Americas` Lusitano Cup Prizelist2

OFFICIALS:
Judges:
Dr. Orpheu Ávila
Yves Manzanares
Nuno Santos Pereira
Veterinarian:
Dr. Wayne Crouch - 936-537-3400
Farrier:
Eric Johnson - 832-477-7074
Announcer:
Will Mitchell
Photographer:
Patricia Ernesto
Concessions:
Haras Restaurant and Haras Cafeteria located on grounds.
Show Manager:
Rob Moyar - 281-818-2321
Show Secretary:
Lauren Maloney - 936-577-1009
Mail entries to:
Haras Dos Cavaleiros
Attn: The Americas’ Lusitano Cup
26427 Peden Road
Magnolia, Texas 77355
(936) 577-1009
lauren@harasdc.us
Facility name:
Haras Hacienda
26427 Peden Road
Magnolia, Texas 77355
(281) 259-4861
info@harasdc.us
THE AMERICAS’ LUSITANO CUP
The Lusitano horse registrations in the United States of America are represented by
IALHA: The International Andalusian & Lusitano Horse Association; which also
maintains the oldest and largest registry of Andalusian horses in the world. Currently,
at this time in the USA there is no competition that highlights solely the Lusitano Breeds
specific characteristics and redeemeing qualities that are so lovingly bred for. This is
what has driven the idea to create a competition, The Americas’ Lusitano Cup, to promote
these beautiful horses. This year in 2016 the competition will be held at the home of Haras
Dos Cavaleiros at Haras Hacienda. The hope for the future is to move to Wellington, Florida
in 2017.
The Competition will be organized by IALHA in coordination with
Haras Dos Cavaleiros, admist the welcomed support of APSL.
Haras Cup proudly sponsors The Americas’ Lusitano Cup held
at Haras Hacienda, home of Haras Dos Cavaleiros, conveniently
located in Houston, Texas on October 8-9, 2016.
MODEL AND MOVEMENTS
COMPETITION REGULATIONS
The Championship is reserved for Lusitano Bred Horses that are registered with or in the
process of revision with the APSL Lusitano Studbook.
Any omissions from this regulation shall be decided by the President of the Jury.
It is the rider’s responsibility to review and be familiar with the contents of the Competition’s
rules, policies & procedures. In the event of an inquiry, USEF rules will prevail.
Horse show management reserves the privilege of substituting or changing judges and/or
officials if it becomes necessary. The judge’s decisions in the show ring are their own responsibility and horse show management accepts no responsibility for these decisions.
Every horse entered for competition will comply with the rules of horse show management, but
management will, in no case, be responsible for any loss or damage that may occur, and it
shall be condition of entry that each exhibitor/owner shall hold this horse show and the officials,
employees and agents of the show blameless for any loss or accident of any kind that may
occur while on the show premises.
The management reserves the right to refuse, accept conditionally, or to cancel any entries,
disqualify any riders or exhibitors, prohibit entries and cancel award prizes without claims for
damages. Additionally, management reserves the right to cancel or combine unfilled classes, to
reschedule classes after due notice to exhibitors, and to change rings or rotate judges.
Exhibitors are notified that any act of discourtesy or disobedience to the judges or officials, on
the part of owners, managers, riders, or grooms will not be tolerated. Each incident will be dealt
with on an individual basis.
No person will be allowed in the show ring during the time of judging except exhibitors and
those having official requested duties to perform.
It is the tradition of the show that riders be correctly attired for the class in question, that attendants be neatly dressed, and horses properly presented. Management may in its discretion bar
any person from entering the ring if not suitably presented to appear before an audience.
Minors who do not have a valid driver’s license which allows them to operate a motorized
vehicle in the state which they reside will not be permitted to operate a motorized vehicle of
any kind, including but not limited to, golf carts, motorcycles, scooters, or farm utility vehicles,
on the competition grounds. Minors who have a temporary license may operate the above
described motorized vehicles as long as they are accompanied by an adult with a valid driver’s
license. The parent(s), legal guardian(s), or individual who signs the entry blank as a parent or
guardian of a minor operating a motorized vehicle in violation of this rule is solely responsible
for any damages, claims, or losses or actions resulting from that operation.
CONCESSIONS
Haras Hacienda offers a concession stand, on-site restaurant and restrooms.
