(PLEASE USE INK) APPLICATION FOR REGISTRATION Form 1-13-18 PERCHERON HORSE ASSOCIATION OF AMERICA | P.O. Box 141, Fredericktown, Ohio 43019 | [email protected] | 740-694-3602 [ ] Stallion 1. I hereby enter the Percheron [ ] Mare Named __________________________________________________ [ ] Gelding, Date gelded __________ ( ) Eligible to Register -Fee $150.00 Contact office for rules regarding Eligible to register. 2. for registry in the Percheron Stud Book of America No. ______________ Foaled ____________________________________________ D o N o t W r i t e I n T h i s S p a c e Give Month, Day and Year, foal was born 3. Color __________ Describe all white markings and include on drawing below or provide photographs. [ ] No White Markings. 4. Description ___________________________________________________________________________________________________ _______________________________________________________________________________________________________________ 5. Bred by ____________________________________ Address ___________________________________________________________ Owner of Dam at time of service 6. Present owner of dam _______________________________ Address _____________________________________________________ 7. Sire ___________________________________# ___________ Dam ________________________________________# ____________ I have read the rules and regulations as printed on this blank, and accompanying instruction sheet. I certify that the foregoing statements contained in this application are true and correct, and each of them is made in accordance with the By-laws of this Association for the purpose of obtaining registry of the animal named on line No. 1, and to induce the Association to issue a certificate of pedigree thereon. I understand that any member who willfully makes out a false application with intent to defraud and who purposely fails to truthfully and completely set forth the information required by the By-laws, shall be automatically suspended from membership in the Association and subject to such penalty as is provided by the By-laws, and that any non-member who willfully makes any misrepresentations in making out an application for registration shall be subject to a heavy fine or the extreme penalty of being forever barred from doing further business with thisAssociation. 8. Date_____________ Signature of owner at foaling ____________________________________ Phone ______ ______ ___________ 9. Address _________________________________________________ e-mail _______________________________________________ I, the undersigned, hereby certify, for the purpose of obtaining registry of the animal named on line No. 1, that I owned the above named sire at the time he served the above named dam for the production of the foal named on this application for registration. 10. Service was [ ] Natural Breeding [ ] Artificial, on Farm [ ] Shipped Semen [ ] Embryo Transplant 11. Breeding date(s) ______________________ Signature of sire owner __________________________________________ If the above named dam has been transferred after service, and service has been certified on the transfer, the stallion owner's signature is not required. Warning about mailing false pedigrees or transfers. The sending of a fraudulent application for registration, a fraudulent transfer, or fraudulent certificate of pedigree through the U.S. Mail, with the intent to defraud, is a federal offense, subject to prosecution by the U.S. Government, and punishable by a "fine of not more than one thousand dollars ($1,000.00) or imprisonment of not more than five years, or both. Registration Fees, Return to: Percheron Horse Association of America Stallion/Gelding, Members $25* P.O. Box 141 Females, Members $75* Fredericktown, OH 43019 Phone: 740-694-3602 E-mail: [email protected] The above minimum fee is good for the Fax: 740-694-3604 balance of the year of foaling and up until June 1st. of the following year. After that If paying by credit card, please include the credit June 1st. and every June 1st. thereafter, add card authorization form. an additional $50. Now accepting PHOTOS in place of drawings! Please e-mail, [email protected], a minimum of three photos, *Non-members add $30 to the member rate. including but not limited to, left side, right side and full front view. Please include photos of any distinguishable markings. White in forehead above line A White in face between line A and B is a "strip", and should be fully described is a star, and should be described as Right Left as long, wide or narrow. White or flesh colored spot below line B, is a "snip", large, small, wide, prolonged, etc. and should be so described. Similar marks on upper and lower lips should be specified as "spot on upper (or lower) lip". C Indicates the hoof. D Indicates the fetlock joint. Right Side E Indicates the pastern. Left Side Put all white Right Left markings on these drawings Right Right Lower Lip Left Left Instructions For Completing Application