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2010 - Texas Quarter Horse Association

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REQUEST TO PURCHASE BY CHECK<br />

Return to <strong>Texas</strong> <strong>Quarter</strong> <strong>Horse</strong> Assoc. at least five (5) days before sale.<br />

This form must be completed in full and notarized.<br />

Date______________<br />

Amount of Credit Desired $______________________________________<br />

To: <strong>Texas</strong> <strong>Quarter</strong> <strong>Horse</strong> <strong>Association</strong>, P.O. Box 9449, Austin, TX 78766<br />

Fed-Ex Address: 1101 W. Anderson Lane, Austin, TX 78757<br />

Applicant Name_______________________________________________<br />

Phone Number(s)_____________________________________________<br />

City, State, Zip________________________________________________<br />

Social Security Number_________________________________________<br />

Driver’s License Number_______________________State_____________<br />

Business Name_______________________________________________<br />

If Licensed Owner/Trainer, Number & State_________________________<br />

Trainer’s Name________________________________________________<br />

The Credit Applicant, named above and signed below, has had an account<br />

with this bank for ______ years, with an average balance in the range of<br />

$ ______________________ .<br />

Signature of Bank Officer________________________________________<br />

Bank Officer Name & Title_______________________________________<br />

Name of Bank________________________________________________<br />

Address_____________________________________________________<br />

Signature of Credit Applicant_____________________________________<br />

Subscribed and sworn to me on this _____ day of ______________, ____<br />

NOTARY PUBLIC_____________________________________________<br />

City_________________________________________________________<br />

County______________________________________________________<br />

My Commission Expires:_________________

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