ARENA DIMENSIONS
Main Indoor Arena measures 175’ X 275’
Small Indoor Arena measures 216’ X 93’
Outdoor Arena measures 100’ X 230’
All arenas have European state-of-the-art footing with permanent irrigation system.
DOGS
All dogs must be keep on a leash or confined in a stall. Loose dogs will be impounded. Impounded dogs would be charged $100.00, which will be donated to the local humane society.
JUNIOR EXHIBTORS
Individual’s that have not reach their 18th birthday as of December 1st of the current competition
year. Junior’s under 14 years of age cannot show a stallion. JUNIORS EXHIBITORS MUST
WEAR APPROVED PROTECTIVE HEADGEAR (ASTM/SEI) AT ALL TIMES WHENEVER
MOUNTED ON THE SHOW GROUNDS. HARNESS MUST BE SECURED AND PROPERLY
FITTED. ANY RIDER VIOLATING THIS RULE AT ANY TIME WILL IMMEDIATELY BE PROHIBITED FROM FURTHER RIDING UNTIL SUCH HEADGEAR IS PROPERLY IN PLACE.
REGISTRATION
Entry forms for the competition must be completed, paid in full and in our offices by September
23, 2016. This is to allow proper approval process with IALHA and APSL.
Horses that reside in the U.S. or Canada must be current IALHA members in order to compete.
Please note the membership application process with IALHA must be completed before September 23, 2016 to allow for the completion of registration paperwork by IALHA.
Current coggins (12 months) must be submitted with entry form.
Proof of Equine Influenza Virus and Equine Herpes Virus (Rhinopneumonitis) vaccinations within six months prior to entering the show grounds. (per USEF rules)
DRUGS & MEDICATIONS
Current USEF rules relating to drugs & medications will be enforced.
A SHARPS DISPOSAL CONTAINER WILL BE AVAILABLE ON THE SHOW GROUNDS
FEES
Entry Fee:
Office Fee:
Stabling:
Tack Stall:
Shavings:
Hay:
Alfalafa:
$275.00 per class by listed closing date.
$35.00 per horse per entry
$210.00/ per week-Includes 3 bags of shavings
$210.00/per week (limited availability)
$10.00 per bag (NO OUTSIDE BEDDING ALLOWED)
$12.00
$30.00
All International horses that are not registered members of IALHA will be subject to a $50
non-member fee.
ADMISSION
Administrative Jury- IALHA will provide APSL with requested entries for competition and
required paperwork providing proof of registery. APSL will confirm eligibilty and inscription in
the APSL Lusitano Studbook. If this process is not completed in entirety the entry is not allowed
to compete.
All horses entered into competition, having received confirmation from APSL must be presented to the Admissions Jury between 12:00 pm and 6:00 pm, on October 7th in the assigned
arena to receive entry numbers and packets.
Any horses not inspected by the Administrative Jury and Admission Jury shall not be eligible to
compete.
Entries must fulfill the following criteria:
1) The capacity to be led in-hand, held in station and perform the three paces.
2) Proof of registration in the Birth Ledger of the APSL Lusitano Studbook.
3) Portuguese style riding attire and harness are recommended. However, if not
Portuguese horses must be harnessed in accordance with presenters attire.
4) Entries are prohibited from having assistants with a whip or switch, so that a
horses willingness to move forward and natural energy can be assessed. A
presenters assistant will be provided by the organizers as necessary.
CLASSIFICATION
Class entry classification will be the responsibility of the jury comprised of multiple breed
judges, assisted by the President of the Jury. In classes in which horses are from the Stud
Farm of one or several of the members of the jury, those jury members shall be replaced by
another judge.
1) In the individual classes with more than 10 horses, there will first be a qualification stage, in which at least one quarter of the horses present in the class
will be chosen on the basis of their Model and Movements and which will go
on to compete in the final.
2) In the final of the individual classes and in the assessment of group classes,
one quarter of the number of horses present at the initial classification, when
numbering more than sixteen, will be classified up to the fourth position.
3) Prizes shall be awarded to the owners of classified horses, with a certficate to
be presented to breeders.
4) Judges’ decisions are not subject to appeal unless they are in breach of any
conditions expressly set out in this Regulation.
5) In the event of an appeal, the appellant must indicate the regulatory disposition breached in addition to the time of occurence.
