application - Iberian Warmblood Registry International
Transcription
application - Iberian Warmblood Registry International
For PC User Only: For a better viewing and fill in form feature experience. The IWRI recommends you download the FREE PDF reader, Nitro Reader www.nitroreader.com Best viewed in IE or Goggle Chrome browser. If you choose to submit your application & required documents by email, for clairty and markings use, all documents must be scanned on flat bed scanner and save in PDF format. No camera photos will be accepted! To insure faster results, please be aware most correspondence from IWRI is done through email. This will include DNA Hair kits, and any application information needed. Please make sure you add our email address to your address book registry@iberianwarmblood.com Thank you! FOR OFFICE USE Date Received: ____ /____ /_____ Amount Paid: $ ______________ Check No: __________________ Iberian Coefficient:_____________ Registration No: ______________ Date Issued: ____ / ____ / _____ IBERIAN WARMBLOOD REGISTRY INTERNATIONAL P.O. Box 460, Sturgis, South Dakota 57785 (605-342-2322) Registry@iberianwarmblood.com / www.IberianWarmblood.com REGISTRATION APPLICATION REGISTRY IS NOT RESPONSIBLE FOR ERRORS DUE TO ILLEGIBLE WRITING 1) REGISTRATION OF HORSE: NAME REQUESTD: SEX: Limit 20 total spaces MARE STALLION GELDING DNA NO: DATE FOALED : ____/____/____ M D Y DATE CASTRATED ____/____/____ M D Y LAB NAME: COLOR: MICROCHIP NO: MARKINGS & LOCATION: APPLICANTES SIGNATURE(S): DATE: ____/____/____ M D Y Applicants certify that all information submitted is correct and agree that the Registry has the privilege to correct and/or cancel the registration certificate for cause under it’s rules and regulations. The Registry is not responsible for the accuracy of statements on the application form. Any horse registered or transferred through misrepresentation and its descendants shall be deleted from the Registry and fines may be imposed. 2) OWNER OF DAM AT FOALING: Is owner of foal at time of foaling. To transfer fill in section 5) below NAME: FARM: ADDRESS: CITY: STATE/PROV: PHONE NO: ( ZIP CODE: ) COUNTRY: EMAIL: OWNERS SIGNATURE(S): DATE: ____/____/____ M D Y 3) BREEDERS CERTIFICATE: Mare owner certifies having owned / leased this mare at the time she was serviced by the stallion named below. If leased provide copy of lease agreement A FRONT & BACK of her registration papers must be enclosed with this application MARE NAME: BREED R EGISTRY: REGISTRY NO: DNA NO: OWNER/LEASSE: FARM: ADDRESS: ZIP CODE: XXX LAB NAME: CITY: PHONE NO: ( ) STATE/PROV: EMAIL: MARE OWNERS SIGNATURE(S): DATE: ____/____/____ M D Y 3) BREEDERS CERTIFICATE: Stallion owner certifies having owned/ leased this stallion at the time he serviced the above mare as indicated below. If leased provide copy of lease agreement. A FRONT & BACK of his registration papers must be enclosed with this application STALLIONS NAME: BR EED REGISTRY: REGISTRY NO: DNA NO: OWNER/LEASSE: FARM: ADDRESS: ZIP CODE: LAB NAME: CITY: PHONE NO: ( DATE LAST BRED: ____/____/____ M D Y METHOD: ) STATE/PROV: EMAIL: NATURAL COVER AI EMBRO TRANSFER TRANSPORTED SEMEN M D Y DATE: ____/____/____ STALLION OWNERS SIGNATURE(S): ( PAGE ONE OF THREE ) 5) TRANSFER REPORT: I / We hereby transfer ownership of the horse being registered to the following new owner(s) (leave blank if horse has not been sold) BUYERS NAME(S): FARM: ADDRESS: CITY: STATE/PROV: PHONE NO: ( ZIP CODE: ) CO UNTRY: EMAIL: DATE OF SALE: ____/____/____ M D Y BUYERS SIGNATURE(S): DATE: ____/____/____ M D Y SELLERS SIGNATURE(S): DATE: ____/____/____ M D Y 6) Drawing/Marking: Draw in only white markings. See website for additional help. All wording go in Section 1) only. Draw white markings Mark whorls with “X” Mark scars with “Z” FRONT VIEW FORE HIND HIND VIEW FORE RIGHT VIEW HIND HIND LEFT VIEW FORE FORE HIND Draw all white marking on head, legs and body. Do not draw in black points on Bay/Grey If no markings are shown here, you must write none on Page 1 Section 1). Mark all scars, and whorl (A whorl is hair growing outward from a central point). Draw all brands and where they appear. Do not write in this section. All writing is to be done in Section 1). The Marking/ Drawing will be scanned and inserted on to the certificate. If you need additional assistance, see our website www.IberianWarmblood.com ( PAGE TWO OF THREE) DOCUMENTATION NEEDED: The horse being registered with the IWRI must verify carrying a minimum of 25% Andalusian and/or Lusitano bloodlines from one or both parents. This application form must be completed and signed.If signatures from original breeders are not available, application must be accompanied with a signed ‘Bill of Sale’ identifying parentage and legal owner OR a copy of registration papers from a recognized registry. Include a clear copy (Front AND Back) of the Andalusian sire and dam’s registration papers, as is applicable. PEDIGREE OF NON-ANDALUSIAN PARENT: In order to appear on the IWRI certificate a Front AND Back copy MUST accompany this application. Registry Certificates must have matching horses name, number and owner listed on it. FEES: (U.S.D.) must accompany application. See website for current fees . We also accept credit card payments online only. RESTRICTIONS: Breeding stock with bloodlines having historically defective genetic carriers will be required DNA testing to rule out specific genetic defects. CHECK LIST All sections are completed All necessary Signatures are in place The Markings/Drawing has been filled in You have included a copy of both parents papers Both parents are registered with the IWRI FEES PAID Registration Fee Transfer Fee DNA Hair Kit Fee Qty_____ WRITE HERE TOTAL FEES ENCLOSED (US FUNDS ONLY) PAYMENT MO/Check # _________ Online PayPal. Date__________ Amount $________ Date _______________ $30.00 Additional charge for NSF/Canceled checks OFFICE ONLY