Your best friend deserves our best protection.

identibase® premiumOne-off payment for the

lifetime of your pet

£20.95We offer a choice of three service packages. With all three, your pet’s details will be securely stored on our database for their entire lifetime, but we always recommend identibase® premium. Our most advanced microchip database service is proven to �double�the�chance�of�finding�your�pet,�should�they�go�missing.*

To join visit identibase.co.uk or call us on 01904 487600 at the heart of pet protection

• One-off payment of £15.95 for the lifetime of your pet

• Free updates to your details at any time

• Addition of holiday address

identibase® plan• Details securely stored for the lifetime of your pet

*identibase® data for lost pets from 22/11/2011 to 03/04/2019.

identibase packages are non-transferable between pets and keepers.

Fees are per pet. Prices subject to change.

Choose your service package

identibase® premium• One-off payment of £20.95 for the lifetime of your pet

• Free updates to your details at any time

• Includes identifind®, which means we’ll use all our tools

to�help����find�your�pet,�should�they�go�missing.�Call�our�

24/7 helpline and we’ll alert local vets, rescue centres,

charities and wardens in your area. We’ll even create ‘lost’

posters for you to display locally

• Addition of holiday address

identibase® plus

Register your identibase®

account by postOr register online at www.identibase.co.uk/registration

AFFIX BARCODE HERE

Registering online is easy and is the quickest way to register your pet. It means identibase® can help yoube reunited with your pet straightaway.

Or write microchip number here:

Vet code:

PLEASE COMPLETE IN BLACK INK AND IN BLOCK CAPITALS

Signed:

Date: D D M M Y Y Y Y

Choose Membership OptionSee overleaf for details

identibase® premium £20.95Lost pets on identibase are twice as likely to be found with identibase premium.*

identibase® plus £15.95

identibase® plan £0.00

Enter payment details below

(Future amends to your details will incur a service & administration fee)

DeclarationI confirm that I am 18 years old or over and that the information given in this form is complete and accurate to the best of my knowledge and belief. Amends to your details after 28 days will incur a service and administration fee, unless you join identibase premium or identibase plus during registration. By completing the registration you are entering a contract with identibase. I understand that this information will be retained by identibase and agree that it may be disclosed to a verified source involved in securing the welfare of the microchipped pet. Your personal data will be used to administer the identibase pet identification scheme including related services and may be disclosed to anyone involved in securing the welfare of your pet. Full details on how we use and store personal information is set out in the privacy policy on our website www.identibase.co.uk/privacy and we recommend that you read this. From time to time, identibase and our partners would like to send you pet healthcare information and exclusive products or services. You can easily opt out later by contacting identibase or our partners when you receive marketing communications.

I’d like to hear about your latest offers, pet healthcare information and products or services via: Email SMS Post Telephone

I’d like to receive information and offers from identibase partners, e.g. 4 weeks free pet insurance from Petplan

Email SMS Post Telephone

Your DetailsTitle:

First Name:

Surname:

House No / Name:

Address Line 1:

Address Line 2:

Town / City:

County:

Postcode:

Country:

Primary Phone:

Secondary Phone:

Other Phone:

Email:

Please complete all sectionsand post this form to:identibase, PO Box 33, York, YO19 5YWOr register online at www.identibase.co.uk/registration

Pet Name:

Breed:

Sex: M / F

Neutered: Y / N

Your Pet Details

Species:

Payment DetailsType: Visa / MasterCard / Maestro

Print Name:

M M Y Y

Credit/debit card payment

Date:

Signed:

D D Y YM Y YM

Date of Birth: Y YM Y YM

Conditions (e.g. Epilepsy, diabetes, etc):

Colours & Markings:

D D Y YM Y YMImplant Date:

Number:

Expiry Date:

CVV No: (The last 3 digits on the back of the card.)

If you are unable to provide credit/debit card payment then please make a cheque or postal order made payable to identibase®