Current Ownership Information

Name(Required)
Owner's Name exactly how it appears on The Jockey Club Certificate.
Address(Required)

Horse Information

This line to be completed ONLY if this horse is breeding stock.

Signature and Certification

The undersigned certifies that (a) he/she is the owner or authorized agent of the owner, (b) that the name and address of the owner is correct, (c) that the undersigned has full power and authority to execute and file this report and to receive any requested or related documents from the TTA, and (d) the information supplied on this form is complete and correct. The undersigned also certifies that he/she has read and understands the Rules and Regulations of the Accredited Texas-Bred Program and that he/she has complied with such rules.
Owner or Agent(Required)
Name(Required)
Signature(Required)