PARE�TAGE D�A TESTI�G SUBMISSIO� FORM

Fill In form, print, sign and date and send DNA hair sample to the ICHO office with current DNA fee.

This for is for Parentage DNA testing only. Registrar will assign/enter NACHR #

HAIR SAMPLE IS FOR:

(Text size will get smaller to accommodate more info as it is being typed into spaces)

X_________________________________________________________________________Date________

Signature of Recorded Owner

Print �ame Here________________________________________________________________________

I hereby certify that the hair sample included with this form was duly collected from the horse identified above:

X__________________________________________________________________________________Date________

Signature of Person Taking Sample

Print �ame Here________________________________________________________________________________

Note- Fold b sample. for hair tail use Foals, For form in thirds with hair sample inside

NACHR_DNA Fill In Form 1-11

U of KY send billing to:

ICHO Office

322 Tulie Gate RdTularosa, �M 88352

office@curlyhorses.org

www.ichocurlyhorses.org

�ACHR Division of ICHO

Registrar Jackie Richardson

9621 Cameron Rd Excelsior Springs, MO 64024

NACHR# Name of Horse date of birth Sex Color Parents of Horse (name & reg#, DNA#) SIRE

DAM

UKY