Service Animal Registry of America TM

not affiliated with any government agency

Service Animal IN TRAINING Registration Form

Attach Service Animal Color Photo (No copies/printouts) Print and mail to:
Checks, money orders accepted

SARA PO Box 607 Midlothian, TX. 76065 VoiceMail: (206) 376-8931 Email: saraorg@aol.com www.affluent.net/sara

Fees: Certification/Registration: $40. Duplicate Certificate: $15. Additional Photo ID Card $15. RUSH SERVICE $20. (10 business day turnaround) Rush: Money orders only PLUS: SHIPPING/HANDLING: $7.00 per order TX residents add 6.75% sales tax

Handler Name:_______________________________________
Address:_____________________________________________________
City:__________________________State:_____________Zip:____________
Home Phone#:________________________Work#:____________________
Email:_________________________________________________________
Handler Disabled?: YES NO

Service Animal Information

Species:_________________________________________________________
Breed:__________________________________________________________
Sex:__________________Age/DOB:________________Color:__________

Call Name:___________________________________________________
Date placed in service training:____________SARA# (renewal only)_________
Tasks to be trained(specialized):___________________________________
________________________________________________________________________________________________________________________________

I hereby attest that the above named animal's primary function is expected to be a service animal for the benefit of a disabled handler, and that the animal is being trained for this specific specialized purpose, and that the animal has been previously socialized and has received basic control training, and is safe and well behaved in public, and is under the safe control of its trainer/handler while working. I declare under penalty of perjury that the foregoing is true and correct.

_____________________________________Handler’s Signature    Date:________

Office Use Only

Denied________        Approved___________ SARA#__________________ Date Issued:_____________