EXPEDITED or NEXT DAY AIR on the outside
Checks
front of and money
the enVelope. orders
Faxed must applications
or emailed be payable within
in US funds and made
the continental UStowill
thebeorder of: an
charged Credit Card Information (Major Credit Cards Accepted) Office Use Only
EXPEDITED SerVice Fee ofUnited Kennel Club
$40. Applications outsideAttn Litter Dept.
the Continental US will be charged a RUSH q Declined
Credit Card Number q Approved
100 E. Kilgore Rd •fee
serVice Kalamazoo,
of $30. MI 49002-5584
Phone: (269) 343-9020 • Fax: (269) 343-7037 • Expiration Date Auth # Fee Init In Date Ctrl #
UKCdogs.com Ck #
Cardholder’s Name
Cardholder’s Signature
Billing Address with Postal Code