AMERICAN PUREBRED REGISTRY
P.O. BOX 111, League City, TX, 77574

Request for Duplicate Registration Certificate

Please complete as much of the information below as possible.  The fee for searching our records and providing a duplicate copy of a registration certificate is $20.00.
Registration Number:________________________________________________

Name:___________________________________________________________

Sex:_____________Color:_________________Breed:_____________________

Breeder:____________________________Date of Birth:___________________

Sire:_____________________________________Color:___________________

Registration No.________________________(__)Organization_______________

Dam:____________________________Color:____________________________

Registration No.________________________(__)Organization:_______________

Estimate the year and month that this animal's registration was originally submitted to our office.

______________________

Owner's Name:________________________Phone No._____________________

Mailing Address:_______________________________________
City, State, Zip:________________________________________