ANOTHER CHANCE 4 HORSES PLACEMENT/Proof of Ownership FORM for Broker Owned Horse Program. Retain for your records.
INSTRUCTIONS FOR COMPLETING THIS APPLICATION- CLOSED SUNDAY
Please read and complete this entire document carefully. Copy and paste in email firstname.lastname@example.org or fax to 610-488-5648 keep a copy for your records. If for any reason the horse is unavailable you will be refunded in full. However, Once funds are transferred to owner or representative of said equine Another Chance 4 Horses, Inc. cannot issue a refund. If you cannot take the horse it will need to be re-homed by you to recoup the funds, any and all deposits are non-refundable. We will be happy to assist by listing the horse on our website at no charge and you are free to use our forms (edit our info off/ add yours) to protect the horses. Notification of intent to rehome required and if that is the intention from the beginning needs to be made clear on this form, otherwise this placement is for permanent non-transfer intent.
Personal Contact Information
Email Address: ______________________________________________
Mailing Address 1: Cig, State Zip 2:
Address Horse will be delivered to if different from above: ________________________________________________________________________
Telephone: ________________________________________________ Cell Phone: ________________________________________________
Work/Other Phone: ________________________________________________
Driver Liscense Number/State: ___________________________________
*List the horse’s name, number and description from website www.ac4h.com here. Use the area below to give any further description of the horse you would like (including color, number and description)
Horse Number from website - please give your horse a name: __________________________________________________
Horse Color, number & Description:_____________________________________________________________________________
Release horse to (layover, quarantine, shipper or you are picking up personally) ___________________________________________________________
B- Holding fee $55.00 helps to pay for hay, bedding, rent of facility and charges to accept credit card and paypal, $25.00 Coggins Test. Note - Health certificate cannot be issued unless horse have been in layover for 2 weeks. Layover is available by independent farms email for list of names. The layover farms do not use the same vet as we do they do not have the same rules, policy or procedure for examining a horse to issue a health certificate please inquire directly with them about this service. Total $80.00
Total Amount Due Add A& B = $ _______________________
Note* If this is not paid by you list the name of who will be paying for you and the amount sent, thank you we also need an email from them saying that they have sent payment on your behalf. ______________________________ Amount paid _____________________________ If paid by credit card the credit card authorization form must also be submitted.
Payment/Donation link: http://www.ac4h.com/ac4hdonate.htm (credit card, paypal, echeck- if will clear before Friday) please notate payment and number/description of the horse. If paying by credit card the credit card authorization form needs to be sent in. To pay by credit card, Credit Card form is Mandatory Credit Card Authorization form can be submitted via fax 610-488-5648, email, text or over the telephone 610-488-5647, thank you.
Important Information and Disclaimer/Agreement please read, initial and sign.
Information and Disclaimer: Another Chance 4 Horses operates a traditional rescue with horses in our care. The broker program is a separate additional program started nine (9) years ago acting as intermediary to horses at broker lots, kill pens and auctions providing the horses with a larger viewing audience and additional time versus the short time they get through the auction ring, at the broker lot or kill pen these horses are not in our care and they are not at an auction. Brokers buy and sell horses to earn a living. Kill buyers make a living by sending a horse to a slaughter plant where it is slaughter for human consumption. We have taken a pro-active, preventative approach by listing these horses in hopes of assisting them out of the auction/slaughter arena and into a private home. Dangers of raw rescue from auctions, kill pens and broker lots are injury, illness and possibly death. We will include all levels of horses available at the broker lots or slaughter pens. We reserve the right to deny anyone.
Quarantine: These horses are not quarantined. It is highly recommended that your horse is quarantined for a minimum of 2 weeks, recommended 30 days. Please consult your veterinarian for advice and plan for adding a new horse to your herd. Please advise the shippers and boarding facilities that your horse is not quarantined.
Board/Quarantine: Another Chance 4 Horses has a list of private farms who are able to arrange temporarily short term temporary board or quarantine inquire about availability and cost. Temporary Boarding may be available, please check and all boarding must be prepaid. Vet, farrier, dentist and training may be arranged for an additional fee. Another Chance 4 Horses, Inc. and it's assigns will be held harmless for equines while in their care- you are responsible for your equine. Rates vary per provider an estimate is $15.00.
