Registration Application - Tennessee Walking Horse Breeders' and ...

REGISTRATION #
INSTRUCTIONS ON REVERSE!
1
THIS IS A:
■ Registration Application and
Parentage Verification Kit Request
(For an unregistered animal.)
8 SCARS,
■ Parentage Verification Kit Request ONLY:
10
(For a TWHBEA registered animal.)
Enter name at right in Block #2;
Enter registration number in upper
left corner.
4 SEX:
■ Stallion
■ Mare
■ Gelding
BRANDS,
UNUSUAL MARKS:
SIRE AND DAM :
5 COLOR:
■ Black
■ Smoky Black
■ Smoky Cream
■ Classic
Champagne
■ Classic Cream
Champagne
2 NAME
Mane/Tail Color
__________________
__________________
__________________
TWHBEA REGISTRATION APPLICATION/PARENTAGE VERIFICATION KIT REQUEST
TENNESSEE WALKING HORSE BREEDERS’ & EXHIBITORS’ ASSOCIATION • P. O. BOX 286 • LEWISBURG TN 37091-0286 • WWW.TWHBEA.COM
APPLICANTS MUST QUALIFY AS OFFSPRING OF THEIR SIRE & DAM. IF YOU HAVE QUESTIONS, PLEASE CONTACT CUSTOMER SERVICE, 931-359-1574.
CHOICES OF ANIMAL TO BE REGISTERED (List three choices; 25 character maximum)
OR REGISTERED NAME OF ANIMAL TO BE PARENTAGE VERIFIED (Enter name below on first line.)
1ST choice
2ND choice
3RD choice
OFFICE USE
*Indicate basic body color of a roan, overo, sabino, and tobiano.
Photos showing both sides, front and back are required for an overo,
sabino, or tobiano.
TWHBEA USE ONLY:
Stallion Breeding Report Number
■ Bay
■ Brown
■ Buckskin
■ Perlino
■ Amber Champagne
■ Amber Cream
Champagne
DILUTIONS
■ Dun
■ Silver
MODIFIERS
■ Grey
■ Roan
■ Chestnut
■ Sorrel
■ Palomino
■ Cremello
■ Gold Champagne
■ Gold Cream
Champagne
■ White
PATTERN*
■ Overo
■ Sabino
■ Tobiano
■ Tobiano/Sabino
6 BODY
MARKINGS:
■ NONE
OFF (RIGHT) SIDE
R L
4 3
Hind Legs
Written description:
L R
1 2
Fore Legs
------------- STOCKING --------------
----------------- SOCK -----------------
------------------- FETLOCK -------------------
------------- CORONET --------------
(1) Left Fore Leg: _________________________________________________________________________________________________________________
(2) Right Fore Leg: ________________________________________________________________________________________________________________
(3) Left Hind Leg: _________________________________________________________________________________________________________________
(4) Right Hind Leg: ________________________________________________________________________________________________________________
Frozen Semen Certificate Number
Sire’s Registered Name PARENTAGE VERIFICATION MUST BE ON RECORD AT TWHBEA. Sire’s Registration Number
Sire’s Owner: X __________________________________________________________________________________________________________________________
AT TIME OF SERVICE; SIGNATURE REQUIRED.
Dam’s Registered Name PARENTAGE VERIFICATION MUST BE ON RECORD AT TWHBEA. Dam’s Registration Number
Dam’s Owner: _____________________________________________________________________________________________________________________________
AT TIME OF SERVICE; PRINTED NAME ONLY REQUIRED.
Dam’s Owner: X __________________________________________________________________________________________________________________________
AT FOALING TIME; SIGNATURE REQUIRED.
10A
11
L R
1 2
Fore Legs
NEAR (LEFT) SIDE
OWNER/APPLICANT INFORMATION:
R L
4 3
Hind Legs
I hereby certify that all information on this registration application and/or parentage verification
kit request is true and correct to my personal knowledge and agree that the Association has the
privilege to correct and/or cancel the registration certificate for cause under its rules and regulations.
X ______________________________________________________________________
Signature of owner
(_______) ________________________
Day telephone
Printed Name: ________________________________________________________________
Mailing Address _______________________________________________________________
___________________________________________________________________________
City/State/Zip__________________________________________________________________
X _______________________________________________________
Signature of preparer if other than owner
DATE FILED BY
OWNER/APPLICANT:
DATE PROCESSED:
(OFFICE USE ONLY)
3 BREEDING
7 FACE
INFORMATION:
3A State Foaled In
MARKINGS:
■ NONE
Draw in every white area.