6) Appeals shall be submitted in writing to the President of the Jury, no later than
one hour from the public announcement of the results of the classification
together with a deposit of 200.00 USD, which shall be returned if a breach has been
committed.
PRIZES
Ribbons to 5th place for all classes.
1) Trophies shall be awarded to the winners of all classes. Gold and silver medals
awarded to horses who achieve classifications of “Excellent” or “Very Good”, respec
tively.
2) “Male Champion” or “Female Champion” titles shall be awarded to the best horse of
each sex, chosen from among the gold medal winners.
3) The “Champion of Champions” title shall be awarded to the best gold medal winning
horse and will receive an APSL trophy.
4) The title of “Champion Lusitano Horse Breeder” shall be awarded to the breeder that
achieves the highest point total, combining together classifications of the two best
horses in each individual class and the best of the group classes (3 mares, descen
dants of male and female horses), in compliance with the following point scheme:
Points to be awarded as follows:
First place
Second place
Third place
Fourth place
Fifth place and remaining places
6 points
4 points
3 points
2 points
1 point
Please note: 5 additional bonus points for each gold medal earned and 3 points for
each silver medal earned.
In the descendants of mare or stallion classes, the total number of points shall be
divided as follows:
A) Males- half of the number of points for the breeder of the competing horse and
remaining half will be equally divided between the breeder of each descendant.
B) Females- half of the number of points for the breeder of competing horse &
remaining half will be equally divided between breeder of each descendant.
C) Geldings are not eligible for championship awards or eligible to earn points.
Please note the following points will also be awarded:
Breeder of the Female Champion
Breeder of the Male Champion
Breeder of the Champion of Champions
5 points
5 points
5 points
5) “Champion Lusitano Horse Exhibitor” to the owner achieving the highest points total,
adding together the classifications of the two best horses in each individual class and
the best ot the group classes (3 mares, descendants of male and female horses), in
compliance with the points scheme mentioned above.
PRIZE MONEY
Male Champion
Female Champion
Champion of Champions
Champion Lusitano Horse Exhibitor
Champion Lusitano Horse Breeder
$2,500.00
$2,500.00
$5,000.00
$5,000.00
$10,000.00
OTHER
Assitance to horses falling ill during the periods of the event shall be provided by the veterinarian on site, unless the horse’s owner wishes to use a private clinic or withdraw from the competition.
A horse removed from the competition enclosure without the permission of the Championship
Commisioner and prior to the scheduled date (between the veterinary inspection and final
classification) shall be disqualified and shall forfeit its right to any classifications and prizes
which shall revert to the competitors classified to the following positions.
Horses qualifying for the finals must remain in the enclosure up to the end of the competition.
Please note horses will be required to be presented in a straight line not in a “triangle”.
In the mounted male horses classes (IV and V), the Admissions Jury will inspect for complete
morphological development of the genital organs.
CHAMPIONSHIPS
Overall Female Champion
Overall Male Champion
Champion of Champions
Champion Lusitano Horse Exhibitors
Champion Lusitano Horse Breeder
THE AMERICAS’ LUSITANO CUP ENTRY FORM
Owner:
Breeder:
IALHA #:
Handler:
APSL #:
Address:
Phone:
Email:
Horses Name:
Coggins #:
Please check the box next to the class that you wish to enter: $275.00 / Entry
Total $:
Class #
Class
Lusitano Fillies
1
2
3
Lusitano Mares
4
5
6
7
$
Lusitano Colts
8
9
10
11
$
$
Lusitano Stallions- 5 and older
12
$
Lusitano Geldings- 4 and older
13
$
Descendants of Stallion
14
$
Office Fee: $35 per entry
$
Stall Fee: $210/week (includes 3 bags of shavings)
$
Tack Stall Fee: $210/week (limited availability)
$
Shavings Fee: $10/ bag (no outside bedding allowed)
$
Coastal Hay: $12/bale
$
Alfalfa Hay: $30/bale
$
Total Amount Due:
$
Name of person receiving any earned prize money:
Owner/Owner Representative:
Make checks payable to: HDC Training, LLC
Date:
APSL & IALHA APPROVED:
1. Lusitano Fillies- 1 year old
2. Lusitano Fillies- 2 years old
3. Lusitano Fillies- 3 years old
4. Lusitano Mares- 4 years and older
- Mares must have had at least one registered lusitano foal
5. Lusitano Mares- Group of 3
- Mares must have had at least one foal
6.
