Litter Notification

Breeder Name *

State Issued Source Number

Email Address *

Breeder Phone Number *

Certificate of Service (upload here)

Date Born *

Number Pups in Litter *

Number of Male Pups *

Number of Female Pups *

Dam Name *

Dam MRR Registration Number

Sire Name *

Sire MRR Registration Number

Outcross *

Curly Coated Retriever

Irish Water Spaniel

Other

No Outcross

Other Outcross (please specify)

Consent (tick applicable) *

I consent to having this litter listed on the website

I will complete the Puppy Transfers when all puppies have homes

I will advise Puppy Owners that their details will be passed on to the MRRA

Declarations (tick applicable) *

The bitch was over 12 months old at time of mating

The bitch has not had a litter in the last 12 months

Neither the Dam nor Sire have a genetic defect precluding breeding

DNA Health Testing has been completed on the Dam and Sire

This litter was the result of an accidental mating

This litter was the result of an outcross

I declare that the details on the form are true and correct *

Yes

No

Name of person completing this form *

Submit litter notification