Cremation Declaration at Pune Pet Park

1

Are you a member of Pune Pet Park* This field is required.(Typing Yes would mean that the deceased Pet is a paid member of the Park)

YESNO

2

Please enter your membership Code* This field is required.Please enter a valid 10 digit code

3

Name* This field is required.Please enter the Pet Owners Name Here

First Name

Last Name

4

E-mail* This field is required.

Please enter a valid email address

5

Mobile Number* This field is required.Please enter a valid 10 digit Mobile Number preferably which has Whatsapp services on it

Mobile Numbers 10 digits only (Whatsapp Number Please)

6

Address* This field is required.

Street Address

Street Address Line 2

City

State

Zip Code

Country

7

Pet Owner Identity Proof* This field is required.Pleae give a valid Identity Proof with Address

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

8

Pet Name* This field is required.Please enter the name of your deceased Pet

(Please enter Name of Your Dog)

9

Breed or Kind of Species* This field is required.Please select from the dropdown or type Other and mention the species/breed

10

If other Breed/Species please specify* This field is required.Please mention other Breed if you have selected Other" Option

11

Age of Pet* This field is required.If age of Pet is 1 Year please type 01

Approximate age of Dog

12

Local Vet Name* This field is required.Please give your Local Vets Name who has last seen your Dog if there is no vet Please repeat your name here.

Please type the name of your Vet

13

Vet Phone Number* This field is required.Please provide a valid 10 digit Mobile Number

Mobile number of the Vet (10 Digits only)

15

Date of Cremation* This field is required.Please enter the time you think you will be able to reach our place to cremate the body.

Date

Hour

Minutes

16

Do you need a vehcile to transport the Body to the Crematorium* This field is required.A Flat Charge of Rs 2000 would apply for distance of 40Km return to the Park. (Click No if you are transporting the Dog yourself)

YES.NO

17

Please specify the time you need the transport to be at your premises* This field is required.(Please leave a buffer of 30 minutes plus minus from the time requested.)

Hour

Minutes

18

Disposal of Ashes Post Cremation* This field is required.If you WIsh to take away please bring along a"Kalas" (Mud Urn) after 24 hours of the Cremation.

Take away for Completing a Ritual.Dispose at Pune Pet Park for Plants

19

Mode of PaymentPlease note Form will be considered incomplete if payment has not been received.

Pay Online via Debit or Credit Card

Pay by Google Pay - 7263900195

20

A payment of Rs 2500/- will be requested on submission of the form, Please ensure that the payment is complete and a confirmation sent to our WhatsApp number 7263900195. (Not applicable for members of Pune Pet Park)

If you do have a problem paying online please send us a message reconfirming the cremation and mention your mode of payment.

21

Name* This field is required.I the undersigned have submitted the above information without any coercion and request that cremation services be provided. Information provided herein is true to the best of my knowledge.

Please Print your name

22

Date* This field is required.This field is not to be filled in will be automatically picked up by the system.

Date

Hour

Minutes