Horse Consignment Form
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1
2Horse Consignment Form
30 Florence Road, Easthampton, MA 01027
Please complete and submit this form by the consignment deadline. Submit one form per horse. The consignment fee is $75 per horse.
Commission fees will be charged. Please review our fees, terms and conditions before submitting this form. NOTE: If you wish to
consign tack, equipment or wheeled vehicles, do NOT use this form. Use the Tack and Equipment Consignment Form instead.
Consignor Information
Full Name: __________________________________________________________________________________________
Address: ___________________________________________________________________________________________
City: ______________________________________________
State: _________ Zip: ___________________________
Preferred Phone: ____________________________________________________
☐ Home
☐ Cell
☐ Work
Secondary Phone: ___________________________________________________
☐ Home
☐ Cell
☐ Work
Email Address: ______________________________________________________________________________________
Other Payee Name (if any): _____________________________________________________________________________
Address: ___________________________________________________________________________________________
City: ______________________________________________
State: _________ Zip: ___________________________
Preferred Phone: ____________________________________________________
☐ Home
☐ Cell
☐ Work
Secondary Phone: ___________________________________________________
☐ Home
☐ Cell
☐ Work
Email Address: ______________________________________________________________________________________
Animal Information
Full Name: __________________________________________________________________________________________
Sex:
☐ Gelding
☐ Mare
☐ Stallion
Breed: _____________________________________________ Color: _________________________________________
Height: _____________________________________ Coggins Date: _________________________________________
Sound?
☐ Yes
☐ No
Rides?
☐ Yes
☐ No
Cribber?
☐ Yes
☐ No
Transfer?
☐ Yes
☐ No
Registry: ___________________________________ Registration No: _______________________________________
Rider Information
Will you ride this horse in the auction?
☐ Yes
☐ No
If not, do you want to book a Heritage Farm rider to ride this horse in the auction?
☐ Yes
☐ No
NOTE: Heritage Farm riders cost $20 per horse. The consignor must handle, groom & tack their horse and bring it to the auction line at
the designated time tacked and ready to be mounted.
I hereby affirm that I own of have agency to sell the above listed animals and/or merchandise. There are no liens, debts, or obligations
that prevent passing clear title to these chattels through the services of Heritage Farm and its staff. I agree to pay all of the
commissions and fees incurred as published in the commission schedule, regardless of whether my items are sold at auction or by
private treaty.
Signed: ____________________________________________________ Date: ________________________
Office use only: Paid: ________________________ Date: _______________________ Check #: ___________ Cash: __________
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