Free INDIANA HORSE RACING COMMISSION - Indiana

INDIANA HORSE RACING COMMISSION MARE MOVEMENT For Thoroughbred Mares
State Form 53541 (2-08)

This form must be fully completed and filed with the Director of Breed Development for all resident mares who leave the State of Indiana and plan to return to foal in the State of Indiana. Resident mares are allowed to leave the state for an advertised public sale, but must return to Indiana within fourteen (14) days of the mare's sale in order for the residency requirements for the foal registration to be fulfilled. All paperwork from the sale must be forwarded to the IHRC office for review. Upon returning to Indiana, the mare must be reregistered with the breed development program. Name of Mare:______________________________________________________
(Please Print)

Name of Owner:_____________________________________________________ Date Sale Starts:_______________ Date Sale Ends: ______________

Location of Sale: ____________________________________________________ Date Mare Left:_______________ Date Mare Returned: ______________

If Mare has to leave Indiana for medical reasons, please complete this section: Reason for treatment:_________________________________________________ __________________________________________________________________ Name and Address of treatment facility: __________________________________ __________________________________________________________________
_____________________________________________________________________________

Date Mare Left:_______________

Date Mare Returned: ______________

I, represent that all information above is true and accurate and agree that registration of said mare may be revoked or denied for misstatement or omission in the foregoing application. Owner Signature ____________________________________________ Date _________________ Owner Printed Name _______________________________________________________________