Service Animal Registry of America TM

not affiliated with any government agency

Service Animal Registration Form

Attach Service Animal Color Photo                   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 orders: Money orders only
PLUS: SHIPPING/HANDLING: $7.00 per order
TX residents add 6.75% sales tax


Disabled Handler Name:_______________________________________
Address:_____________________________________________________
City:__________________________State:_____________Zip:____________
Home Phone#:________________________Work#:____________________
Email:_________________________________________________________
Your Disability?:________________________________________________

 

Service Animal Information

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

Call Name:___________________________________________________
Date placed in service:_____________SARA# (renewal only)___________________
Trained Assistance Tasks:_________________________________________
________________________________________________________________
________________________________________________________________
 Trainer/Instructor Information      (If self, use your name)

Name:__________________________________________________________
Address:_________________City:____________ State:_____Zip_________
 

I/we hereby attest that the handler has a qualified disability under the Americans with Disabilities Act; and the above named animal's primary function is as a service animal for the benefit of its disabled handler, and that the animal is qualified by training, is well behaved in public, and is under the safe control of its handler while working. I/we declare under penalty of perjury that the foregoing is true and correct.

______________________________________Handler Signature    Date:_________
______________________________________Witness Signature     Date:_________
Witness printed name:__________________________Ph#:____________________    

Office Use Only

Denied________        Approved___________ SARA#__________________ Date Issued:_____________ 

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