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