Page 147 - NM Winter 2023

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 or 2, whichever applies).
1. For an individual owner (one person) Name
Address
City State Phone #
Zip
Social Security #
2.
For a business, syndicate or farm owner
Give name of manager who handles all business matters:
Name
Address
City State Zip
Phone #
Social Security or Tax ID #
MUST BE COMPLETED AND SIGNED ON REVERSE SIDE
REVISED OCT. 2022
WINTER 2023 145