Form Sl-1 - Notice Of Claim Of Lien In Crops - Idaho Secretary Of State
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2STATE OF IDAHO - NOTICE OF CLAIM OF LIEN IN CROPS -
FORM SL-1
450 N 4th, PO Box 83720, Boise ID 83720-0080
Mail to:
Secretary of State, UCC Division, 700 W Jefferson, PO Box 83720, Boise ID 83720-0080
Telephone: 208-334-3191 Fax: 208-334-2847
See complete instructions and tables of codes on reverse.
Customer Account Number
Fee $4.00 ($8.00 if not typed)
Enter your customer account number if you wish the fee to be
deducted from your prepaid account with the Secretary of State
Each claimant listed below claims a lien in the designated crop(s) of
the producer(s) under §45-308,I.C. and certifies to the truth thereof.
This notice relates to a lien
Farm
Seed
for (check one):
labor
Name or business name of each producer against whom the lien is claimed, and the address of each.
First Name
Middle Name
Organization or Indiv. Last Name
1
City
State
Zip
Address
First Name
Middle Name
Organization or Indiv. Last Name
2
State
Zip
Address
City
First Name
Middle Name
Organization or Indiv. Last Name
3
State
Zip
Address
City
First Name
Middle Name
Organization or Indiv. Last Name
4
City
State
Zip
Address
Name or business name of each claimant, and the address of each.
Organization or
Organization or
1
3
Indiv. Last Name
Indiv. Last Name
First Name
Middle Name
First Name
Middle Name
Address
Address
State
Zip Code
City
State
Zip Code
City
Signature of Claimant
Signature of Claimant
Typed/Printed Name of Signer
Capacity of Signer
Typed/Printed Name of Signer
Capacity of Signer
Organization or
2
Mailing address for acknowlegement, if not Claimant #1
Indiv. Last Name
First Name
Middle Name
Name
Address
Address
City
Zip Code
City
State
Zip Code
State
Signature of Claimant
Total Dollar
$ ___________________
Amount of Claim
Typed/Printed Name of Signer
Capacity of Signer
Crops to which lien attaches
County Code(s) or Name(s)
Crop Code
Crop Name
Crop Year
Rev. 07/2001
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