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Association
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| This is to Certify: | __________________________ | ____________ |
| Name of Stallion Giving Service | C.P.A. Reg. No.
|
|
| Was bred to: | __________________________ | ____________ |
| Name of Mare Served
|
C.P.A. Reg. No. | |
| On: | __________________________ | |
| List different dates including year mare was bred
|
||
| __________________________________ | ____________ | |
| Signature of Owner of Stallion at time
of Breeding
|
C.P.A. ID No. | |
| __________________________________ | ____________ | |
| Signature of Owner of Mare at time of Breeding | C.P.A. ID No. | |
Chincoteague Pony Association
P.O. Box 407
Chincoteague, Virginia 23336-0407
Telephone: 757-336-6917
Email: chincoponyassoc@esva.net