Mail to: Secretary of State UCC Division 700 W Jefferson 450 N 4th PO Box 83720 Boise ID 83720-0080 Telephone: 208-334-3191 Fax: 208-334-2847 Customer account number See instructions, fee schedule and tables of codes on reverse. This block for Filing Office use only. STATE OF IDAHO - NOTICE OF LIEN ON AGRICULTURAL PRODUCTS - FORM C-1 Pursuant to Idaho Code § 45-1804, the agricultural commodity producer or dealer identified below claims a lien against the purchaser of an agricultural product until payment for the product is made in full by the purchaser. Purchaser Organization or Indiv. Last Name First Name Claimant Organization or Indiv. Last Name Middle Name First Name Address Middle Name Address City State Zip Code Dollar amount of lien (after deducting credits and offsets): $ City State Zip Code Mailing Address for acknowledgment, if not Claimant Organization or Indiv. Last Name First Name Delivery Date: ______/______/______ Address Date Last Payment Due: ______/______/______ City Middle Name Commodity on which lien is claimed: (only one crop per notice of lien). See reverse for crop code. State Crop Code Zip Code Crop Year 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. Signature of claimant Date Rev. 03/2004 American LegalNet, Inc. www.FormsWorkflow.com Instructions for completion of Form C-1 1. A notice of lien on agricultural products must be filed within 180 days of either the date of delivery of agricultural products to a purchaser or the date final payment was due, but not paid, whichever date comes later. The lien provided for by Idaho Code Section 45-1802 remains in effect for a period of 1 year after the date the notice of lien is filed. 2. Please type this form in black or print neatly. If the form cannot be read correctly, the lien may not be effective. 3. Enclose filing fee of $ 5.00. If you have a pre-paid account with the Secretary of State, enter your customer number in the block at the top of the form in lieu of enclosing fees. 4. File only the original. Make a copy for your file. The original will be returned as your acknowledgment. To discharge the lien simply sign the original notice of discharge and file it with this office. 5. Enter only one purchaser name or business name exactly as it is to be indexed. The term “title” as used in the purchaser’s name includes “Sr.”, “Jr.”, “III”, “Dr.”, etc. The purchaser is the person against whom the lien is claimed. 6. Enter the name and address of the claimant; include Zip Code. 7. Enter the dollar amount of the claim, the date the crop was delivered and the date the final payment was due and not paid. 8. Enter either the three-digit code for the crop from the table below, or the name of the crop, or both, in the appropriate column. 9. The person claiming the lien must sign the notice. Enter the name of the person signing below the signature. Instructions for completion of Form C-2 1. Upon receipt of the purchaser’s payment in full for the agricultural product, the claimant is required to file a notice of discharge of the lien within thirty days. 2. Claimant must sign and date under the C-2 section on the front of this form. Return the entire form to the Secretary of State’s office. Crop Table Code 010 011 020 021 022 023 024 025 026 027 028 030 040 050 060 070 080 081 082 090 100 101 102 110 120 130 131 140 150 160 161 162 163 Crop wheat buckwheat barley rye (including triticale) oats sorghum grain flaxseed safflower rape (including canola) field corn millet hay ensilage potatoes sugar beets dry beans dry peas lentils garbanzos (chick peas) sweet corn onions onion seed garlic mint hops popcorn sunflower seeds soybeans rice grass for seed alfalfa for seed other hay legumes for seed garden vegetable & flower seeds Crop Table Code 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 190 191 192 193 194 195 196 200 201 210 211 212 213 220 230 300 310 Crop green peas tomatoes lettuce cucumbers broccoli cauliflower lima beans green beans melons carrots turnips asparagus spinach & collards pumpkins & squash radishes peppers apples apricots cherries nectarines peaches pears plums strawberries raspberries sod nursery stock (trees & shrubs) christmas trees flowers and potted plants mushrooms grapes grass alfalfa American LegalNet, Inc. www.FormsWorkflow.com