Form 48657 - Thoroughbred 2012 Foal Application
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For Office Use Only:
DATE
Thoroughbred
: ___________
COMPLETE
2012 Foal Application
IHRC # _________
* Foal applications must be received within ONE year of
State Form 48657 (R13 / 4-11)
the foaling date to avoid late fees. *
Foal Information
Name of Foal
Foaling Date
Sex
Color
(month, day, year)
Sire
Dam
Owner Information
Name of Owner
Address (number and street)
Telephone Number
City
State
ZIP Code
Email address
Breeder Information
Breeder of Foal
Farm foal was born
Address of Breeder (number and street)
Telephone Number
City
State
ZIP Code
Breeder Award Recipient Information
It is understood that it is the sole responsibility of the applicant to designate a name, address and social security or
federal I.D. number to be used when breeder awards are issued. It is further understood that it is the designee’s
sole responsibility to distribute the breeder award to other owners or partners.
Name of designated recipient of award
Address (number and street)
City
State
ZIP Code
Social Security or Federal ID Number
I, the undersigned, represent that all information above is true and accurate and agree that registration of said foal
may be revoked or denied for misstatement or omission in the foregoing application.
Owner Signature __________________________________________
Date
_______________
(month, day, year)
Owner Printed ____________________________________________
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