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351 Avera Street
Sarepta, LA 71071
352-342-5737 Anna Paul - mobile
318-847-4170 home
318-578-1724 Sales
Sarepta, LA 71071
352-342-5737 Anna Paul - mobile
318-847-4170 home
318-578-1724 Sales
| Fanlew Farm 352-342-5737 Anna 351 Avera Street 318-578-1866 Ray Sarepta, Louisiana 71071 2013 Mare Information Sheet THIS FORM MUST BE ON FILE IN OUR OFFICE PRIOR TO BOOKING THE MARE INTO THE BREEDING SHED. NO EXCEPTIONS!! STALLION: _____________________________________________ MARE OWNER INFORMATION Please type or print the following information (as it should be reported to the Jockey Club): Name: __________________________________________________________ Address _________________________________________________________ Phone #’s _______________________________Fax # ___________________ E-Mail _____________________________ Mare Information (Correct Spelling Needed) Mare's Name __________________________Year ________Color_________ Mare's Sire ____________________________________ Mare's Dam ____________________Dam’s Sire ___________________ IMPORT STATUS: Is this mare an IMPORT for the 2013 Breeding Season? ( )NO ( )YES Import Date: _____________ Country of Origin:________________ Mare's Current Status: ( ) Maiden ( ) Barren ( ) Slipped ( ) In Foal ( ) Not Bred ( ) Foaled; Date ______Color ______ Colt/Filly Stallion Bred To in 2012 _______________ Last Date Bred ______________ Mare's Produce History: Foaling Date Color Colt/Filly Stallion Bred to in 2011 /12 ________ _________ Stallion Bred to in 2010 /11 ________ _________ Mare will board in Louisiana at __________________________________________ Farm Manager's Name ____________________________Phone _______________ Fax ______________________ Cell _________________________ Do we have permission to tranquilize this mare if necessary? YES NO Mare's Veterinarian: ______________________________Phone:_______________ Signature: ___________________________________Date:____________________ |