NEBRASKA THOROUGHBRED OFFICIAL REGISTRY
PO Box 2215
Grand Island, NE 68802
308-384-4683
APPLICATION FOR REGISTRATION OF STALLION
Date _____________
Name of Stallion:____________________________Color:___________________Age _____________
Sire ___________________________________ Dam _______________________________________
Jockey Club Registration Number ____________________ Tatoo Number _______________________
Date Stallion arrived in Nebraska ___________________
Name of Owner(s) - All interest must be indicated                  Complete Address
_____________________________           _______________________
_____________________________           _______________________
_____________________________           _______________________
Name of Farm or Stable where now standing _______________________________________________
Address of Farm where standing _________________________________________________________
Name of Stallion Manager ______________________________________________________________
Date Stallion arrived here _____________

Notify the NTBA Registry when Stallion leaves the above farm.
IF STALLION IS LEASED, ATTACH CERTIFICATE OR PHOTOSTATIC COPY OF LEASE AGREEMENT
A PHOTO COPY OF THE JOCKEY CLUB PAPERS AND FEE MUST ACCOMPANY THIS REGISTRATION
Rule 24.003.03 - A change in the ownership of a stallion cancels the registration, except in the case of a partial change of ownership or sale of a share or shares in a syndication that does not affect an existing stallion ownership agreement or syndication agreement. In the event of invalidation of a stallion registration due to change in ownership, the new owner or lessee must register the stallion with the official registry.
_____________________________

Owner/Lessee
_____________________________

Street or Route & Box Number
_____________________________

City/State/Zip

Subscribed and Sworn to before me this ____ day of ___________,_____
______________________________

Notary Public
___________________________________________________________
___________________________________________________________
NTBA Date of Registration ____________________By: _______________________________________