Duplicate Passport

If your passport has been lost, stolen or damaged, you will need to apply for a duplicate passport. Any such passport will be stamped "DUPLICATE" and will state that the equine cannot be slaughtered for human consumption.

Owner

Name………………………………………………………………..……………………………..………..

Address……………….……………………………………….…………………………………………..…

…………………………......………………………..…… Postcode …………………..……………...…

Telephone Number……………………………........... Email ………..……………………………...…

I confirm that the passport for the equine named below has been lost/stolen.

Signature……………………………………………………..……………….Date…..……………..….

Equine

Name of Equine………………………………………………………………………….………………

Passport Number (UELN)………………………………….…………………….……………………...

Microchip number ………………..……………………. Freezemark ………………….…………………

Colour………………………………...………………….……… Gender………….………….………………...

Tel: 0844 8911200 Fax: 0844 8911221 Web: www.petidequine.net Email: horsepassports@petidequine.net Pet ID Equine - Stable Cottage, Wheatsheaf Road, Henfield, West Sussex, BN5 9AU United Kingdom Registration No 4238663 Registered in England & Wales Defra Approved Passport Issuing Office : 826 073

Our administration charge is £25 .00 per passport, please make cheques payable to Pet ID Equine or to pay by credit card, please complete and sign below

Please debit my credit/debit card the sum of £…………………………………………………………

Issue Date : ………….…. Expiry Date : ……….…... Issue No (Switch only) : ………………………

Cardholder Name : .……….…………………… Signature of Cardholder : …………….…………….

Jun 2018

Card Number : ……………………………………………………………………Sec No………………………

Section 1 - Identification

Pet ID Equine -Jun 2018

Partie B - Signalement graphique Part B - Outline Diagram

5. Code du transpondeur (si dispoible) Transponder code (where available)Système de lecture (si différent de ISO 11784)/Reading system (if not ISO 11784): Code-barres (optionnel)/Barcode (optional):

Partie A - Données d’identification Part A - Identification details

(1) (a) Espèce/Species: ..................................................

(1) (b) Sexe/Sex: ..............................................................

(2) (a) Date de naissance/ Date of birth: ........................................................

(2) (b) Pays de naisannce/Country of birth: ..................................................

(3) Signalement/Description

(3) (a) Robe/Colour: ...........................................................................................................................................................................................

(3) (b) Tête / Head: .............................................................................................................................................................................................

(3) (c) Ant. gauche / Foreleg left: ....................................................................................................................................................................

(3) (d) Ant. droite / Foreleg right: ....................................................................................................................................................................

(3) (e) Post. gauche / Hindleg left: ..................................................................................................................................................................

(3) (f) Post. droite / Hindleg right: ...................................................................................................................................................................

(3) (g) Corps / Body: ..........................................................................................................................................................................................

(3) (h) Marques / Markings :..............................................................................................................................................................................

(4) Numéro unique d’identification valable à vie (15 chiffre)/Unique Life Number: 15 digits):

(18)(15)

(16)

(17)

GaucheLeft

DroitRight

Nez Muzzle

(12) Côté droiteRight side

(13) Côté gaucheLeft side

(14) Lignesupérieuredes yeax

Upper eye level

GaucheLeft

DroitRight

Encolure Vue inférieure

Neck Lower view

AntérieursVue postérieure

ForeRear view

PostérieursVue postérieure

HindRear view

FOR OFFICE USE ONLY

PLEASE AFFIX MICROCHIP BARCODE HERE

PLEASE LEAVE BLANK

Signature et cachet du vétérinaire ou de la personne qualifiée ou de l’autorié compétente (nom en lettres capitales)/

Signature and stamp of the vetinarian or qualified person or competent authority (name in capital letters)/

(9) Date: .....................................................................

(10) Place:..................................................................

(11) Veterinary Signature: .......................................

Veterinary Stamp:

Important Guidelines for Completion of Application Form and Silhouette

Both the application form and the silhouette must be completed in BLOCK CAPITALS and in ink. Please mark on the diagram with where the microchip is implanted in the equine. Veterinary Surgeon to sign and stamp the silhouette.

Please indicate the equine’s white markings by lightly hatching the full extent of the marking in the appropriate place on the diagram in red ink. Please be as accurate as possible in showing the extent of the markings. It is not sufficient simply to indicate the top edge of a white marking. Please note, in words, details of the white markings (e.g. ‘white to mid-cannon’ or ‘white to below knee’) in the boxes provided .If the equine has no white markings, please write ‘nil white’ or ‘no markings’. Flesh markings should be outlined and completely shaded. Take care not to obliterate whorls.

Coloured horses. Piebald horses are those with large irregular patches of black and white and the patches are well defined. Skewbald horses are those with large irregular patches of white and any other colour except black. The patches are well defined. If the horse has a coat with more than two colours it should be described as tri-coloured. Please describe the colours eg “skewbald (chestnut & white)”.

Spotted horses. Please describe the base colour and the colour(s) of the spots eg “brown with white spots”.

The equine’s whorls (changes in the direction of hair growth) should be marked on the diagram with ‘X’ where appropriate in black ink. If the equine has no other distinguishing marks, please note, in words, the position of the whorls, (e.g. ‘whorl mid-crest’ or ‘whorl at point of stifle’) in the boxes provided.

Please indicate on the diagram any acquired marks such as scars with ‘V’ where appropriate, and describe, in words, these marks in the boxes provided.

DuplicatePassportForm_Jan2016Sillhouette 20161up Important Guidelines for Completion of Application Form and Silhouette[9]