Foal Registration/Accreditation

LOUISIANA THOROUGHBRED BREEDERS ASSOCIATION

P.O. Box 24650 | New Orleans, LA 70184 | 504-947-4676
OFFICIAL APPLICATION FOR REGISTRATION AND ACCREDITATION OF LOUISIANA-BRED FOAL 2024

This application is due on or before August 31 of foal's year of birth. Be sure to fill out all Information.
BREEDER OF FOAL*
Must match Jockey Club Registration Papers
ARE YOU SUBMITTING AS AN INDIVIDUAL OR BUSINESS ENTITY?*

INDIVIDUALBUSINESS ENTITY
SS#*
FED ID#*
STREET OR BOX NUMBER*
CITY*
STATE*
ZIP*
PHONE*
If BREEDER of FOAL is a partnership and the partnership does NOT have a tax identification number, please indicate ownership interest of each partner for the payment of breeders awards and for reporting breeders award payment to the Internal Revenue Service.
Partner 1
Social Security#
% of Breeders Award to be paid
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
EMail
example@example.com
Phone
Partner 2
Social Security
of Breeders Award to be paid
EMail
example@example.com
Phone
Partner 3
Social Security
% of Breeders Award to be paid
EMail
example@example.com
Phone
FARM WHERE FOAL WAS DROPPED*
STREET OR BOX NUMBER
CITY
STATE
ZIP
PHONE
FOAL INFORMATION
COLOR*
SEX*

FCG
Date of Foaling*

MonthDayYear
Date
SIRE*
DAM*
DOMICILE OF SIRE*
Enter State
MARE BRED BACK TO*
If not bred, type in "not bred"; if mare is deceased type in "deceased" and the mare's name.
DOMICILE OF BREED BACK STALLION*
Enter State
RESIDENT MARE?*

YesNo - (mare leaving form must be sent to the LTBA office)
DOMICILE OF MARE*
Farm Name & City Farm is Located in
FARM NAME & CITY FARM IS LOCATED IN

Payment Due with Application Form

I hereby certify that the above foal is eligible for accreditation as a Louisiana-bred as described in Part C, Section 1 of the By-Laws of the Louisiana Thoroughbred Breeders Association. | am fully responsible for the information furnished on this application and assume full responsibility for the registration of the horse with the Jockey Club and agree that if the horse is later proved to be ineligible due to registration based upon false or fraudulent information, then (1) the horse shall no longer be considered an accredited Louisiana-bred, (2) I may be forever denied the privilege of registering any animals as accredited Louisiana-breds, and (3) all my rights and privileges of membership in the Louisiana Thoroughbred Breeders Association shall be surrendered. The undersigned certifies that he/she has full power to execute and file this form.
Signature X*

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Date*

MonthDayYear
Date
Signature of: (please check one):*

BreederAuthorized Agent
FOR COMPLETE RULES REGARDING ACCREDITATION CONTACT THE L.T.B.A. OFFICE.
ACCREDITATION FEES (MEMBER RATES)

YEARLINGS.................................................................	$250.00
TWO YEAR OLDS (unraced) ........................................	$1,000.00
HORSES THAT HAVE STARTED IN A RACE .................	$5,000.00

My Products*
prevnext( X )
YEARLINGS
$250.00 Quantity



TWO YEAR OLDS (unraced)
$1,000.00 Quantity



HORSES THAT HAVE STARTED IN A RACE
$5,000.00 Quantity



Total

$0.00

Payment Methods

Debit or Credit Card

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LOUISIANA THOROUGHBRED BREEDERS ASSOCIATION

OFFICIAL APPLICATION FOR REGISTRATION AND ACCREDITATION OF LOUISIANA-BRED FOAL 2024

FOAL INFORMATION

ACCREDITATION FEES (MEMBER RATES)