Form to be completed by licensed Veterinarian

1

Mail-In Passport Application Form

Form to be completed by licensed Veterinarian

Horse Name: ______________________________ Reg/USEF# _________________________

Sire/Breed/Registration #: ___________________________________________________________ If known

Dam/Breed/Registration #: ___________________________________________________________ If known

Breeder: _________________________________________________________________________

Address: _________________________________________________________________________

Phone: __________________ Fax: __________________Email: ____________________________

Owner (if different from breeder): _____________________________________________________

Address: ________________________________________________________________________

Phone: __________________ Fax: __________________Email: ____________________________

Horse Description

Color: ___________________ Sex: _________________ Date of Birth: ____________________

Age Verification Method:____________________________________________________________

________________________________________________________________________________

Markings:________________________________________________________________________

________________________________________________________________________________

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Microchip Present? Yes No Horse Name:___________________________Note: If a microchip is not present, a fifteen digit ISO Compliant microchip must be implanted in the Nuchal ligament of the neck on the left side of the horse and notated below.

Microchip # and type :______________________________________________________________ Microchip Sticker may be attached here

Identifying Brands/Tattoos/Scars: ________________________________________________

________________________________________________________________________________

Please draw markings in RED PEN if possible. All face, neck and chest whorls (x’s), as well as any identifying marks, brands, tattoos and scars in BLACK or BLUE PEN onto attached diagram. If DNA testing is required and has not already been completed, please pull mane or tail hairs with root attached and place in a sealed and labeled baggie, and attach to this form. Please mail this this completed and signed form, microchip information, DNA sample if requested, and completed markings diagram to Westfalen Verband NA office address below.

Veterinarian name (print): __________________________________________________________

Veterinarian Practice address:_______________________________________________________

_______________________________________________________________________________

Phone: ____________________ Fax: ___________________ Email: ________________________

By signing this form, I agree that I am a licensed veterinarian in the state of ____________________ and attest that I personally inspected the above described horse for the purpose of drawing identifying markings, obtaining a DNA sample if required, checking for the presence of a microchip and if no microchip was found, have inserted a microchip and listed the microchip number on this form as well as on the markings diagram attached to this form.

Veterinarian signature: _______________________________ Date: _____________________

Please return this completed form with the DNA Sample (if requested), Markings Diagram, and Microchip Stickers if implanted to:

Westfalen Verband NA P.O. Box 429 Murdo, SD 57559 605 • 669 • 2200 fax: 605 • 734 • 8060 Email: [email protected] Website: www.westfalenverband.com

Westfalen Verband NA P.O. Box 429 Murdo, SD 57559 (605)669-2200 www.westfalenverband.com [email protected]

Westfalen Verband NA Westfälisches Pferdestammbuch e.V.

P. O. Box 429 Sudmülenstrasse 33

Murdo, SD 57559 D-48157 Münster-HandorfTelephone: 1 (605) 669-2200 Telephone: +49 (0) 251 32809-0

Fax: 1 (605) 734-8060 Fax: +49 (0) 251 32809-24

www.westfalenverband.com www.Westfalenpferde.de

[email protected] [email protected]

Membership Declaration for New Members (Foreign Countries)

Farm Name: _____________________________________________________________

Last Name: ______________________________ First Name: ___________________

Address: ________________________________________________________________

City/State/Zip Code: ______________________________________________________

Telephone Number: ________________________Fax Number: ___________________

Email Address: __________________________________________________________

Website Address: _________________________________________________________

1. With my admission to the Westfälisches Pferdestammbuch e.V. I acknowledge the statutes and stud-

book rules of the association.

2. The jurisdiction of the courts for the seat of the Pferdezuchtverband is hereby agreed upon in case one

of the parties to this agreement does not have an ordinary domestic place of jurisdiction. Likewise, the

applicability of German law is hereby agreed upon.

________________________________________________ ____________________________

Place, Date Signature

Note:

● Full Westfalen Memberships must be renewed annually and includes breeding and awards privileges and

one free change of ownership. The Westfalen Verband NA should be notified of any change of personal

data (i.e. changes of name and/or address, etc.).

Pferdezuchtverband Official

http://www.westfalenverband.com/

mailto:[email protected]


http://www.westfalenpferde.de/



Westfälisches Pferdestammbuch e.V. / Westfalen Verband NA POST OFFICE BOX 429 • MURDO, SD 57559 • PH 1-605-669-2200 • FAX 1-605-734-8060

www.westfalenverband.com [email protected]

BREEDING CERTIFICATE / INSEMINATION CERTIFICATE STUD

Breeder (Mare’s owner at time of breeding)

__

Mare (Registration No.) (Name, Breed) (Year of Birth)

Color and Marking

Father of mare (Name and Registration No.)

Mother of mare (Name and Registration No.)

has been bred Breeding Date/s:

In addition by the stallion mentioned below

inseminated with fresh semen bred inseminated with frozen semen inseminated with fresh semen

Embryo Transfer donor mare If ET, Date Embryo Transferred: (Check all that apply)

___________________________

ET Recipient Mare Name: __________________________________________

ET Recipient Mare Number: ________________________ Color:___________

inseminated with frozen semen

Stallion Name: Name

RN

Reg #: on

last on

Place Date Signature: Stallion owner/Stud supervisor/Veterinarian

BREEDING RESULT / FOAL NOTIFICATION (Breeding certificates from breedings by other stallions must be enclosed)

Foal born on: Sex: Name:

Color and Markings: _

The mare – remained not in foal / aborted on / the foal was born dead/died on: circle appropriate response


2021 Westfalen Paperwork Checklist

General

In-Person Inspections are expected to resume in late summer/early fall 2021. Mail-In Foal/Youngster Registration and Virtual Mare Inspection will again be offered in 2021. You may request a microchip to be mailed or your vet may use his/her own.