Descendants of Mare
- 3 registered lusitano foals sired by at least 2 different stallions
7. Lusitano Mares Under Saddle- 4 years and older
8. Lusitano Colts- 1 year old
9. Lusitano Colts- 2 years old
10. Lusitano Colts- 3 years old
11. Lusitano Colts- 4 years old
- presented under saddle and in-hand
12. Lusitano Stallions- 5 years and older
- presented under saddle and in-hand
13. Lusitano Geldings- 4 years and older
- presented under saddle and in-hand
14. Descendants of Stallion
- 5 foals out of at least 3 different dams
STALL REQUEST FORM
Owner:
HORSE NAME:
SEX:
BREED:
Show
Horse
Stall
Tack
Stall
COLOR:
Total Shavings Other- Hay, Etc.
Lusitano Cup
Arrival Date:
Departure Date:
Notice: All requests for stabling must be made on this form in the notes section. All forms must be signed.
NOTES:
Email Contact:
Cell Phone #:
Signature:
Date:
All forms must be signed. Stalls are available on a first come first serve basis.
Please submit this form with horse show entry form. Please include payment with show entry.
HDC Training LLC
Attn: The Americas’ Lusitano Cup
26427 Peden Rd
Magnolia, TX 77355
lauren@harasdc.us
Tentative Schedule of Events
Friday
Entry Inspection with Admissions Jury:
12:00 noon - 6:00 pm
Competitor Welcome Party:
6:30 pm
Saturday
Competition Begins:
10:00 am
Class 1- Lusitano Fillies- 1 Year old
Class 2- Lusitano Fillies - 2 Years old
Class 3- Lusitano Fillies - 3 Years old
Class 4- Lusitano Mares - 4 Yrs and older
Class 5- Lusitano Mares - Group of 3
Class 7- Lusitano Mares - Under Saddle
Class 6- Descendants of Mare - Under Saddle
Lunch:
1:00 pm
Competition resumes:
2:00 pm
Class 8- Lusitano Colts- 1 Year old
Class 9- Lusitano Colts - 2 Years old
Class 10- Lusitano Colts- 3 Years old
Class 11- Lusitano Colts - 4 Yrs and older
Class 13- Lusitano Geldings- 4 Yrs and older
Class 14- Descendants of Stallion
Class 12- Lusitano Stallions- 5 Yrs and older
Sunday
LUSITANO BREED SEMINAR:
10:00 am
Lunch:
1:00 pm
Overall Female Champion
2:00 pm
Overall Male Champion
Champion of Champions
APSL Revisions
ENTRY AGREEMENT
By entering the below-identified show held on the premises of Haras Hacienda at 26427 Peden
Road, Magnolia, Texas, and adjoining properties, (the “Competition”) and signing this entry
blank as rider, owner, parent/guardian, on behalf of myself, my child, and my principals,
representatives, employees and agents, I agree that I am subject to the applicable rules
governing the Competition; including, but not limited to, those of USEF, USDF, WEIAUSA,
Houston Dressage Society, and/or GHCTA as well as all applicable local rules of competition
(collectively “the Rules”). I agree to be bound by the Rules and to the applicable codes of
conduct. I will accept as final the decision of the Competition officials on any question arising
under the Rules, and agree to release and hold harmless the Competition, its officials,
directors, employees, independent contractors, premises owners, agents and assigns for any
action taken under the Rules. I represent that I am eligible to enter and/or participate under
the Rules, and every horse I am entering is eligible as entered. I also agree that as a condition
of and in consideration of acceptance of entry, the Competition may use or assign
photographs, videos, audios, cable-casts, or other likenesses of me and my horse taken during
the course of the competition for the promotion, coverage or benefit of the Competition.
Those likenesses shall not be used to advertise a product and they may not be used in such a
way as to jeopardize amateur status. I hereby expressly and irrevocably waive and release
any rights in connection with such use, including any claim to compensation, invasion of
privacy, right of publicity, or misappropriation. The construction and application of the Rules
are governed by and construed in accordance with the laws of the State of Texas, and all
actions to enforce, dispute, or assert any claims under this agreement shall be brought in the
courts of the competent jurisdiction in Harris County, Texas.