Shipping Another Chance 4 Horses is not affiliated with any shipping companies, does not endorse any shipping companies and does not offer shipping internally. We can assist you with receiving a shipping quote from independent shippers by presenting your information and zip code to independent shippers and to yahoo groups. The shippers will contact you directly with quotes. If you would like us to present your information to independent shippers please fill in the following information. I am requesting and give my permission to present the information that I have provided for quotes. I understand that arranging shipping of this equine is my responsibility. We reserve the right to reject or deny any shipper.
Insurance - Protect your horse with insurance - for example All American Horse Insurance - offer's added security for the shipment and for 30 days thereafter at your facility. (not affiliated with AC4H) With living breathing creatures there can never be a 100% guarantee which is why we advise to protect your horse and your finances with Insurance.
Paperwork We are not responsible for providing paperwork if you or your hauler cannot wait for the paperwork to be issued. Should you choose to leave without your paperwork you are responsible for providing a self addressed stamped envelope so that your paperwork can be mailed. If your horse has registration papers, these will be sent to you by your chosen method let us know how and send funds necessary for this method. Horses that are fundraised for - the papers do not go with the horses but are retained in the office. They can be applied for after 1 year.
Coggins and Certificate of Veterinary Inspection-Health Certificate Transport of horses out of the state require a Coggins (EIA test) available within hours of vetting and a Certificate of Veterinary Inspection also known as a health certificate to transport your horse into or across the state. A Certificate of Veterinary Inspection is a document that is certified by a veterinarian indicating the horse has been examined for signs of infectious and contagious disease. This is not a lameness, soundness, or vet check examination or guarantee that the horse will not get sick. The purpose of the examination is strictly for preventing horses with communicable diseases from being transported and spreading disease. If your horse is examined and a Certificate of Veterinary Inspection and any signs of contagious disease are found, the Certificate will not be issued on Monday. Some things the vet looks for are; Fever, nasal discharge, strangles, lice, ringworm, equine herpes, or signs of neurological issues. Nasal discharge is quite common in stress situations where horses are moved from auction to auction, to the lots, and also in general transport. A horse can be dry and clear when evaluated and then after being transported to the pickup lot, they have nasal discharge due to the shipping. Health Certificates - a horse will qualify to be seen by the vet for a health certificate if it has been at the lot or layover for two (2) weeks. However, the horse will still have to pass the criteria to pass the health cert for it to be issued. We recommend that you speak with your vet about quarantine, health certificates and what is legally required in your State.
XX- I understand that only a coggins will be issued. I understand that a health certificate will not be issued Monday. I understand the horse is not quarantined. XX Initial Here ________________________
By signing below, the buyer understands that Another Chance 4 Horses is assisting horses we have evaluated one time. Buyer agrees that Another Chance 4 Horses will be held harmless concerning said horses. Any and all questions and quarantine's should be requested in writing. All information listed via Another Chance 4 Horses, Inc. or and divisions thereof, regarding any particular equine is based solely on information provided by the owners or appointed representatives. Buyer agrees that Another Chance 4 Horses and/or any representatives thereof can not be held liable for any misrepresentations, shipping of or care of said equine and will be held harmless regarding such. It is agreed that if said animal is offered for sale, in the future, that Another Chance 4 Horses will be notified and given First Right Of Refusal. Another Chance 4 Horses has fourteen business (14) days in which to exercise its First Right of Refusal from the date of notification by the owner. If Another Chance 4 Horses opts not to exercise its First Right of Refusal, the owner shall provide Another Chance 4 Horses with the name, address and telephone number of any prospective owner to which the horse may be transferred so that Another Chance 4 Horses may update its records and monitor the whereabouts, health and safety of the horse. It is further agreed that any subsequent owner will complete a copy of the within Application and Agreement, and the subsequent owner shall be bound be the terms thereof. Finally, the undersigned agrees that this animal will only be transferred privately and will not be resold at any type of auction, horse broker, feed lot or slaughter destination and agrees to protect this horse with a written contract for it's lifetime. In the event the undersigned fails to comply with the terms of this Application and Agreement, Another Chance 4 Horses reserves the right to commence legal proceedings to recover the horse, and the undersigned shall be liable for all costs including damages to AC4H, Inc. is assumed at a minimum of $5,000.00, inclusive of attorney’s fees, in connection with such legal proceeding which would be held in Berks County, PA.
*I do hereby release Another Chance 4 Horses and any and all representatives of any liability for representation, shipping and or care of the horses offered for sale either via www.ac4h.com, or any divisions thereof. Buyer signature warrants that they buyer is at least 18 years of age at the time of signature and acknowledges receipt of the Processing Terms and Conditions contained within this agreement.