Demexpgb 2016 - France Galop

Service Livrets
Stéphanie DAVAINE
Tél 01 49 10 20 75
Fax 01 49 10 20 66
[email protected]
APPLICATION FOR EXPORT CERTIFICATE
HORSE NAME……………………..……………………………………….COUNTRY OF BIRTH………………….
COLOUR…………………..……….SEX……………….…..………YEAR OF FOALING……………………………
SIRE…………………..……………….………..….………DAM…………………..……………….………..………….
COUNTRY OF DESTINATION……………………………..……… DATE OF DEPARTURE……………….…….
Name of the consignee…………………...……………….……………………………………………………….…….
Address of destination…………………...……………….………………………………………………………….….
…………………...……………….………………………………………………………………………………………….
Email……………………………..…………………..………………….Phone………………...…..…………..………
Name of the applicant…………………...……………….……………………………………………………………..
Address…………………...……………….………………………………………………………………………………..
…………………...……………….………………………………………………………………………………………….
Email……………………………..…………………………………….Phone…………………..…………..…….…….
In case of regularization of a temporary export in definitive export the applicant undersigned attests
by the present application that the horse stayed in the mentioned country.
Export certificate fees 2016 : 51,60 €
With Express mail : + 30,60 = 82,20 €
Payment by cheque
French draft bank
France Galop account n° ………………………………
Signature
or
Check that your account is sufficiently funded
Date…………………..……
Documents to be provided :
passport + ownership card
Only complete application will be processed
FRANCE GALOP : Société d’Encouragement pour l’Amélioration des Races de Chevaux de Galop en France
SIEGE SOCIAL : 46, PLACE ABEL GANCE – 92655 BOULOGNE CEDEX • www.France-galop.com
Association Loi 1901 déclarée au JO du 31.05.1995 • SIREN : 401 415 500 • TVA intracommunautaire : FR 48 401 415 500