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 AddressConsignor 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 AddressConsignee Name* First Last Physical Address* Street Address Address Line 2 City State Zip Code Name of facility (if applicable)Phone*Reason for leaving Canada*Export Status* Permanent (>30 days) Temporary (< than 30 days) Are you stopping in Montana?* Yes No Location stopping at in Montana*Reason for stop*Staying overnight?* Yes No EmailThis field is for validation purposes and should be left unchanged.
