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 DEPOSITS CHECKS ARE TO BE MADE OUT TO LUANN ROZEK

I agree to the terms of said contract.

Date Signed ___/___/___

Buyer’s Name: _________________________

Address: __________________________

__________________________

Buyer’s Phone # ____________________________

Buyer's E-Mail Address _______________________

Buyer’s Signature: _________________________________

Seller : LuAnn Rozek

24 Whippoorwill Lane

Cedar Run, NJ 08092

Seller’s Signature _____________________________________

Sale Price: $____________

Deposit $_____________

Amount Due $____________

Puppy Name or # _______________________
Sex ________________