Indicate all dark spots
within white area.
Upper Lip
Lower Lip
and Chin
Describe facial markings:
____________________________________
____________________________________
____________________________________
© 2007 TWHBEA RETURN THIS COPY TO TWHBEA! 1/07
9 SHIP
Foaling Date
Breeding Date
If pasture bred, enter dates mare was exposed:
From: _____/_____/_____ To: _____/_____/_____
12
PARENTAGE
VERIFICATION KIT TO:
If different from owner/applicant’s
address at left.)
Printed Name ____________________________
_______________________________________
Address ________________________________
_______________________________________
City ___________________________________
State/Zip _______________________________
FEE SCHEDULE:
Registration Fee ____________
Parentage
Verification Fee ____________
Other ____________
TOTAL ENCLOSED ____________

This is a dual purpose form valid for 6 months from the date
1 processed (located on the front of the form in the upper right
corner). There are two choices in block #1: (a)Registration
Application/Parentage Verification Kit Request; (b)Parentage Verification
Kit Request ONLY.
If this is an application for registration of an unregistered animal and
a parentage verification kit request, check the appropriate box, and leave
the registration # box in the upper left corner blank. If the application for
registration is for a foal that is to be shown under halter prior to receipt
of the official registration certificate, the assigned name and assigned
registration number (upper left hand corner) as they appear on the copy
of this form returned with the parentage verification kit may be used for a
period of six months from the processing date.
If this is a request for a parentage verification kit only for an animal
foaled before 10/1/93 but already registered, the registration certificate
must accompany the request. This form may also be used to retype a
previously tested animal. In either case, check the appropriate box in
block #1 and enter the animal’s registration number in the registration
number box in the upper left corner. Complete all blocks except #9.
2
NAME: If this is an application for registration, provide three name
choices in block #2. Names are limited to 25 characters including
spaces & apostrophes. Do not use the line for “office use”. If this is a
parentage verification kit request only, please enter the registered name
in the “first choice” space.
3
BREEDING INFORMATION: Enter exact date of foaling. Enter date
mare was bred. (For parentage verification request only, breeding
date is not required.)
3A
Indication of the state in which a foal is born will allow records to be
kept that could be used in states where awards are available through
agricultural agencies. (Optional)
4
5
In block #4, indicate whether the animal to be registered and/or
parentage verified is a stallion, mare or gelding.
COLOR: Choose one base body color. Then choose a dilution, and/or
modifier, and/or pattern as applicable. If the animal is overo, sabino,
tobiano, or tobiano/sabino, you must submit photographs showing front,
back and both sides of the animal. The application will be returned if
this area is not completed. This will cause a delay in processing your
application. For example: Base body color - Black, Modifier - Roan,
Pattern - Sabino. May be applicable depending on animal.
6
BODY MARKINGS: In block #6 outline, with dark solid lines, all white
markings of horse represented by this application and draw all scars
and brands. Include markings on sides of head and chin. If there are no
markings, check the box marked none.
7
FACE MARKINGS: Outline, with dark solid lines, all white on face,
lips and chin. Indicate dark spots within white areas. Give written
description as blaze, strip, star, snip or bald. If there are no markings,
check the box marked none.
8
9
SCARS, BRANDS, UNUSUAL MARKS: Give written description and
location.
SHIP PARENTAGE VERIFICATION KIT TO: Print name and street
address where parentage verification kit may be shipped, if different
from applicant’s address or if applicant’s address is a post office box.
10
SIRE AND DAM: Supply complete, accurate information! Carefully
enter the registered names and numbers of both the sire and dam in
block #10. Also, enter stallion report number for this service (except on
parentage verification kit request only, when it is not required). Obtain
signatures of mare owner at foaling time and stallion owner at time of service.
Print the name (signature not required) of mare owner at time of service.
INSTRUCTIONS SCHEDULE OF FEES
(Not required if this is a parentage verification kit request only.) When foal
application is being used for a foal that results from the use of retained frozen
semen, the owner of the semen will be allowed to sign for the breeding
provided he/she has filed a Retained Semen Disclosure Statement. In
order for the Association to accept the signature of anyone other than the
recorded stallion owner at the time of breeding, the Certificate for Frozen
Semen must be endorsed by the current owner of the frozen semen.
10A
Frozen semen certificate number must be completed and frozen
semen certificate attached to the application for foals that result
from the use of frozen semen. Failure to include the certificate will
cause the Registration Application to be incomplete.
