Date: ___   /__   _/__   _

I ____________________________(Buyer) agree to pay a non-refundable deposit

of $__________ to hold a _____________________________.

Deposit is only refundable if death or illness of the desired puppy occurs before the pick up date.  I also understand that the balance of the purchase price of the puppy is due when the puppy is picked up at approximately eight weeks of age.  

THE BALANCE OF THE PUPPY IS TO BE PAID IN CASH AT THE TIME OF PICK UP.  ALL DEPOSIT CHECKS ARE TO BE MADE OUT TO LUANN ROZEK

I, the Buyer, agree to the terms of said contract:

Name: _________________________                                    

Address: __________________________                               

Phone #: ___________________________                           _

E-Mail Address: ______________________                           _

Buyer’s Signature ________________________________      _

Seller: LuAnn Rozek   24 Whippoorwill Lane   Cedar Run, NJ 08092

Seller’s Signature _____________________________________

Sale Price: $____________  Deposit: $_____________  Due: $____________

Puppy Name or #: _______________________    Sex: