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And Dover Downs in 2013 & 2014 CHECK PAYABLE TO AND MAIL TO: Delaware Standardbred Breeders Fund,2320 S DuPont Hwy,Dover,DE 19901 OWNER OR AGENT MAKING PAYMENT PHONE: STREET CITY, STATE, ZIP: COUNTRY & POSTAL CODE (If Outside U.S.): FAX: E-MAIL ADDRESS: Indicate the Type of Payment and Total Amount (U.S. Funds Only) 1ST PYMT .......... $100.00 *SUPPLEMENT PYMT $350.00 2ND PYMT $200.00 DATE DUE . MAR 15, 2013 DATE DUE. MAR 15, 2013 DATE DUE .... MAY 15, 2013 TOTALPAID.

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