NORTH AMERICAN PERUVIAN HORSE ASSOCIATION
AUTHORIZATION TO ACT AS AGENT
I,_____________________________________, the recorded owner of the horse
_____________________________________, of the NAPHA #__________________
do hereby declare that I designate _____________________________________
________________________________________________________________________
of______________________________________________________________________
________________________________________________________________________
to act as my agent with regard to registration and showing matters of the
NAPHA. This authorization is to take effect___________________________
and continue until______________________________________________________
________________________________________________________________________.
My Agent has authority to act on my behalf in the following matters: (please initial)
[ ] Signing of entry forms for shows.
[ ] Horse to be shown under Agent's name.
[ ] Horse to be shown under Recorded Owner's name.
[ ] Signing of Breeder's Certificates
[ ] Signing of Service Certificates
[ ] Signing and filing of Stallion Reports
[ ] Signing of applications for registration.
[ ] Signing of transfer of ownership on horses registered in my name.
[ ] Other:
SIGNED: __________________________________________________________________
OWNER
__________________________________________________________________
ADDRESS
__________________________________________________________________
TELEPHONE
__________________________________________________________________
DATE
SIGNED: __________________________________________________________________
AGENT
__________________________________________________________________
ADDRESS
__________________________________________________________________
TELEPHONE
__________________________________________________________________
DATE
3095 Burleson Retta Road
Burleson, TX 76028
Tel: 447-7574 Fax: (707) 447-2450
e-mail:
info@napha.net