Colorado Secretary of State 1700 Broadway, Ste. 200, Denver CO 80290 Phone: 303-894-2200, press 2 www.sos.state.co.us EFS Master List Registration Form The completed registration form must be accompanied by the proper fee and delivered to the above address. Check or money order must be made payable to the Colorado Secretary of State. Registrant Name: (if an individual) ____________________ ______________ ______________ _____ (Last) (First) (Middle) (Suffix) OR (if an organization) ______________________________________________________ (Caution: Do not provide both an individual and an organization name.) Address: _________________________________________________________________________________________ City: _____________________________________ State: ______________________ Zip: _______________________ Phone: ____________________________________ E-mail:___________________________________________________________________________________________ An e-mail address is required in order to receive future communications about your subscription Contact (optional): ____________________ ______________ ______________ _____ (Last) (First) (Middle) (Suffix) Registration will be effective when the Secretary of State processes the completed registration form and fee. Registration may be made at any time, but will expire on June 30. However, a registration that becomes effective between April 1 and June 30 will remain effective through June 30 of the following year. The master list will be distributed on CD by United States Postal Service first-class mail. Fee: $50.00 Select one of the following formats for the master list and any custom lists: (If no selection is made, Format A will be distributed.) Format A- four PDF documents, each with a vertical list of entries. Each file is first sorted alphabetically by farm product and then sorted in different orders, based on (1) debtor name, (2) debtor ID #, (3) county, and (4) crop year(s). Format B - four tab delimited text files. Each file is first sorted alphabetically by farm product and then sorted in different orders, based on (1) debtor name, (2) debtor ID #, (3) county, and (4) crop year(s). REG_MLIST Page 1 of 3 Rev. 03/22/2010 American LegalNet, Inc. www.FormsWorkFlow.com Custom List Selection (Optional) You will receive the complete master list containing all farm products in all counties for all crop years. You may also request additional custom lists. Any custom list(s) that are requested will be provided in the same format as the format requested for the master list. Instructions: For each custom list, indicate the following: • A farm product or All farm products; • A county, group of counties, region(s), or All counties; and • A crop year, range of crop years, or All crop years. Attach additional pages if necessary for additional custom lists. See the following page for a list of farm products and counties. Custom List 1: Farm Product: _______________ County(ies): _______________ _______________ _______________ _______________ _______________ Crop Year(s): ____________ or ____ to ____ Custom List 5: Farm Product: _______________ County(ies): _______________ _______________ _______________ _______________ _______________ Crop Year(s): ____________ or ____ to ____ Custom List 2: Farm Product: _______________ County(ies): _______________ _______________ _______________ _______________ _______________ Crop Year(s): ____________ or ____ to ____ Custom List 6: Farm Product: _______________ County(ies): _______________ _______________ _______________ _______________ _______________ Crop Year(s): ____________ or ____ to ____ Custom List 3: Farm Product: _______________ County(ies): _______________ _______________ _______________ _______________ _______________ Crop Year(s): ____________ or ____ to ____ Custom List 7: Farm Product: _______________ County(ies): _______________ _______________ _______________ _______________ _______________ Crop Year(s): ____________ or ____ to ____ Custom List 4: Farm Product: _______________ County(ies): _______________ _______________ _______________ _______________ _______________ Crop Year(s): ____________ or ____ to ____ Custom List 8: Farm Product: _______________ County(ies): _______________ _______________ _______________ _______________ _______________ Crop Year(s): ____________ or ____ to ____ A custom list of all farm products in all counties sorted by debtor name. REG_MLIST Page 2 of 3 Rev. 03/22/2010 American LegalNet, Inc. www.FormsWorkFlow.com Farm Products All field crops All fruits All livestock All vegetables Angora Apples Apricots Artichokes Asparagus Barley Beefalo Broccoli Buffalo Cabbage Cantaloupe Carrots Cattle and calves Cauliflower Celery Cherries Chickens Corn Cucumbers Dry beans Ducks Eggplant Eggs Elk Emu Fish (Specify) Flax seed Fur animals (Specify) Geese Grapes Green beans Green peas Hay Hogs Honey Honeydew melon Horses Legumes Lettuce Llamas Milk Millet Mules Muskmelon Nectarines Oats Okra Onions Ostrich Other field crops Other fruits (Specify) Other livestock (Specify) Other vegetables (Specify) Peaches Pears Pecans Peppers Pheasant Plums Popcorn Potatoes Pumpkins Quail Radishes Raspberries Rye Safflower Seed crops (Specify) Semen Sheep and lamb Silage Snap beans Sorghum grain Soybeans Squash Strawberries Sugar beets Sunflower seeds Sweet corn Tomatoes Trees (Specify) Triticale Turkeys Turnips Vetch Walnuts Watermelon Wheat Wool Counties Group 1: Northwestern Colorado: Moffat, Routt, Grand, Rio Blanco, Garfield, Eagle, Summit, and Pitkin; Group 2: Western Colorado: Mesa, Delta, Gunnison, and Montrose; Group 3: Southwestern Colorado: Ouray, San Miguel, Hinsdale, Saguache, Dolores, San Juan, Mineral, Rio Grande, Alamosa, Montezuma, La Plata, Archuleta, Conejos, and Costilla; Group 4: North Central Colorado: Jackson, Larimer, Boulder, Gilpin, Clear Creek, Jefferson, Denver, Adams, Broomfield and Arapahoe; Group 5: Weld county; Group 6: Northeast Colorado: Morgan, Logan, Sedgwick, and Phillips; Group 7: Eastern Colorado: Washington, and Yuma; Group 8: Central Colorado: Lake, Park, Douglas, Chaffee, Teller, El Paso, Fremont, Pueblo, Custer, and Huerfano; Group 9: Eastern Central Colorado: Elbert, Lincoln, Kit Carson, Cheyenne, and Crowley; Group 10: Southeastern Colorado: Kiowa, Otero, Bent, Prowers, Las Animas, and Baca. Groups 1, 2, and 3 Groups 4 and 5 Groups 6 and 7 Groups 8, 9, and 10 REG_MLIST Page 3 of 3 Rev. 03/22/2010 American LegalNet, Inc. www.FormsWorkFlow.com