Westfalen NA Membership is required for registration of foals and youngstock. Membership Forms may be filled out and submitted online, or downloaded/

printed from the website and submitted with paperwork. If you are already a member and your address hasn't changed you do not need to fill out the Membership Form again. Branding is optional and will be completed on the following inspection tour if horse is eligible for brand. The cost of branding is included in the cost of registration.

Microchipping is mandatory for all horses receiving registration papers. Westfalen NA microchips are 15-digit ISO compliant chips that fulfill the USEF Horse Identification

requirements. The Microchip ID # will be included on your horse's passport. If your 2021 foal or youngster to register already has a microchip, please have your veterinarian scan and confirm the microchip number on the registration form. 2021 foals registered through the mail will receive a USEF Lifetime # if all registration requirements are fulfilled in the year of birth. Older youngstock registered are not eligible to receive a complimentary USEF Lifetime #. All foals presented for registration will be DNA Tested for Parentage Verification. Please feel free to call or email with any questions.

Mares Original registration papers will be inspected and stamped on next year's tour Photocopy of Registration Papers. If mare does not already have DNA on file with

Westfalen NA or another registry, we will send you a baggy to include her hairs.

5-generation pedigree.

Mares eligible for the Main and Premium books include: Mares registered with full (pink) papers from a recognized Warmblood breeding association (see a full list in our Bylaws online), Thoroughbreds, Arabians, Anglo-Arabians, and Shagya Arabians. For

the Pony Books: All of the above, as well as German Riding Ponies, Welsh A, B, and

C’s, Welsh Cobs, British Riding Ponies, Connemaras, American Sport Ponies and New

Forest Ponies. Knabstruppers. Please reference the website for a complete listing of

breed eligibilities. Mares whose papers have been lost may be eligible for the Pre-Mare

books if they are of sport type and reach a certain overall score.

Foals at Mare’s Side

Breeding Certificate signed by the stallion owner. Breeding Certificate forms are

available for downloading from the website.




Weaned Foals and older unregistered horses Breeding Certificate signed by Stallion Owner

Dam must be inspected as well if she has not already been inspected into the Westfalen

NA mare books. For 2020/2021 we will accept Video Inspections / mare may be inspected following year. Please include a copy of the dam’s mare inspection score sheet

from a different registry if she’s already in a mare book. Call for more information for other situations. Weanlings and Youngstock sired by stallions approved by the

Westfalen NA or by a different warmblood registry but not active in the Westfalen

NA’s current year stallion rosters are eligible for inspection and registration for an

additional $85 fee per foal.

All weaned foals, youngstock and older horses to be registered and receive a passport must be DNA tested. Passports for weaned foals and older youngstock will be printed and mailed to the owner of record as soon as all Registration Forms, Microchip and Pedigree Verification and DNA has been submitted and completed.

Please note – DNA test results/case number are also required for the sire and dam of

weaned/older offspring requesting original registration papers. Please include the

sire and dam’s breed and registration number (if available) and a copy of the breed

papers if available (unless horse is already in the Westfalen books) so that we may

request the parents’ DNA Case #’s from the appropriate registry. If you do not know this information please state so on the form and we will assist.

Stallions (call for more information ) Original registration papers

Photocopy of Registration Papers

5-generation pedigree

Mare must be inspected and entered into an appropriate mare book as well if she has not

already been inspected by the Westfalen NA. For 2020/2021 we will accept Video Inspections / Mare may be inspected the following year. Call for more information if questions remain. Foals sired by stallions approved by the Westfalen NA or by a different

warmblood registry but not active in the Westfalen NA’s current year stallion rosters are

eligible for registration for an additional $85 fee per foal.

All foals must be DNA tested.

Passports for 2021 foals will be printed and mailed to the owner of record as soon as all Registration Forms, Microchip and Pedigree Verification and DNA has been submitted and completed.




Printout of show results (if applicable)

Completed Stallion Vet Exam form, filled out in advance by veterinarian (form

available for download). X-ray reports of joints indicated on the Vet Exam Form will be

required for licensing to be granted.

All stallions who do not already have DNA on file will have hairs pulled on

will be required to complete DNA testing. In order to expedite this process, please complete an online fillable DNA Testing Form available on the Westfalen NA/ website

and you will be sent a DNA kit with instructions on how to pull and submit the hairs.

Stallions of breeds other than those accepted into the main and pony books are not

eligible for licensing. For a list of accepted breeds (including but not limited to

Warmbloods of recognized breeding associations, Thoroughbreds, Arabians, Anglo-

Arabians, Shagya Arabians, German Riding Ponies, Welsh A, B, and C’s, Welsh Cobs,

British Riding Ponies, Connemaras, American Sport Ponies, New Forest Ponies, and

Knabstruppers) please reference the Westfalen NA website. Anyone with questions

should please call or email the Westfalen NA North American headquarters.

NOTE for 2021 - All Stallions to be licensed will need to be inspected on the next available inspection tour - the office will accept video submissions along with all eligible completed health paperwork in order to allow for pre-licensing breedings to take place in 2020/2021. Please contact the office for more information.



Documents

Form to be completed by licensed Veterinarian