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Shiba Inu Rescue
S.O.S. Save Our Shibas
Refund Form


Date: ___________________

I, __________________________________________, release the Shiba Inu/Shiba mix, named_____________________________________________, back to the Shiba Inu Rescue, S.O.S. The above named dog was previously adopted by me, but the adoption was not satisfactory.

I understand that I will receive $____________, a refund of the original adoption fee for the above named dog.

Adopter Signature: ___________________________________________
S.O.S. Rescue signature: _______________________________________

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