§ 185.260. Matters not covered by rules.
Any situation not covered by the rules of this Commission shall be referred to the Commission for disposition.
APPENDIX A
SWORN STATEMENT OF COMPLAINT
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Name of ComplainantAddressCityTel. No.
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Name of LicenseeAddressCityTel. No.
State Harness Racing Commission
Harrisburg, Pennsylvania
COMMONWEALTH OF PENNSYLVANIA
COUNTY } ss:
, being
(Name of Complainant)
first duly sworn deposes and says that
(Write in a brief
statement of the act complained of.)
Appendix A (Continued)
Complainant Sworn to and subscribed before me this day of , 19
Notary Public
WITNESSES
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NameAddressTele. No.
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NameAddressTele. No.
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NameAddressTele. No.
Mail original complaint, with two additional copies.
Type or write complaint clearly.
State facts briefly and clearly.
Name witnesses who can support your statements.
Enclose a Photostatic copy of each document to which this complaint refers.
APPENDIX B
CORPORATE RESOLUTION OF WAIVER PENNSYLVANIA STATE HARNESS
RACING COMMISSION
HARRISBURG, PENNSYLVANIA
WHEREAS, it is the desire of
to waive the hearing fixed in Citation No.
, to admit the charges therein contained and to authorize the Pennsylvania Harness Commission to enter a final order without hearing thereon,
THEREFORE, be it resolved that such a waiver be filed with the Pennsylvania Harness Racing Commission and that
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Name of OfficerTitle
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Name of OfficerTitle
be authorized and either or both are hereby authorized to execute the necessary documents as may be required by the Pennsylvania State Harness Racing Commission.
(Corporate Seal)*
*If no seal, have resolution sworn to before a Notary Public or Justice of the Peace.
I hereby certify that the foregoing is a true and correct copy of the Resolution adopted by
Name of
Corporation or Organization
at a regular or special meeting held on the
day of
, 19
.
Secretary
APPENDIX B (Continued)
WAIVER, ADMISSION AND AUTHORIZATION
PENNSYLVANIA HARNESS RACING COMMISSION
HARRISBURG, PENNSYLVANIA
WE
I do hereby acknowledge receipt of Citation No.
, and do waive the hearing fixed therein, subject to the approval of the Commission. All the charges averred in the citation are admitted and you are authorized without hearing to enter a final order.
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WitnessSignature of Licensee
Date
APPENDIX C
COMMONWEALTH OF PENNSLVANIA
STATE HARNESS RACING COMMISSION
2301 North Cameron Street
Harrisburg, Pennsylvania
VETERINARY HEALTH CERTIFICATE
FOR STANDARDBRED HORSE
THIS CERTIFICATE MUST ACCOMPANY THE HORSE DESCRIBED FOR ADMITTANCE TO A PENNSYLVANIA PARA-MUTUEL HARNESS RACING TRACK.
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Name of HorseTattoo NumberAgeSex
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Owner’s NameTrainer’s Name
I hereby certify that I have examined the above described horse on
and have found no clinical evidence of infectious, (date)
contagious, or transmissible disease and that it was afebrile and free of ectoparasites at the time of this examination. To the best of my knowledge this horse has not been exposed to other horses with any infectious, contagious, or transmissible diseases within the past two weeks.
Horse’s Temperature
At Time of Examination
Veterinarian’s Signature
Veterinarian’s State License Number
Address
Date IssuedAN INDIVIDUAL FORM MUST BE ISSUED FOR EACH HORSE. FORMS AVAILABLE AT ALL LICENSED ASSOCIATION AND COMMISSION OFFICES.
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