FOREVER BRANDED PROGRAM INVOICE FORM Forever Branded Programs: Invoice for Payment Use this form after an animal has been adopted or sold as part of the Branded Adoption Center or Branded Partnerships program to receive payment. Operator/Trainer Name(Required) First Last Email(Required) PhoneWhat are you submitting an invoice for? Adoption/Sale of a Program Enrolled Animal Mileage Reimbursement (Adoption Centers Only) Mare/Foal or Jenny/Foal Pair Select this option only if a mare of jenny foals in your care. Forever Branded will reimburse $2/day for a maximum of 100 days for the foal's care until the mare/jenny and foal are adopted/sold.Forever Branded will reimburse mileage to the Branded Adoption Center operator for trips over 500 miles round-trip to approved BLM facilities from the official Branded Adoption Center address once per quarter at the current federal government mileage reimbursement rate. Receipts must be submitted.Branded Adoption Center/Branded PartnershipsWhat program was this animal adopted/sold through? Branded Adoption Center Branded Partnerships As a Branded Partnerships trainer, I certify that the animal adopted/sold could complete the following skills upon leaving my facility (select all that apply): Halter & Lead Pick Up Feet Load In Trailer None of the Above (was adopted/sold as ungentled) Select AllDate of Adoption/Sale MM slash DD slash YYYY Animal FreezemarkAnimal Signalment KeyWhat route was this animal adopted through as part of your Branded Adoption Center? Individual Adoption/Sale Scheduled Public Adoption/Sale Event Branded Bonanza Pick-Up Animal Species Horse Burro Adopter/Purchaser Name First Last Do you have additional animals that were adopted on this same date to include on this invoice? Yes No Animal #2 FreezemarkAnimal #2 Signalment KeyWhat route was this animal adopted through as part of your Branded Adoption Center? Individual Adoption/Sale Scheduled Public Adoption/Sale Event Branded Bonanza Pick-Up Animal #2 Species Horse Burro Animal #2 Adopter/Purchaser Name First Last Animal #3 FreezemarkAnimal #3 Signalment KeyWhat route was this animal adopted through as part of your Branded Adoption Center? Individual Adoption/Sale Scheduled Public Adoption/Sale Event Branded Bonanza Pick-Up Animal #3 Species Horse Burro Animal #3 Adopter/Purchaser Name First Last Animal #4 FreezemarkAnimal #4 Signalment KeyWhat route was this animal adopted through as part of your Branded Adoption Center? Individual Adoption/Sale Scheduled Public Adoption/Sale Event Branded Bonanza Pick-Up Animal #4 Species Horse Burro Animal #4 Adopter/Purchaser Name First Last Animal #5 FreezemarkAnimal #5 Signalment KeyWhat route was this animal adopted through as part of your Branded Adoption Center? Individual Adoption/Sale Scheduled Public Adoption/Sale Event Branded Bonanza Pick-Up Animal #5 Species Horse Burro Animal #5 Adopter/Purchaser Name First Last Mileage ReimbursementStarting Date of Travel MM slash DD slash YYYY End Date of Travel MM slash DD slash YYYY Please provide justification for your travel.Please upload your receipts. Drop files here or Select files Max. file size: 50 MB. Mare/Jenny & Foal PairMare/Jenny FreezemarkMare/Jenny SignalmentDate of Foaling MM slash DD slash YYYY Please provide any pertinent details.As the named Forever Branded program participant on this form, I certify that the information I have provided here to be true and correct. I understand that I will not be paid until all information has been verified with the Bureau of Land Management. If animal was adopted as part of Branded Partnerships, I understand that I will not receive payment until the Adopter Assessment Form has been completed and verified. I understand that payment may be forfeited if both the invoice and Adopter Assessment forms are not received within 60 days of adoption/purchase. I understand that payment is remitted by direct deposit only and certify that I have provided the correct information to Forever Branded as part of my onboarding process to complete such payment.(Required) I agree to the statement above.