SIMON BUCKING STOCK SALE January 10 & 11, 2012 Oklahoma State Fair Arena, Oklahoma City, OK CONSIGNOR NAME: ADDRESS: CITY, STATE, ZIP: PHONE: EMAIL: CONSIGNMENT TYPE (CIRCLE): Bareback Saddle Bronc Bull Pickup Horse COLOR BRAND SEX_________________AGE___________YEARS BUCKED DELIVERY: REMARKS: Rules and Regulations: Consignment fee of $125 per head, commission 10%, Pass out 10% OF LAST BID Catalog deadline December 5th, 2011 There will be no substitutes. Horses and bulls not cataloged sell last. All horses must have a current (6 months) coggins test, current health certificate All bulls must meet Oklahoma state requirements (see attached letter) Consignments must be accompanied by a check or money order for total entries All bulls and horses will be unloaded and kept at the Oklahoma State Fair Grounds Check in livestock: Monday, January 9th, 2012 8:00 a.m. to 8:00 p.m. I have completed this form to the best of my ability. I have reviewed the conditions of the sale and am willing and able to meet both the obligations and deadline schedule. Signature of Consignor: _______________________________________________________ MAIL TO: Simon Bucking Stock Sale PO Box 27, Webster, MN 55088 Email: dakotawest@aol.com website: jshorsecompany.com Phone: 952-469-3901 Fax: 952-469-5986