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1.... OFFICE USE <br /> 011 <br /> Animal Type <br /> Date Received <br /> ORANGE COUNTY - <br /> WILD *ANIMAL REGISTRATION FORM <br /> Use Separate Form For Each Wild Animal Kept <br /> 1. Owner(s) N e: <br /> A. Owner( ) Address - (If on Rural Route, include Road Name) <br /> B. Owner(s) Home Telephone: <br /> C. Owners) Work Telephone: <br /> B. Descrie Owner(s) Qualifications to Care For Animal: (If Applicable) <br /> 2. Name of Persons) Responsible for Care of Animals: <br /> (If owner(s), write -SAME- and skip to item 3) <br /> A. Home Address of Person(s) Who Care for the Animal: <br /> (Include Rural Route Road Name) <br /> B. Home Telephone of Person(s) Who Care for the Animal: <br /> C. Work Telephone of Person(s) Who Care for the Animal: <br /> D. Describe Keeper(s) Qualifications to Care for Animal: <br /> 3. Type of Anigal (Be Specific - see examples below) : <br /> A. General description of Animal (Include mention of identifying markings, <br /> tatoosl other physical characteristics) : <br /> B. Age of Animal: <br /> C. Weight: <br /> D. Length:, <br /> E. Height: <br /> F. Sex: <br /> G. If convenient, attach small non-returnable picture of Animal.: <br /> 4, Location where Animal Kept: <br /> (If Rural route Include Road Name) <br /> A. Descri e caging used where animal kept: <br /> B. Is the Animal Ever Transported Away from Location Where Kept and Returned? <br /> Yes No _ <br /> C. Describe Transport Vehicle or Means and the Special Transport Equipment <br /> used, i. any: <br />