Blank Birth Certificates Certificates

							    Application for Registration of Ewes                                                                       UNITED SUFFOLK SHEEP ASSOCIATION
                       Is this a Rush Order?                                                                                   P.O. Box 256 - Newton, Utah 84327
                           Yes ___ No ___                 Date Needed _________                                           Phone (435) 563-6105                 Fax (435) 563-9356

Breeder
                  Member Code                            Membership Name                    Address                                  City             State                         Zip Code                          Phone
Owner
                  Member Code                            Membership Name                    Address                                  City             State                         Zip Code                          Phone
Private Flock Name:
Do not use this form to order duplicate certificates, transfers, re-registrations, or to correct a previous application                                                The fees must accompany your application
 Leave Blank            Private Flock Number             Permanent ID Birth Date Birth Type Sire Flock Name & Number                         Sire Registration No.       Dam Flock Name & Number             Dam Registration No.     AI



Date of Sale Exact Name & Address of Purchaser




 Leave Blank            Private Flock Number             Permanent ID Birth Date Birth Type Sire Flock Name & Number                         Sire Registration No.       Dam Flock Name & Number             Dam Registration No.     AI



Date of Sale Exact Name & Address of Purchaser




 Leave Blank            Private Flock Number             Permanent ID Birth Date Birth Type Sire Flock Name & Number                         Sire Registration No.       Dam Flock Name & Number             Dam Registration No.     AI



Date of Sale Exact Name & Address of Purchaser




 Leave Blank            Private Flock Number             Permanent ID Birth Date Birth Type Sire Flock Name & Number                         Sire Registration No.       Dam Flock Name & Number             Dam Registration No.     AI



Date of Sale Exact Name & Address of Purchaser




 Leave Blank            Private Flock Number             Permanent ID Birth Date Birth Type Sire Flock Name & Number                         Sire Registration No.       Dam Flock Name & Number             Dam Registration No.     AI



Date of Sale Exact Name & Address of Purchaser



I hereby certify to the truth and accuracy of the information listed above and offer this (these) animal(s) for entry on the                X
records of, and in accordance with, the provisions of the Bylaws and Rules of the United Suffolk Sheep Association.                         Signature of person owning the dam(s) listed above or authorized representative    Date

                                                                                                                                            X
If ram is leased or borrowed, breeding certificate is on other side                                                                         Signature of person owning the sire(s) listed above or authorized representative   Date