Stallion Service Application -- Kentuckiana Farms

STALLION*

Muscle Mass -- $10,000.00 U.S.Swan For All -- $6,000.00White Bliss -- $1,500.00 (No shipped semen)

Pay or share breeding?*

Share #

Is this an embryo donor*

YesNo

Name of Mare*

Tattoo Number*

Color of Mare

Year of Birth*

Sire of Mare

Dam of Mare

Sire of Dam

Mare Race Record & Earnings

Owner of Mare*

Percent Owned*

Owner Address*

Office Phone*

Home/Cell Phone*

FAX

Contact Email*

Additional Owner of Mare (Owner #2)

Percent

Owner #2 Address

Additional Owner of Mare (Owner #3)

Percent

Owner #3 Address

Additional Owners

Please use this field to enter any additional information you consider necessary to complete your application.(e.g. a list of additional owner names, addresses & percentages if there are more than 3 owners)

Was the mare bred in 2022? (Yes/No)*

To

Result (Maiden, Barren, Aborted, In-foal)*

Due Date

Was the mare bred in 2021? (Yes/No)

To

Result (Barren, Live Foal)

Does mare have any fertility or foaling problems?

If you answer yes, please explain

Will mare be bred by semen transport or pickup? (Semen Transport/Pickup)

If transport, where will semen be sent?

Please provide the farm name & the state where the farm is located

E-Signature*

Today's Date*