North American Tsvetnaya Bolonka Club
Litter Application
Use this application to record a litter of Tsvetnaya Bolonka puppies born in the USA out of a NATBC registered female and sired by an NATBC registered male. Please use black ink and PRINT. Information you omit or is ineligible will delay the application. Important information and instructions are provided as the second page to this form Recording is not guaranteed. Application fees are nonrefundable and are subject to change without notice.

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Payment and Submittal Information...................See last page  for complete details
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Calculate this litter’s puppy fee:
Processing Fee................................................................................................................................$25
Number of living  Males + females = ___x  2.00 =Puppy fee..........................................................____
Enter $35.00 if you want expedited handling.  See back of form for details....................................____
Enter $50.00 if it has been more than 6 months since the litter was whelped.................................____
Send the completed application to the address specified at the end  of this form. 
Checks returned for insufficient funds will be charged a $25 handling fee. 
									Total Fees...........____

****************************************************************************************************Litter Information
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Date of Birth:____Month-______Day____Year 	
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Sire: (Male) information: 
To be completed and Signed by Co-Owner of Sire on Date of Mating.
_______________________	__________________________________________
Registration number of sire (male)	Registered name of sire (male)

I certify that the identified Dam (Female) was mated to the identified Sire and that the Sire was owned/co-owned by me on the date of meeting.

________________			_________________		______________________________
Owner’s First Name			Owner’s Last Name		Sire Owner’s or Co-owners signature
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Dam: (Female) information: 
To be completed and Signed by all owners or lessees of Dam on Date of Birth

________________________		____________________________________________________
Registration number of Dam (female)		Registered name of Dam

I (we) certify that I (we) am (are) the owners)s) or lessee)s) of the identified Dam on the date of birth of the litter; that this Dam was not mated to any other dog during her season; that all of the representations on this application are true, and I (we) agree to comply with NATBC rules and regulations. I (we) witnessed this mating: __________yes or _____________no.

Please continue onto second page.

	Page Two NATBC Litter Registration

NATBC will send the litter kit (one registration application for each puppy to the address below:

_________________		________________________________ ________________________________________
1st owner’s first name		1st owner’s last name

1st owner’s Signature________________________________________________________Date_________________________

___________________________________________________________________________________________________
Street Address		

____________________				_____________			_______________________
City						State				Zipcode

_________________				______________
Telephone Number					Email Address

__________________				____________________
2nd Owners First Name				2nd Owners Last Name

2nd Owner Signature__________________________________________________________________Date_________________

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To be completed only if ownership of Dam changed or Lease terminated while Dam was in whelp (pregnant).
I (we) certify that * (we) was (were) the owner(s) or lessee(s) of the identified Dam on the date the Dam was mated to the Identified Sire. * (we) certify that the Dam, while in my (our) possession, was not mated to any other dog during her season.

_________________				________________________________________________________
Owner’s First Name				Owner’s Last Name

Signature of owner/lessee_____________________________________________________________Date__________________

	

Send application and requisite fees in the form of a check or money order to:
North American Tsvetnaya Bolonka Club
Attn: Litter Registration
70 Rt. 130
Pedricktown, NJ 08067

Visit our website at:
http://tsvetnayabolonka.homestead.com

NATBC Litter Registration General Information and Instructions

Purpose: Use this application to register a litter of puppies born in the USA from a NATBC registered Female that was mated to a NATBC register male of the Tsvetnaya Bolonka Breed.  Once submitted this application becomes the property of the NATBC

Litters Mated Abroad: Request and Submit a Special Litter Registration Application, instead, this form.

Multiple Sired Litters: Request a multiple sire Litter Application and use the Multiple Sire Litter Application form to register each litter. The application coverpage contains details on fees and required DNA certification.

Artificially Inseminated Litters: 
Fresh Semen: Submit an Artificial Insemination Using Fresh Semen form along with this litter registration.

Fresh extended Semen: Submit an Artificial Insemination using Fresh Extended Semen form along with this litter registration.

Frozen Semen: Submit an Artificial Insemination using Frozen Semen form instead of this form

Fees: Fees are nonrefundable and are subject to change without notice
A litter application fee always comprises two parts:
A processing fee ($25) plus a puppy fee (multiply the number of live puppies by $2.00)

Additional fees are determined by circumstance:

Expedited Handling ($35.00....Available only in the US with no delivery to a post office box number (full address only) and no Saturday delivery. Allow 3-5 days for delivery

Late Fee: ($50).............Required if it has been more than 6 months since the litter was whelped.

Lease Notification form ($15.00)   To process a Lease Notification Form

Mailing information: Send the completed application plus required fees to:
North American Tsvetnaya Bolonka Club
70 RT. 130.
PEDRICKTOWN, NJ 08067

Additional requirements: If there are more than two (2) dam owners, contact the NATBC for an Additional signature form.
Additional requirements: 
	If a Dam was leased at the time of mating or birth of a litter, you must submit a Lease Notification Form	If a Sire has sired seven (7) or more litters in his lifetime or more than 3 litters in the calendar year, a DNA profile number must be included.

Authorizations: Signatures of persons other than the owners or lessees will be accepted only if a properly completed authorization 

form has been filed with the NATBC.

Notice: The NATBC has the right to correct or cancel for cause the registration of this litter and its descendants.  Any misrepresentation on this application is one example of for cause cancellation and may result in loss of NATBC privileges. Registration is not guaranteed.  Application fees are nonrefundable and are subject to change without notice.

Copyright NATBC 2003.