The Australian Pony Stud Book Society Inc.
ABN: 18 280 213 644
PO Box 267, Glenbrook NSW 2773
Phone 02 4739 0008
Fax 02 8014 5762 registrar@apsb.asn.au
Veterinary Surgeon or Accredited AI Technician to complete this form at time of artificial insemination.
Stallion Owner
On completion of insemination program a fully completed form to be given to mare owner with service certificate.
Mare Owner
Please return this form to the Registrar Australian Pony Stud Book Society when registering the foal together with the service certificate, your application for registration, foals blood type application and relevant fees.
Veterinary/Technician to complete mare identification below.
I hereby acknowledge receipt of semen from the stallion
In a sealed container from
On
I certify that I have artificially inseminated the mare known as
Registration Number
Brands
Owned By
Stallion name
_____ / ______/__________
APSB Registration Number
N/S O/S
Date (s) and time inseminated Name and address of Veterinary/Technician
Veterinarian’s Signature
Please post to The Registrar, Australian Pony Stud Book Society, PO Box 267, Glenbrook NSW 2773 or fax to 02 8014 5762