GELDING AND SPAYED MARE REPORT
GELDING AND SPAYED MARE REPORT
Items needed in order to submit this form:
1. *The Original PHBA Certificate of Registration- (The Certificate will be stamped “Gelded” or
“Spayed Mare” and returned to the current owner of record at No Charge)
If a new Certificate is requested, please enclose the items below:
1. *The Original PHBA Certificate of Registration
2. * A Reissue fee of $10.00
Complete the information below and return to PHBA along with the Original PHBA Certificate.
Horse’s Registered Name:_________________________________PHBA Registration #____________
Date Gelded or Spayed:__________________Performed By:_________________________________
If Known
Current Owner of Record:___________________________________Membership #______________
Please Print
Address:__________________________________________________________________________
City:_____________________________State:______________________Zip:__________________
Phone # (_____) _______________________E-Mail Address:____________________________
I do certify that the aforementioned horse was gelded on date listed above:
Signature of Current Owner of Record:__________________________________________________
15253 E SKELLY DRIVE
TULSA, OK 74116
(918) 438-1234 Fax (918) 438-1232