Application for Foal Registration

SIRE/DAM INFORMATION

Application for registration of the 20_ _ foal of the following dam and sire.

Name of dam of foal Registration number

Name of sire of foal Registration number

Color (Check one) Sex (Check one) o Bay o Brown o Chestnut o Black o Grey o Roan o Pinto o White o Filly o o o Ridgling

Foaling date Where foaled Month/Day Year City State or Province

o Check if foal is a twin o Check if from embryo transfer

NAME CHOICES

o Leave as unnamed (I understand that the foal must be named by Dec. 31st of its year to avoid further charges.) You can submit up to three (3) name choices at the time of application. Names are limited to four (4) separate words and 18 characters (including Print FIRST name choice - include spaces between words spaces, apostrophes and hyphens). Names of that have been raced or bred in the last 15 years or those of horses that are outstanding or have had Print SECOND name choice - include spaces between words honors bestowed upon them will not be approved. More complete naming guidelines are available at: members.ustrotting.com/registration.cfm Print THIRD name choice - include spaces between words

MATING CERTIFICATE The mating certificate will be released by the owner, either electronically or mailed to you or directly to the USTA, once you have paid the stud fee. This must be completed within the time frames listed on the back of this form to get the appropriate pricing and to complete your foal registration.

OWNERSHIP TRANSFER (optional)

SIGNATURE OF If foal is to be transferred (no additional fee) all current owners of the foal (the owners of the at the time of foaling) must sign below. If the seller is a registered farm, stable or corporation, a signature from the corresponding ALL SELLERS: officer is required.

1. 2. 3. 4. Buyer Information: 1. Name: Member No: 3. Name: Member No:

2. Name: Member No: 4. Name: Member No:

COMPLETE DATE OF SALE: Month Day Year

APPLICATION CONTINUED ON OTHER SIDE REG4 2/18 MARKINGS

Left Side Right Side

L R R L R L L R Front Legs Hind Legs Head Markings Hind Legs Front Legs

Key: 1. Coronet REAR FRONT 2. Pastern VIEW VIEW 3. Ankle

–3– –3– –3– –3– –2– –2– –2– –2– –1– –1– –1– –1– L R L R R L R L Hind Legs Front Legs Front Legs Hind Legs

If has no white markings, check this box o Head ______Left front leg ______Right front leg ______Left hind leg______Right hind leg______Scars and brands ______

REGISTRATION PAPERS AND FEES This application, the mating certificate and fee must be received by the USTA Hard Copy Registration Papers - $10 according to the timeframe below to get the appropriate pricing: By holding the registration certificate electronically, only an Application for Trans- As sucklings (within 4 months of foaling date) $150 fer will be needed to complete a future sale. As weanlings (between 4 months and 12/31 of year foaled) $185 ____ I do not want my registration certificate held electronically and understand Yearlings (after December 31 of year foaled) $450 that there is a $10 processing/shipping fee. The Certificate will be mailed to the first listed owner of the foal once they have been named, microchipped and DNA- tested. PAYMENT INFORMATION Registration Fee $ ______Submitted by: ______Hard Copy Registration Papers Fee (optional) $ ______Phone No.: ______TOTAL ENCLOSED $ ______Please do not send cash. For U.S.: Pay by check, money order or credit card in U.S. funds only. Outside U.S.: Payment is by credit card only. Payment Method: o Check o Money order o Visa/MasterCard Name as appears on card: ______Complete only if paying by credit card: CVV Code

Expiration date: _____/_____ Signature: ______

U.S. Trotting Association Phone (toll free U.S. & Canada): 877.800.USTA (8782) 6130 S. Sunbury Rd., Westerville, OH 43081-9309 Phone: 614.224.2291 l [email protected] www.ustrotting.com Fax (toll free U.S. & Canada): 844.229.1338 REG4 2/18