RELEASE, ASSUMPTION OF RISK, WAIVER, AND INDEMNIFICATION
This document waives important legal rights. Read it carefully before signing.
I AGREE that in consideration for my participation in this Competition to the following:
I AGREE that I choose to participate voluntarily in the Competition with my horse, as a
rider, owner, or as parent or guardian of a junior exhibitor. I am fully aware and acknowledge
that horse sports and the Competition involve inherent dangerous risks of accident, loss, and
serious bodily injury including, but not limited to, broken bones, head injuries, trauma, pain,
suffering, or death (collectively “Harm”).
I AGREE to release USEF, USDF, WEIAUSA, Houston Dressage Society, and/or GHCTA, the
Competition, their officials, directors, employees, independent contractors, agents and
assigns from all claims for damages or otherwise for any harm to me, my child or my horse,
and for any harm caused by me, my child or my horse to others, even if the harm resulted,
directly or indirectly, from the negligence of the Competition.
I AGREE to expressly assume all risks of harm to me, my child or my horse, including
harm resulting from the negligence of the premises owners or the Competition.
I AGREE to indemnify (that is, to pay any losses, attorney fees, damages, or costs
incurred by) the Competition and to hold it harmless with respect to claims for harm to me,
my horse, and or my child, and for claims made by others for any harm caused by me, my
child or my horse at the Competition. I understand that I am entitled to wear protective
equipment without penalty, and that my child is required to wear protective equipment. If I
am a parent or guardian of a junior exhibitor, I consent to my child’s participation and AGREE
to assume all of the obligations of this Release on behalf of my child.
I AGREE that “Competition” as used herein includes all of the officials, officers,
directors, employees, independent contractors, premises owners, agents, personnel, and
volunteers of the Competition, as well as any affiliated organizations.
I AGREE that if I am injured at this Competition, the medical personnel treating my
injuries may provide information on my injury and treatment to Competition management. I
represent that I have the requisite training, coaching and abilities to safely compete in this
Competition.
BY SIGNING BELOW, I AGREE to be bound by all the Rules and all terms and provisions
of this entry blank.
Name of Competition: _________________________________________________________________
Rider Name: _________________________________________________________________________
Rider Signature: ________________________________________________
(Parent/Guardian if Rider is a minor)
Owner/Agent Name:__________________________________________________________________
Owner/Agent Signature: _______________________________________________________________
W-9
Request for Taxpayer
Identification Number and Certification
Form
(Rev. December 2014)
Department of the Treasury
Internal Revenue Service
Give Form to the
requester. Do not
send to the IRS.
Print or type
See Specific Instructions
on page 2.
1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank.
2 Business name/disregarded entity name, if different from above
3 Check appropriate box for federal tax classification; check only
one of the following seven boxes:
C Corporation
S Corporation
Partnership
Individual/sole proprietor or
single-member LLC
Limited liability company. Enter the tax classification (C=C corporation, S=S corporation,
P=partnership)
Trust/estate
Exemption from FATCA reporting
Note. For a single-member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for
the tax classification of the single-member owner.
Other (see instructions) 5 Address (number, street, and apt. or suite no.)
4 Exemptions (codes apply only to
certain entities, not individuals; see
instructions on page 3):
Exempt payee code (if any)
code (if any)
(Applies to accounts maintained outside the U.S.)
Requester’s name and address (optional)
6 City, state, and ZIP code
7 List account number(s) here (optional)
Part I
Taxpayer Identification Number (TIN)
Social security number
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid
backup withholding. For individuals, this is generally your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other
entities, it is your employer identification number (EIN). If you do not have a number, see
How to get a
TIN on page 3.
–
or
Employer identification number
Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for
guidelines on whose number to enter.
Part II
–
–
Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. I am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions.
You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup
withholding
because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply.
For mortgage
interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement
arrangement (IRA), and
generally, payments other than interest and dividends, you are not required to sign the certification, but you must
provide your correct TIN. See the
instructions on page 3.
Sign
Here
Signature of
U.S. person
Date
General Instructions
• Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T
(tuition)
Section references are to the Internal Revenue Code unless otherwise noted.
Future developments . Information about developments affecting Form W-9 (such
as legislation enacted after we release it) is at
www.irs.gov/fw9 .
