LEASE TERMINATION by wdp11935

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									                              The Australian Pony Stud Book Society Inc.
                                                                                                 ABN: 18 280 213 644
                                                                                      PO Box 57, Geebung, Qld 4034
                                                                                 ph: 07 3216 2011 fax: 07 3216 2509
                                                                                        e-mail: registrar@apsb.asn.au

                                                LEASE TERMINATION
  To be completed on termination of an indefinite lease or early termination of a defined period lease.
                     PLEASE PRINT IN BLOCK LETTERS - DO NOT USE CORRECTION FLUID

Pony Details:

Reg.No:                           Prefix:                             Name:

Date of Birth:        /   /          Brands - Near Shoulder:                           Off Shoulder:


Leased From (owner):

Member No:                           Name:

Address:




Leased To (lessee):

Member No:                           Name:

Address:




Period of Lease:           From             /    /   To           /   /       (leave end date blank for indefinite lease)

The lessor and lessee hereby certify that the pony, detailed above, was returned by the lessee to the owner on

      /      /            (date of return).


Owner’s Signature:                                                                        Date:          /         /


Lessee’s Signature:                                                                       Date:          /         /




FEE PAYMENT DETAILS:
Enclosed is a cheque / money order made payable to APSB for: $

Or charge my credit card:          Mastercard                  Visa            Bankcard



Expires:         /            Name on Card:                                                       CARD CHECK VALUE
                                                                                                  (3 digit no. on back of card)

Signature:                                                Receipt Required

refer to website (www.apsb.asn.au), your State Branch Secretary or the Registrar for latest fee schedule


                                                                                                                       April 2005

								
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