11
OWNER/APPLICANT INFORMATION:
Owner’s signature required! Print name, address and phone
number of owner. Applicant should enter the date of filing in the space
provided in the upper right corner. If the person preparing this document
is someone other than the owner of this animal, that person’s signature
is also required.
12
FEE SCHEDULE: Consult the fee schedule at right and enter
appropriate fees in block #12. Enter “FREE” on registration fee line
if you wish for this to be your free registration. Enter certified mail fees
on line marked other.
REGISTRATION REQUIREMENTS
Any person or persons who shall willfully register or record a false
pedigree shall be forever barred from making further registrations
and the registration of such false pedigree shall be canceled.
•
Application for registration must be typed or in ink. This application
becomes an important part of the records of the Association. Every
care should be exercised in giving dates, markings, etc.
• All foals, in order to be registered, must be the progeny of a
parentage verified, TWHBEA registered stallion and mare.
•
All foals must be parentage verified before a certificate of
registration will be issued.
•
The recorded owner of the dam at time of foaling may transfer the
unregistered foal by completing a Transfer Report/Bill of Sale. The
appropriate fees (both transfer and registration) must accompany the
registration application. To transfer an unregistered foal, leave block
#1 on the Transfer Report/Bill Of Sale blank, but complete block #2
which asks for the year of foaling and the dam’s registration number.
•
Mailing responsibility: TWHBEA takes no responsibility for the
certificates of registration once they are mailed to the owner. The
person applying for transfer or registration is solely responsible for
the accuracy of the mailing address. Certified mail or special delivery
may be requested by the applicant at his or her expense.
•
Free Registration: TWHBEA members are entitled to register one
foal free each year their dues are paid, provided the dam of said foal
is recorded in said member’s name on date of the foal’s birth, and
provided the foal is registered within six months of foal date. Dues
must be paid for the calendar year in which the foal is born. This free
registration must be requested at the time the application for
registration is submitted. Adjustments will not be made later, nor will
the free registration be automatically granted unless requested.
(Effective January 1, 2007)
TWHBEA MEMBERSHIP OPTIONS
Adults 18 or over may chose between annual dues which are $60
or lifetime memberships which are $1,000. Both include a subscription
to the Voice magazine. Adult members also receive, during each paid
dues period, a free foal registration, provided the dam of the foal
is recorded in the member’s name on the date of the foal’s birth,
and provided the foal is registered within six months of foaling. The
free registration must be requested at the time the paperwork is
submitted. No adjustments will be made later; the free registration will
not be automatically granted.
Individuals under 18 may become a junior member for $10
annually and conduct business at the reduced membership rate.
However, junior memberships do not include the free foal registration
or a subscription to the Voice.
REGISTRATION OF FOALS
(The fee, which must accompany application, is based on the date
the application is postmarked and the membership status of the owner
of the mare at the time of foaling.)
Foal Application* Member Non-Member
If registered :
Within 6 months of foaling: $ 40 $ 100
After 6 months, but within 12 months: $ 70 $ 130
After 12 months, but within 24 months: $ 130 $ 190
After 24 months, but within 36 months: $ 250 $ 310
After 36 months, but within 48 months: $ 370 $ 430
After 48 months: Contact TWHBEA
*To be registered, animals must be parentage verified.
** See special gelding incentive registration savings at www.twhbea.com
TRANSFER OF OWNERSHIP
(The fee, which must accompany application, is based on the date the transfer is
postmarked and the membership status of the person making the transfer. Seller(s)
required to sign transfer and fill in date of purchase in his/her personal handwriting.
Transfer Fee Member Non-Member
Within 30 days of purchase date: $ 40 $ 100
After 30 days but within 120 days: $ 70 $ 130
After 120 days but within 180 days: $ 100 $ 160
After 6 months of purchase date: $ 130 $ 190
OTHER SERVICES
Fees Member Non-Member
Blood typing kit: $ 50 $ 110
DNA kit: $ 40 $ 100
Duplicate certificate of registration: $ 150 $ 210
Alteration after certificate is issued: $ 20 $ 80
Certified pedigree: $ 20 $ 80
Name change (25 character limit including spaces):
Name of registered TWH may be changed provided it has not sired
or produced a registered foal. $ 50 $ 110
Research (per hour) $ 50 N/A
Stallion production record:
First year requested: $ 20 N/A
Each additional requested at same time: $ 10 N/A
Mare production record: $ 10 N/A
DNA Conversion (2007) $ 25 $ 25
Microchip $ 10 $ 70