Page 55 - New Mexico Summer 2021

FORM #200 NEW MEXICO PERMANENT BROODMARE REGISTRY FORM #200 (Please print or type)
Indicate which breed (mark square with an X) NMHBA Registration Number
TB QH
For Office Use Only
We must have the correct name of the broodmare before she can be officially entered into the New Mexico Horse Breeders Association's permanent broodmare registry.
Name of Broodmare Sire
Dam
NOTICE IMPORTANT
A copy of the broodmare's registration papers must accompany the application.
If this is a recipient mare that is not papered we require four photos (front, back, left and right sides)
Complete one block only (1, 2, or 3, whichever applies).
1. For an individual owner (one person) Name
Address
City State Phone #
Zip
Social Security #
2.
For a partnership owner (two or more persons)
Partnership name
Who will represent the partnership? (Give name and address below) Name
Address
City State Zip
Phone #
Social Security or Tax ID #
MUST BE COMPLETED AND SIGNED ON REVERSE SIDE
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