address

American Trakehner Association
Application for Duplicate Certificate of Registration

Instructions: Please read carefully

  1. Complete the following information (*=Required) and print this form
  2. Part 1 must be completed by owner on ATA records
  3. Part 2 is completed if certificate was lost by someone other than owner on ATA records
  4. DNA is Required
  5. Remit fee: $100.00 (call the ATA with a credit card # or mail with check/credit card information to the ATA) along with $60 for a DNA kit
  6. If a change in ownership needs to be processed, include a properly completed transfer report with fee of $30.00

Registered Name of Horse*: Registration No*:

Part 1: To be completed in ALL INSTANCES by recorded owner:

I,* , hereby affirm that the sentence marked below describes the circumstances surrounding the loss or destruction of the certificate for the horse identified in this affidavit.

One of the boxes below must be marked in order for us to proceed*:
            I lost the certificate
           
                                                                 If given to an auction company, please list the date of the sale:
            Other (explain)

The undersigned agrees to indemnify and hold harmless the ATA from any and all liability, whenever or however arising, by virtue of its reliance on this affidavit and its issuance of the replacement certificate; agrees to defend the ATA at his expense; and if judgment is made against the ATA, to pay judgment and obtain written release in form acceptable to the ATA.

Sworn to before me this ____ day of ______________, ______                       ____________________________________________
                                                                                                                                 Signature of Recorded Owner

Notary Public ________________________________________                      ____________________________________________
                                                                                                                                 Address

My commission expires________________________________                       ____________________________________________
                                                                                                                                 City                                   State       Zip

                                                                                                                        ____________________________________________
                                                                                                                                 Owner's Phone Number

                                                                                                                         ____________________________________________
                                                                                                                                 e-mail address

 


Mail Certificate to:    ___________________________________________________________________________
                                       Name

                                   __________________________________________________________________________
                                        Address

                                    __________________________________________________________________________
                                        City                                          Address                                           State       Zip

                                    __________________________________________________________________________
                                        Daytime telephone number

                                    __________________________________________________________________________
                                        e-mail address

Enclosures:
        Four Recent Photos     Owner Transfer Form     Bills of sale, unbroken chain of ownership


Part 2: To be completed IN ADDITION to Part 1 if the certificate was not lost by recorded owner:

I,* , hereby affirm that the sentence marked below describes the circumstances surrounding the loss or destruction of the certificate for the horse identified in this affidavit.

One of the boxes below must be marked in order for us to proceed *:

Other (explain)

The undersigned agrees to indemnify and hold harmless the ATA from any and all liability, whenever or however arising, by virtue of its reliance on this affidavit and its issuance of the replacement certifiate; agrees to defend the ATA at his expense; and if judgement is made against the ATA, to pay judgement and obtain written release in form acceptable to the ATA.

Sworn to before me this ____ day of ______________, ______                       ____________________________________________
                                                                                                                   
      Signature of Person requesting Certificate (not recorded owner)

Notary Public ________________________________________                       ____________________________________________
                                                                                                                         Address

My commission expires________________________________                       ____________________________________________
                                                                                                                          City                       Address               State       Zip

                                                                                                                       ____________________________________________
                                                                                                                           Owner's Phone Number

                                                                                                                        ____________________________________________
                                                                                                                           e-mail address

 

Call the office with a Credit Card, or send a check to the ATA Office at the address below:

address