For Registration Fill the application out neatly, In Ink, No Pencil. Print or type everything except the signatures. When filling in the drawing and descriptions, go directly to the animal and examine it carefully for white markings. The animal's feet and legs must be washed and every white marking listed, no matter how small, even on grey animals. Give all dates complete, Day, Month, and Year. Give all addresses complete, including street, rural route, box number, etc., city, state and zip code. Line 1 Sex - Give the sex as: Mare, Stallion or Gelding, if gelded, we need the date the animal was gelded. Line 1 Name - Do Not Use Another Breeder's Registered Name. If you use a registered name anywhere in the name of your horse, we must simply remove that part of the name which is registered. Line 2 Foaling Date - Give month, day and year which the foal to be registered was born. Line 3 Color - Check the color carefully, especially when a horse may be grey. Black horses do not turn grey, but grey horses nearly always appear black at birth. Grey horses usually have at least a few white hairs above the eyes or in the forehead. Grey horses should be registered as grey, whether they have one white hair or are completely white with age. When a horse is registered incorrectly, in color or description, the pedigree must be rewritten to correct the error. The applicant for registration is responsible for the rewriting fee, regardless of the age or current ownership of the horse. Line 4 Description - List all white markings on line 4, as instructed on the application. You must wash all four feet and list all white markings, no matter how small. These markings must be also designated by filling in solid with ink, all white areas on the drawings. White on feet must be shown on both inside and outside if it is there, complete both drawings. Left and Right - In describing the horse always designate the horse's left and right side, not your left and right when facing the horse, see drawing. Line 5 Bred By - The breeder is the owner of dam at the time of service for the production of the foal being registered. Give complete address of the breeder if you know it. Line 6 Present owner of Dam - The person who owns the dam when you are applying for registration of the foal. Line 7 Sire and Dam - Give the full name and registration number of both the sire and dam. Always use the American registration number, if American registered. Sire must have DNA markers on file with Percheron Horse Association of America. Line 8 Date - This is the date the application for registration is completed and/or mailed to the Association. Line 8 Signature - The application must be signed by the first owner, (owner at foaling), and mailed by that first owner to the office of the Association. Please do not print your name as a signature! Line 9 Address - Give the complete address of the applicant. Line 10 Method of Breeding - Designate either Natural, Artificial breeding on farm, Shipped Semen, or Embryo Transplant, check the method used. Line 11 Breeding Date - Give the breeding date, Month, Day and Year, for the production of the foal to be registered. When pasture breeding is used, you must give the date the dam was put with the stallion and the last date she was with the stallion, example: Pasture bred, March 2, 2000 to July 23, 2000. Line 11 Stallion owner's Signature - This is the signature of the person who owned or leased the sire of the foal to be registered, at the time the dam was served. If you purchased the dam after she was served for this foal and this breeding was recorded as required on the application for transfer and certificate of pedigree for the dam, the stallion owner's signature is not required on this application. DNA Policy ~ All Percheron females registered by this Association, from applications received after December 31, 2007, must be DNA typed and matched with its sire before the registration is completed and a certificate of pedigree is issued. You will simply complete the application for registration as before and include the new fee, (regular fee plus $50) after December 31, 2007. When we receive your application, we will apply for, print and mail you a bar coded envelope, addressed to the lab, with instructions to pull the hair and mail to the University. You will also sign a form and return it to the Association. We will then, in usually two weeks or less, receive the report from the lab. We can then, provided all matches are correct, proceed with the registration as before. Membership ~ If you are a nonmember and would like to become a member, you can print a membership application from our web page, under forms at: www.percheronhorse.org. Send this along with your registration or transfer applications. This will allow you to pay the member rate on your registrations and transfers. Photos ~ Photos are now be accepted in place of hand drawings. We ask that you provide digital photos to us via e-mail, [email protected].