Purpose of Form
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only if you are a U.S. person (including a resident alien), to
provide your correct TIN.
An individual or entity (Form W-9 requester) who is required to file an information
return with the IRS must obtain your correct taxpayer identification number (TIN)
which may be your social security number (SSN), individual taxpayer identification
number (ITIN), adoption taxpayer identification number (ATIN), or employer
identification number (EIN), to report on an information return the amount paid to
you, or other amount reportable on an information return. Examples of information
returns include, but are not limited to, the following:
If you do not return Form W-9 to the requester with a TIN, you might be subject
to backup withholding. See What is backup withholding? on page 2.
• Form 1099-INT (interest earned or paid)
3. Claim exemption from backup withholding if you are a U.S. exempt payee. If
applicable, you are also certifying that as a U.S. person, your allocable share of
any partnership income from a U.S. trade or business is not subject to the
withholding tax on foreign partners' share of effectively connected income, and
• Form 1099-DIV (dividends, including those from stocks or mutual funds)
• Form 1099-MISC (various types of income, prizes, awards, or gross proceeds)
• Form 1099-B (stock or mutual fund sales and certain other transactions by
brokers)
• Form 1099-S (proceeds from real estate transactions)
By signing the filled-out form, you:
1. Certify that the TIN you are giving is correct (or you are waiting for a number
to be issued),
2. Certify that you are not subject to backup withholding, or
4. Certify that FATCA code(s) entered on this form (if any) indicating that you are
exempt from the FATCA reporting, is correct. See
What is FATCA reporting? on
page 2 for further information.
• Form 1099-K (merchant card and third party network transactions)
Cat. No. 10231X
Form
W-9
(Rev. 12-2014)
Form
W-8BEN
Certificate of Foreign Status of Beneficial Owner for United
States Tax Withholding and Reporting (Individuals)
(Rev. February 2014)
a
Department of the Treasury
Internal Revenue Service
OMB No. 1545-1621
a For use by individuals. Entities must use Form W-8BEN-E.
Information about Form W-8BEN and its separate instructions is at www.irs.gov/formw8ben.
a Give this form to the withholding agent or payer. Do not send to the IRS.
Do NOT use this form if:
• You are NOT an individual
Instead, use Form:
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• You are a beneficial owner claiming that income is effectively connected with the conduct of trade or business within the U.S.
(other than personal services) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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. W-8ECI
• You are a U.S. citizen or other U.S. person, including a resident alien individual
• You are a beneficial owner who is receiving compensation for personal services performed in the United States .
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• A person acting as an intermediary
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Part I
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Name of individual who is the beneficial owner
3
Permanent residence address (street, apt. or suite no., or rural route). Do not use a P.O. box or in-care-of address.
2
Country
Mailing address (if different from above)
City or town, state or province. Include postal code where appropriate.
5
U.S. taxpayer identification number (SSN or ITIN), if required (see instructions)
7
Reference number(s) (see instructions)
Part II
10
. W-8IMY
Country of citizenship
City or town, state or province. Include postal code where appropriate.
9
8233 or W-4
.
Identification of Beneficial Owner (see instructions)
1
4
. W-9
8
Country
6
Foreign tax identifying number (see instructions)
Date of birth (MM-DD-YYYY) (see instructions)
Claim of Tax Treaty Benefits (for chapter 3 purposes only) (see instructions)
within the meaning of the income tax treaty
I certify that the beneficial owner is a resident of
between the United States and that country.
Special rates and conditions (if applicable—see instructions): The beneficial owner is claiming the provisions of Article
of the treaty identified on line 9 above to claim a
% rate of withholding on (specify type of income):
.
Explain the reasons the beneficial owner meets the terms of the treaty article:
Part III
Certification
Under penalties of perjury, I declare that I have examined the information on this form and to the best of my knowledge and belief it is true, correct, and complete. I further
certify under penalties of perjury that:
•
I am the individual that is the beneficial owner (or am authorized to sign for the individual that is the beneficial owner) of all the income to which this form relates or
am using this form to document myself as an individual that is an owner or account holder of a foreign financial institution,
•
The person named on line 1 of this form is not a U.S. person,
•
The income to which this form relates is:
(a) not effectively connected with the conduct of a trade or business in the United States,
(b) effectively connected but is not subject to tax under an applicable income tax treaty, or
(c) the partner’s share of a partnership's effectively connected income,
•
The person named on line 1 of this form is a resident of the treaty country listed on line 9 of the form (if any) within the meaning of the income tax treaty between
the United States and that country, and
•
For broker transactions or barter exchanges, the beneficial owner is an exempt foreign person as defined in the instructions.
Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the income of which I am the beneficial owner or
any withholding agent that can disburse or make payments of the income of which I am the beneficial owner. I agree that I will submit a new form within 30 days
if any certification made on this form becomes incorrect.
F
Sign Here
Signature of beneficial owner (or individual authorized to sign for beneficial owner)
Print name of signer
For Paperwork Reduction Act Notice, see separate instructions.
Date (MM-DD-YYYY)
Capacity in which acting (if form is not signed by beneficial owner)
Cat. No. 25047Z
Form
W-8BEN
(Rev. 2-2014)
APSL & IALHA APPROVED:
14000 Medical Complex Dr.
Tomball, TX 77375
Phone: (281) 516-0400
99.00/ night
Shuttles Available
www.ihg.com
14055 Park Dr.
Tomball, TX 77377
Phone: (832) 639-4900
109.00/ night
Shuttles Available
Meetings & Events
• Main Plaza (Capacity for 300-guest max.)
• Glass House (Capacity for 60-guest max.)
• Main indoor arena
• Outdoor area
• Mirror Room
• Media Room
®
L ocated in the equestrian heart of Texas forty minutes
Airport, HARAS HACIENDA provides you with the perfect
ambiance of a contemporary Hacienda offering a diversity of
areas that can be combined to suit your needs and taste.
HARAS HACIENDA is the ideal wedding venue for religious
events, and special occasions. Open and covered areas are
chapel, decks, lounges, large and small plazas and a state of
luxury and comfort that enriches any special occasion.
Weddings
• Haras hotel suite
• Parking
• Room set up
• Staff
The Venue
• Outdoor chapel
• Main indoor arena
• Main plaza
• Glass house
• Mirror room
• Media room
Hours of Operation
Email: info@harasdc.us
Thursday-Saturday: 11 am to 9 pm
Sundays: 11 am to 3 pm
Ph: (281) 259 4861 I (281) 305 1471
26427 Peden Road, Magnolia, TX 77355
harashacienda.com
Apettizers
• Haras Crab Cake - France
• Seared Foie Gras - France
• Baked Brie - France
• Haras Guacamole - Mexico
• And more
Soups and Salads
• Caesar Salad - Italy
• C aprese S alad - Italy
• Lobster Bisque - France
• Onion Soup - France
• Poblano Soup - Mexico
• And more
Haras Restaurant is a place for you to enjoy and delight
your taste buds. Located in the Magnolia area, our
wonderful restaurant can be found right next to the lovely
with a charming atmosphere. Treat yourself with our special
menu, for whatever reason you choose; join us for a
or any special ocassion.
Main Course
• B lackberry D uck - F rance
• Ahi Tuna - Hawaii
• C oconut S hrimp - C aribbean
• And more
Hours of Operation
Email: info@harasdc.us
Thursday-Saturday: 11 am to 9 pm
Sundays: 11 am to 3 pm
Ph: (281) 259 4861 I (281) 305 1471
26427 Peden Road, Magnolia, TX 77355
harasrestaurant.com
Laser & Aesthetics
•Hair Services
•Laser Services
•Colour
Facials
• Botox Tightening Facial
• HydraFacial MD
Body & Spa
• Massage Service
Haras Spa is a place for you to relax and treat yourself,
thing only: YOU.
can be found right next to the lovely Haras Hacienda. Haras
Spa is the perfect beauty retreat with a calming
atmosphere. Treat yourself with our pampering and
accessible services, for whatever reason you choose; join us
• Injectables
• Pca Peel
• Pelleve
• Swedish Massage
• Prenatal Massage
• Deep Tissue Massage
• Chinese Cupping
Contact us
Email: spa@harasdc.us
Thursday-Friday: 9 am to 5:30 pm
Saturdays: 10 am to 2:30 pm
Sundays: By special request
Ph: (281) 789 6071 I (281) 305 1729
26503 Peden Road, Magnolia, TX 77355
harasspa.com