International Miniature Horse & Pony Society www.imhps.com e-mail: [email protected] APPLICATION FOR HORSE / DONKEY PASSPORT o PASSPORT o EXPRESS PASSPORT ARE YOU AN IMHPS MEMBER YES / NO Please check current fees at www.imhps.com/fees.html and return form to the Registrar (Tick ü appropriate category) o International Miniature Horses not exceeding 34” (86.5cm) o Midi horses and ponies exceeding 34” (86.5cm) but not exceeding 42” (106.5cm) 100% pure-bred Falabella horses which will have to be registered with The Falabella Studbook (www.thefalabellastudbook.com) and be o subject to their regulations. IMHPS do not hold the official studbook for this breed and therefore the passport issued will be for an International Miniature Horse, but will have complete breeding records inserted from The Falabella Studbook. o Latin American blend horses of less than 100% Falabella bloodlines Passport will be issued as International Miniature Horse o American Miniature horses pure-bred o American Miniature horses part-bred IMHPS do not hold the official studbook for this breed and therefore the passport issued will be for an International Miniature Horse The following will be ID only passports; however breeding details, where available, will be provided in non-statutory pages at the back of the passport o Donkeys or mules not exceeding 36” (91.5cm) o Donkeys or mules exceeding 36” (91.5cm) o Horse or pony (any height) Name ……………………………………………………………………………………………………………………………..………. Registered Prefix ………………………………………………………..Date of foaling …………………………………………………….. Must be registered with British Central Prefix Registry (DD/MM/YYYY). Colour ………………………………………………………..Sex …………………………………………………….. Mare, gelding, stallion, colt, filly European Height ………………………………………………………..Worldwide Height ……………………………………………………….. Inches See over for instructions Centimetres See over for instructions Name of Sire ……………………………………………………………………….………… .. Reg No. ………………………….. Name of Paternal Grand Sire ……………………………………………………………………….………… .. Reg No. ………………………….. Name of Paternal Grand Dam …………………………………………………………………………………… Reg No. ………………………….. Name of Dam ……………………………………………………………………….………… .. Reg No. ………………………….. Name of Maternal Grand Sire …………………………………………………………………………………… Reg No. ………………………….. Name of Maternal Grand Dam ……………………………………………………………………….………… .. Reg No. ………………………….. Breeder’s Details Owner’s Details Name …………………………………………………………………Na….me ……………………………………………………………………. Address ……………………………………………………………………Address …………………………………………………………………… ………………………………………………………………… …. ……………………………………………………………………. …………………………………………………………………… …………………………………………………………………… ………………………………………………………………… …. ……………………………………………………………………. Post Code ……………………………………………………………………Post Code …………………………………………………………………… Telephone …………………………………………………………………Te….lephone ……………………………………………………………………. Email ……………………………………………………………………Email …………………………………………………………………… APPLICATIONS CANNOT BE PROCESSED WITHOUT DECLARATIONS ON THE NEXT PAGE BEING SIGNED AND COMPLETED MEASUREMENTS Worldwide: Measure your horse from the base of the last hair of the mane in centimetres. Make sure your horse is standing on level concrete with all feet square. European: Measure in inches from the withers to the ground. Please note that if passporting foals the estimated adult height must be completed by the vet on the silhouette form ------------------------------------------------------------------------------------------------------------------------------------------------------------------ Passports cannot be processed unless this Declaration and the Service Certificate are completed and signed DECLARATION I certify that I have completed the application form to the best of my knowledge and the details I have given are accurate in all respects. I confirm that I have read and understood the instructions and that the markings relate to the animal described on the application form. I also confirm that to the best of my knowledge this animal has not been registered with another society and has not been previously issued with a passport. I understand that my name and address will be printed into the passport at issue. The IMHPS respects the rights to privacy of all its clients and is registered under the Data Protection Act 1998. The IMHPS will need to use the information provided by you for its own internal administration but will not divulge any individual details to a third party without your consent. Under the terms of Article 28E of the Commission Implementing Regulation (EU) 2015/262 the IMHPS is legally required to share the information contained on the application form with the Central Equine Database. I confirm that I have read and understood the requirements of the service certificate. Your full legal responsibilities can be found at: http://www.imhps.com/legal.html Signature …………………………………………………………………….. Owner / Keeper / Representative of Owner Delete as applicable Print Name ………………………………………….…………………………. Date …………………………. ------------------------------------------------------------------------------------------------------------------------------------------------------------------ SERVICE CERTIFICATE This must be completed if person owning the dam was not the owner of the sire at the time of service. Non completion of this certificate will be taken as confirmation that the applicant owns both sire and dam. This does not apply to horses of unknown breeding I certify that my stallion (name) ………..…………………………………………………………………………….. Reg No. …………………………………. was bred by Natural Service/or Artificial Insemination* to the mare (name) …………………….………………………………….Reg No. … ……………………… on (date): ……………………………….at …………………………………………………………………………….……………………………..………(name of Stud) Name of owner of stallion or authorised agent ………………………………………………………………………….. Date …………………………………………… Signature of owner of stallion or authorised agent ………………………………………………………………………………………………………………………….. Address: ………………………………………………………………………………………………………………………………………………………………….……… ……………………………………………………………………………………………………………………………………………………………………………………. Post Code: …….…………………… Telephone number:: ………………………………………Email…………………………………………………………………… DESCRIPTION AND WHORLS NAME OF HORSE: ……………………………………………………………………....................................................………………….. MICROCHIP NUMBER: ……………………………………………………… Chip sticker: IMPORTANT - PLEASE ALSO CHECK VERY CAREFULLY FOR FREEZE / HOT BRANDS – These can be partially hidden so do a good search. If ANY brand is present – state number / details here ……………………………………………. The diagram and written description must agree and be sufficiently detailed to ensure the positive identification of the animal in the future. White markings must be shown in RED and the written description completed using BLACK INK in BLOCK CAPITALS or TYPESCRIPT. If there are no white markings, this fact must be stated in the written description. All head and neck whorls should be marked (‘X’) and described in detail. Other whorls should be similarly recorded. Acquired marks (‘V’) and other distinguishing marks should always be noted. The Veterinary Surgeon must indicate the location of the microchip on the silhouette with an ‘M’ symbol. COLOUR (ROBE) SEX (SEXE) DATE OF BIRTH ESTIMATED SIRE COLOUR DAM COLOUR (ANNEE) ADULT HEIGHT (ROBE DU PÈRE) (ROBE DE LA MÈRE) / / Description taken by: (Signalement relevé par): On (le): / / Head (Tete) Neck (Encolure) LEGS (JAMBES) Hoof Colour (Couleur de sabot) Left Fore (AG) Right Fore (AD) Left Hind (PG) Right Hind (PD) Body (Corps) Acquired Marks (Marques Acquises) DATE OF EXAMINATION I certify that the markings are a true representation of the equine presented and that I inserted a microchip into the equine / scanned and read a microchip previously inserted (delete as applicable) / / Was the foal on the mare at the time of examination? Signature and Stamp of Veterinary Surgeon Yes ….. No ….. (TICK ü) .