(Copy as needed) LETHAL WHITE OVERO - RED FACTOR - AGOUTI (/Black) - CREAM DILUTION SUBMISSION FORM Veterinary Genetics Laboratory, School of Veterinary Medicine, One Shields Avenue, University of California, Davis, CA 95616-8744 (530) 752-2211 FAX (530) 752-3556 http://www.vgl.ucdavis.edu/ Results will only be mailed, e-mailed and/or faxed to address provided below: NOTE: Multiple test prices effective for THIS request only! (Please print legibly or type) Check one or more tests Name: ( boxes) below: Fees for 1=$50; 2=$75; VGL Office Use Only Address: 3=$100; 4=$125 City, State: Lethal White Overo Zip Code: Red Factor Check # FAX(include area code): FAX Number Only Agouti (Bay/Black) Amount FAX Number Only Cream Dilution Date E-mail address for results:

I hereby certify that the described below by name and number is the horse from which the sample was taken. Printed name of person taking sample: Date sample taken: Signature of person taking sample:

HORSE SAMPLED ** see back for codes PARENTS OF HORSE SAMPLED Year Sire Registered Name of horse Registration # of Breed Sex Color and Name of horse Color Registration # Only one horse per form Birth ** (Circle) ** Dam **

Gelding

Instructions: Results: 1) Send 30-50 or hairs pulled with roots attached in #10 business size envelope. 1) All results are confidential. The Veterinary Genetics Laboratory will not 2) Label envelope clearly with the horse's name as indicated on the paperwork or provide results by phone and results will only be released to registration papers. person listed above. 3) Include a check for appropriate amount (see above) payable to U.C. Regents for the lab fee. 2) One copy will be mailed to the address in upper left corner. (Your veterinarian may charge an additional fee.) 3) Samples will not be tested until payment is received. 4) Non-U.S. checks must have "U.S. Dollars" or "USD" imprinted by a bank. 4) Results will also be e-mailed or faxed if information is provided above. 5) Samples from foreign countries MUST be accompanied by a current USDA import permit. 6) Visa/MasterCard can be used for payment by completing lower right box. Credit Card Information 7) Send package first class mail or via any two-day or next-day service to: Print customer name as it appears on card:

Veterinary Genetics Lab - Coat Color Testing Account: Expiration Date: One Shields Ave/Old Davis Road University of California Daytime Phone Number: ( ) VISA____ MC____ Davis, CA 95616-8744 USA Signature of Cardholder

These tests are Lethal White Over-Red Factor-Agouti-Cream Dilution 2003 performed under a license agreement for the PCR 4/18/2003 technology with Roche Molecular Systems, Inc. BREED CODES Code Breed Code Breed AN = Andalusian MS = Mexican AP = MU = AR = Arabian NF = Norwegian Fjord Horse AS = American Sport Horse NS = AT = Akhal Teke NT = North American AW = American OL = Oldenburg AZ = Azteca ON = BA = PF = BE = Belgian PI = Performance Horse Int'l BW = PN = Percheron CB = PP = Peruvian Paso CL = Clydesdale PT = Paint Horse CO = Connemara PW = Polish Warmblood CR = Criollo PZ = Przewalski CU = Curly QH = Quarter Horse DA = Danish Warmblood RH = DO = , Ass, Burro RL = Rheinland DW = RO = Russian Orloff EX = SA = Sillo Argentino FL = SB = FR = Friesian SF = Appalachian Singlefoot FT = SH = Shire FW = French Warmblood (Selle Francais) SP = HA = Half Andalusian ST = HF = Haflinger SW = Swedish Warmblood HH = SX = Shire Crossbred HN = Hanoverian TA = Tarpan HO = TB = HP = TC = Trocha IH = Irish Hunter TG = and Gallop IP = Iceland Pony TK = Trakehner IS = International Sport Horse TP = Trocha and Gallop KI = Kiang TW = KU = Kulan VW = Virginia Warmblood LI = Lipizzaner WF = Westfalen LU = Lusitano WH = MA = Mangalarga WP = Welsh Pony MB = Moroccan Barb XP = American Sport Pony MF = Moriesian XX = Crossbred (or no breed indicated) MH = ZA = MI = ZC = Chapman's MO = Mongolian Domestic Horse ZG = Grevy's Zebra MR = ZH = Hartmann's Zebra

COLOR CODES (Choose up to 3 letters) Code Color Code Color B = Bay W = White C = BN = Bay or Brown E = Cremello CD = Claybank or red dun G = Gray MD = Mouse dun or grulla I = R = K = Black D = Dun L = Liver or liver chestnut O = Overo N = Brown T = P = A = Appaloosa S = Sorrel Y = Smoky Black Adminxl\Breed 4/18/2003

TWO NEW TESTS NEW MULTIPLE COAT COLOR FEES EFFECTIVE APRIL 21, 2003

You may now submit one sample (30-50 pulled mane or tail hairs) from a horse for one, two, three or four of the following coat color tests to be completed at the same time

• Agouti (Bay/Black) - New • Cream Dilution - New • Lethal White Overo • Red Factor

Multiple Test Fees for: 1 test = $50.00 2 tests = $75.00 3 tests = $100.00 4 tests = $125.00

Note: Multiple test prices (for one horse) effective for original submission request only!

Download the new Sample Submission Form from our web site: www.vgl.ucdavis.edu

VGL test results are not public record. All VGL test results are confidential and considered the property of the person or registry that originally submitted the sample and paid for the test(s).