Owner Contact Information

 *

Owner Contact Information

Owner Name	Address	City
State	Zip	Day Time Phoneext.
Evening Phoneext.	Cell Phoneext.	Email Address

Type of Animal 

Type of Animal

Dog

Cat

Other

 

Date Lost

Location Animal was Lost

 

Animal Name

Age

Breed

Color

Gender

Gender

Male

Female

Spayed / Neutered

Spayed / Neutered

Yes

No

Size

Size

Small

Medium

Large

Coat

Coat

Long

Short

Curly

Wire

Tail

Tail

Short

Long

Bushy

Sleek

Ears

Ears

Erect

Droopy

Disposition

Disposition

Shy

Aggressive

Will Respond to Name

Collar

Collar

None

Leather

Nylon

Chain

Color of Collar

Color of Collar

License #

License #

Town

Town

Other ID

Other ID

Microchipped

Microchipped

Yes

No

Microchip Company Contact Number

Microchip Company Contact Number

Other Comments

Other Comments

If you have a picture of your lost animal please send to to lostanimal@farmington-ct.org with the pet name in the subjest line.

FPD Case # (if applicable)

FPD Case # (if applicable)

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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