Check appropriate square:Cow   Bull   Steer       Calving Date: mo/day/yr

Type of birth: Natural   Twin   In-herd AI   In-herd Embryo

Name of Animal to be Registered-not to exceed twenty-four characters/spaces-do not use symbols:

Holding brand:   Location on animal:

(membership number for the Holding Brand)***Ear tags are not accepted as private herd number locations.

P.H. no.   Location on animal: PH number must be branded on the animal in accordance

to the TLBAA Rules and Regulations***

Color description (do not use abbreviations-do not use more than 18 words-Click Here For Description word list:

Name of Sire   P.H. No.   Sire TLBAA No.

Membership No. (owner of sire)   Name:

Address:

Owner of sire on service date of bred cow):

Name of Dam   P.H. No.   Dam TLBAA No.

Membership No. (owner of dam)   Name

Address:

Owner of dam at time of service):

Owner Membership No.

Name (will appear as OWNER on Certificate of Registration):

Address:

City   State   Zip

Applicant Membership No.

Signature*

*I or we certify the above is a true and correct statement and I desire to have same recorded in the Texas Longhorn Breeders Association of America registry. In consideration of which I agree to abide and be bound by the articles of incorporation bylaws and rules and regulations of the association and amendments thereto.