Equine Passport Application Form

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1 Identification Details

2Outline Diagram

3Owner & Keeper

4Animal details

5Declaration

Part B - Outline Diagram
This section is to be filled in by the VET (white markings to be shown in red ink)

Section 4 - Declaration
I understand that my consent is required for the NIHB to process personal data which it may have in its possession converting me including disclosure to third parties such as SAERA/ Central Equine Database. As such, I consent to the processing of any information relating to me either contained in this form or otherwise.*
- Yes I confirm that I have read, understood and agree to the NIHB Terms & Conditions and that the detailed provided on this form are to the best of my knowledge accurate in all respects.
Signature*
Date*
MM slash DD slash YYYY
Fees:
ID Document - NIHB Member- £35.00
ID Doucument- Non Member- £60.00
Duplicate ID Document- NIHB Member- £45.00
Duplicate ID Document- Non Member- £70.00
Northern Ireland Horse Board, Office Suite, Meadows Equestrian Centre, Embankment Road, Lurgan, Co. Armagh. BT66 6NE

Section 1 - Identification