State of Ohio
Application for Registration of Accredited Thoroughbred
Incomplete or illegible applications will be returned. Applicable Fee Must Accompany Application.
FOR OFFICE USE ONLY
OSRC NUMBER
_______________________
Owner
CHECKS
PAYABLE TO:
Ohio State Racing Commission
77 S. High St. -- 18th Floor
Columbus, OH 43215-6108
Social Security Number (Fed. Tax ID if Corporation/Partnership)
Address (Street or Post Box, City, State & ZIP)
Telephone Number
E-mail Address
Name of Foal (If unnamed, so state)
Jockey Club Certificate Number
Sire of Foal
Dam of Foal
Sex
Sire’s OSRC #
Dam’s OSRC #
Color
Dam’s Sire
Date of Foaling
Location of Foaling (Name of Farm)
Address of Farm (City, County, State and ZIP)
Date dam was covered by sire of foal
Veterinarian in attendance
List All Breeders. Breeders Must Agree With Broodmare Application/Transfer.
Breeder
Social Security Number (Fed. Tax ID if Corporation/Partnership)
Address (Street or Post Box)
Address (City, State & ZIP)
Breeders License Number
Telephone Number
E-mail Address
Registration of Accredited Thoroughbred – page 2
Breeder
Social Security Number (Fed. Tax ID if Corporation/Partnership)
Address (Street or Post Box)
Address (City, State & ZIP)
Breeders License Number
Telephone Number
E-mail Address
Breeder
Social Security Number (Fed. Tax ID if Corporation/Partnership)
Address (Street or Post Box)
Address (City, State & ZIP)
Breeders License Number
Telephone Number
E-mail Address
Markings of Foal:
The applicant certifies the breeder, the broodmare, the stallion, the location and date the foal was dropped, and the name,
Jockey Club Certificate Number, color and sex of the foal are as indicated on the Jockey Club Certificate, if known, for said foal. The
applicant further certifies the present owner of this foal is as indicated on the face of the Jockey Club Certificate or on the Transfer of
Ownership duly executed on the back of the Jockey Club Certificate, and the stallion and mare fill all the requirements of Section
3769.083 (A)(1) of the Ohio Revised Code pertaining to Accredited Ohio Thoroughbred Horses . I understand I may be
subject to fines up to $10,000 for having incorrect information on this application.
STATE OF OHIO
COUNTY OF
_________________________, SS
SWORN TO BEFORE ME THIS
Signature of Owner
Notary Public
Date
NOTICE: The issuance of an Accredited Ohio Thoroughbred Horse Certificate for this foal is contingent on the fulfillment of
requirements for eligibility as set forth in the Ohio Revised Code and Rules and Regulations adopted by the OSRC.
Registration Fees & Deadlines
New Stallion ................................ $100 Before Covering of First Broodmare
Stallion Renewal ................................................... $25 Prior to January 31
New Broodmare .............................. .................... $100 Prior to August 15
Broodmare Renewal ............................................... $25 Prior to August 15
Mares Bred Report ..................................................... No Fee (October 15)
Accredited Ohio Foal ....................................................... $25 (October 15)
Ohio Foaled ................................................................... $25 (October 15)
Retroactive Registration Fees
Weanlings .................................... October 16 through December 31 ▬ $75
Yearlings ...................................... January 1 through December 31 ▬ $150
2-Year-Olds .................................. January 1 through December 31 ▬ $300
3-Year-Olds and up .................... January 1 through December 31 ▬ $2,500