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I certify that the information provided on this form is true and correct, to the best of my knowledge. I am
also financially and physically able to care for this animal. I understand that proper food and veterinarian
care can be costly and I am able and willing to meet these requirements. Home checks are made on a
random basis following or prior to adoption. If upon inspection we find that the information contained in
this application to be false, we retain the right to deny your application and/or remove the animal from
your premises without a refund of monies paid.