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Form C-1 - Notice Of Lien On Agricultural Products - Secretary Of State, State Of Idaho

Customer account number

STATE OF IDAHO - NOTICE OF LIEN ON AGRICULTURAL PRODUCTS - FORM C-1

See instructions on reverse.

Pursuant to Idaho Code § 45-1804, the agricultural commodity producer or dealer identified below claims a lien against the purchaser of

an agricultural product, and the proceeds of the product, until payment for the product is made in full by the purchaser.

Claimant (Name and address, including ZIP CODE)

Purchaser (Name and address, including ZIP CODE)

Mailing Address for acknowledgment, if not Claimant

Dollar amount of lien (after

deducting credits and offsets):

Date of Sale:

______/______/______

Delivery Date:

______/______/______

Crop/Proceeds Code

Crop/Proceeds Year

Commodity on which lien is claimed: (only one crop or proceeds per notice

of lien). See reverse for crop code.

Signature of claimant:

Name of claimant:

STATE OF IDAHO - NOTICE OF DISCHARGE OF LIEN ON AGRICULTURAL PRODUCTS - FORM C-2

Upon actual receipt of the purchaser's funds in full payment for the agricultural product, the agricultural commodity

producer/dealer is required by Idaho Code

45-1807 to file a notice of discharge of the lien within thirty days. THERE IS

NO CHARGE FOR FILING A NOTICE OF DISCHARGE FOR THIS TYPE OF LIEN. If taken to court, the failure to have

filed the notice of discharge may subject the lienholder to a damage award of $300.00

The Claimant no longer claims a lien as described above.

Date

Signature of claimant

Filing Office Use Only

Submit Notice of Lien in Agricultural Products and $5.00 fee to:

Secretary of State

UCC Division

Mailing Address:

Street Address:

PO Box 83720

700 West Jefferson

Boise ID 83720-0080

Basement West

Telephone: (208) 334-3191

Fax: (208) 334-2847

Form C-1 - Notice Of Lien On Agricultural Products - Secretary Of State, State Of Idaho