I, *Name of Applicant *Telephone Number *eMail Address *Street *City *State Country *Zip
request that the HORSE described below be branded with the ATA purebred brand signifying that the horse is registerable or registered as a purebred Trakehner from approved breeding stock in accordance with the Corporate Regulations of the Association:
*Sex: Stallion Mare Colt Gelding Registration Pending Name Applied For: *Color and markings: *Foal Date: *Breeding Certificate Submitted: Yes No Attached *Sire Name: *Registration No. *Dam Name: *Registration No. If already registered insert registered name and number below: ATA Reg. Name: Registration No.
I enclose the applicable fees and understand that I am additionally responsible for all equitable expenses incurred by the ATA in connection with the branding of my horse. I further confirm that I will not hold the ATA or its authorized representatives responsible for any damage or injury incurred or inflicted by or upon any person and/or animal or other property in conjunction with or resulting from the branding procedure.
* Date *Signature of Recorded Owner
Date Branded: at (location):
I, _________________________________________________________________________________________________ (print name and address of branding representative)
Have performed the following:
seen the horse’s ATA registration certificate and confirmed that it is the horse described on the certificate: believe the markings for this horse should be changed as follows seen the dam’s official Stud Book registration certificate; convinced myself above foal is indeed out of indicated mare; confirmed color and markings of foal; personally and properly applied ATA brand to left hip of above horse; supervised proper application of ATA brand to left hip of above horse.
Remarks:______________________________________________________________________________________ ______________________________________________________________________________________________
________________________________________ __________________________________________________ Owner or Owner’s Agent Signature of Branding Representative WITNESS TO BRANDING
License fee (one-time)
Per Horse Branded
I am presently a member of the ATA I am not presently a member of the ATA but I wish to join at this time Membership choices: Active Member ($75.00) Lifetime Member ($750.00) Junior Member ($35.00) Fill out the ATA Membership Application and add appropriate fees to branding fees. Pay through Paypal or print this form and send it with your check to the ATA *Please select one of the following payment forms: I will Pay Using Paypal I will call a credit card # to the ATA I am mailing a check Please print this form prior to submitting your online application and paying your fees. Thank you.
I am presently a member of the ATA I am not presently a member of the ATA but I wish to join at this time
Membership choices: Active Member ($75.00) Lifetime Member ($750.00) Junior Member ($35.00) Fill out the ATA Membership Application and add appropriate fees to branding fees. Pay through Paypal or print this form and send it with your check to the ATA
*Please select one of the following payment forms: I will Pay Using Paypal I will call a credit card # to the ATA I am mailing a check
Please print this form prior to submitting your online application and paying your fees. Thank you.
Instructions: