Free 2002foalapp8.PDF - Indiana

Quarter Horse

State Form 50012 (R/12-01)

Foal Registration Application for Foals Prior To 2002 Foaling Year
Indiana Bred

For Office Use Only:

Type or print the following information. Incomplete or illegible applications will be returned!
Indiana Foaled
Name of Foal Foaling date Sire Dam's Sire Owner(s) of Foal Address of Owner(s) City Telephone Number(s) Home Fax Breeder of Foal
(Owner at Conception)

IHRC Reg. No.

(If unnamed, so state) Sex: Colt / Filly Dam Color

State

Zip Business

E-Mail Address

Breeder's Address City Breeder's Telephone Farm Address City State Zip State Name of Farm
(Where Foal was dropped)

Zip

Continued

It is understood that it is the sole responsiblity of the applicant to designate a name, address and a social security or federal I.D. number to be used when breeder awards are issued and that only one social security or federal I.D. number will be used. It is further understood and agreed that it is the designee's sole responsibility to distribute the breeder award to other owners or partners. Name of designated recipient of breeder award check Address where breeder award check should be mailed City Social Security or Federal I.D. number
(Only one SS# or Federal I.D. # can be used by IHRC)

State

Zip

I, represent that all information above is true and accurate and agree that registration of said foal may be revoked or denied for misstatement or omission in the foregoing application. Owner Signature Owner Printed Name Date

DEFINITION OF AN INDIANA BRED FOR FOALS PRIOR TO 2002:
An Indiana bred Quarter Horse foaled prior to the year 2002 will require that the breeder must be a resident of Indiana as noted on the American Quarter Horse Association (AQHA) certificate. These horses must be registered with the commission by September 1, 2002 or will not be eligible for the Indiana bred program. The horse must be registered with the commission prior to being entered in an Indiana bred conditioned race.

Continued

No Registration Fee Required

A COPY OF THE AQHA REGISTRATION CERTIFICATE, BOTH FRONT AND BACK, MUST ACCOMPANY THIS APPLICATION PLEASE DO NOT SEND ORIGINALS

This completed application must be on file at the office of the Indiana Horse Racing Commission (IHRC) before any awards can be made from the Breed Development Fund.

Mail or fax signed application to: Indiana Horse Racing Commission ISTA Center - Suite 530 150 West Market Street Indianapolis, IN 46204 Phone: (317) 233-0187 Fax: (317) 233-4470 Attention: Jacki Brown Quarter Horse Breed Development Director www.in.gov/ihrc [email protected]

INCOMPLETE APPLICATIONS WILL BE RETURNED! NO APPLICATIONS WILL BE ACCEPTED AFTER SEPTEMBER 2, 2002