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.
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.
FOR COMPLETE RULES REGARDING ACCREDITATION CONTACT THE L.T.B.A. OFFICE.
Please click one of the PayPal options to complete payment and submit the form.