Form 4710-10 - Application For Adoption Of Wild Horse(S) Or Burro(S) - 2014 Page 2
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2
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4Applicant’s Name
MAP OF LOCATION OF ADOPTED WILD HORSES AND/OR BURROS
Facility Address
State
Zip Code
City
Phone Number
Property Owner(s) Name
Draw a map to the location where animal(s) will be kept (from the
Draw a layout of corral(s) and shelter(s).
nearest major highway).
N
N
Directions to the Facility
INSTRUCTIONS
State. (For the correct address, refer to the pamphlet “Adopting a Wild
1. Carefully read the PROHIBITED
ACTS and TERMS
OF
Horse or Burro” or take it to an adoption event.)
ADOPTION printed below.
4. So that we may notify you when and where the animal(s) you
2. Carefully read information provided in the pamphlet “Adopting a Wild
requested are available, provide the Bureau of Land Management
Horse or Burro.”
office serving your State within 10 days of any change in your address
3. Submit your completed Application for Adoption of Wild Horse(s) or
or telephone number.
Burro(s) to the Bureau of Land Management (BLM) office serving your
PROHIBITED ACTS
(a) Maliciously or negligently injuring or harassing a wild horse or burro;
(f) Branding a wild horse or burro;
(b) Treating a wild horse or burro inhumanely;
(g) Removing or altering a freeze mark on a wild horse or burro;
(h) Violating an order, term, or condition established by the BLM under
(c) Removing or attempting to remove a wild horse or burro from the
this part;
public lands without authorization from the BLM;
(i) Commercially exploiting a wild horse or burro;
(d) Destroying a wild horse or burro without authorization from the BLM,
Any person who commits a prohibited act is subject to a fine of not more
except as an act of mercy;
than $2,000 or imprisonment for not more than one year, or both, for each
(e) Selling or attempting to sell a wild horse or burro or its remains;
violation.
(Form 4710-10, page 2)
(Continued on page 3)
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