Request for US Export

Date of export exam*
MM slash DD slash YYYY
Veterinarian*
Name of horse(s) being exported:*
Date horse(s) leaving country*
MM slash DD slash YYYY
Date papers to be picked up*
MM slash DD slash YYYY
Exporter information

Canadian Address
Consignor name*
First Last
Mailing address*
Address Address Line 2 City State / Province / Region ZIP / Postal Code
Horse location*
Legal Land Description (and facility name if applicable)
Primary Contact Phone #*
US destination/ importer information

US Address
Consignee Name*
First Last
Physical Address the Horse is Going To*
Street Address Address Line 2 City State Zip Code
Name of facility (if applicable)
Phone*
Reason for leaving Canada*
Export Status*
- Permanent – More than 30 Days
- Temporary – Less than 30 Days
Phone
This field is for validation purposes and should be left unchanged.

Exporter information