NORTH AMERICAN PERUVIAN HORSE ASSOCIATION
AFFIDAVIT OF LOST CERTIFICATE OF REGISTRATION
STATE OF ______________________________)) ss. COUNTY OF _____________________________) _________________________________________, being duly sworn deposes and says as follows: 1. That_________________________________________________________resides at __________________________________________________________________in the State of ________________________________________________________. 2. That the Certificate of Registration #_________________issued by the Peruvian Paso Horse Registry of North America (a California Non-Profit Corporation) OR #_________________issued by the American Association of Owners and Breeders of Peruvian Paso Horses (a California Non-Profit Corporation) for the horse_____________________________________________________________________________ has been (initial correct statement) [ ] lost [ ] destroyed [ ] wrongfully taken and that although diligent search has been made for same, it cannot be found. 3. That the Certificate disappeared at a time not known to me, as well as unknown circumstances. 4. That the undersigned agrees to hold harmless and indemnify the North American Peruvian Horse Association and its Officers and Directors, from any claims made in connection with said lost Certificate and/or the issuance of a duplicate certificate, and further agrees to pay court costs and attorneys fees in the event said Corporation and/or its Officers and/or Directors are compelled at any time in the future to legally defend themselves from any such claim in a court of law. I/we hereby request that a duplicate Certificate for said lost Certificate be issued by the North American Peruvian Horse Association. __________________________________________________________________ (Signature) __________________________________________________________________ (Signature) Subscribed and sworn to before me this _________________day of ___________________________, 19_____. ____________________________________________________________ NOTARY PUBLIC IN AND FOR SAID COUNTY AND STATENORTH AMERICAN PERUVIAN HORSE ASSOCIATION
3095 Burleson Retta Road
Burleson, TX 76028
Tel: 447-7574 Fax: (707) 447-2450
e-mail: info@napha.net