Pet Litter Surrender Agreement

Your Full Name

First NameLast Name

Email Address

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Address (optional)

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Are you surrendering litter for a specific animal?

If yes, please specify the pet/animal (name, type, breed, etc.)

Type of Litter/Product Being Surrendered

Brand/Manufacturer (if known)

Condition of Litter/Product

Other (please describe)

Quantity (number of bags/boxes or total weight)

Reason for Surrender

Preferred Drop-Off Date and Time

Date

Hour MinutesAM/PM Option

Preferred Handoff Method

Other (please specify)

Notes or Special Handling Instructions

I acknowledge that I am voluntarily surrendering the above litter/product to the organization and confirm that the information provided is accurate to the best of my knowledge.