PRE-SHOOT FITNESS CERTIFICATE – PART-A

PROFORMA

I, Dr. ________________________, VCI Regn. No. ___________________ have personally examined today_____________ at _______________, the animals/birds of following description to be used for shooting in the Film M/s. ________________________________________________ .

S. No.

Species

Number

Breed

Sex

Age

Colour / Markings

2. The animals / birds are owned by Shri. _______________________________.

3. It is certified that the animals/birds mentioned above are in a state of good health, free from infectious or contagious diseases and are fit to perform in the film shooting.

Place : Signature of the Veterinarian :

Date : Name & Address of the Veterinarian:

Seal :

OWNERSHIP CERTIFICATE

Certified that the animals described in this Certificate belong to me and that I have permitted the use of the animals in the film (title) ---------------------------------------------------- produced/directed by -----------------------------------

I have registered the performing animal earlier (Registration Number ________)/ applied for registration.

Station Signature

Name

Date Address