Form APL-1 (430) "Notice of Agr' icultural Produce Lien" - Oregon

What Is Form APL-1 (430)?

This is a legal form that was released by the Oregon Secretary of State - a government authority operating within Oregon. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2012;
  • The latest edition provided by the Oregon Secretary of State;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form APL-1 (430) by clicking the link below or browse more documents and templates provided by the Oregon Secretary of State.

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Download Form APL-1 (430) "Notice of Agr' icultural Produce Lien" - Oregon

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Secretary of State
Print
Corporation Division - UCC
255 Capitol St. NE, Ste. 151
Reset
Salem, OR 97310-1327
Phone: (503) 986-2200
Fax: (503) 373-1166
FilingInOregon.com
(Reserved for Filing Officer Use)
APL -1
Notice of Agricultural Produce Lien
In keeping with ORS 192.410-192.595, the information on the application is public record.
Pursuant to ORS 87.710
We must release this information to all parties upon request and it may be posted on our website.
Please Type or Print Legibly in Black Ink. Attach Additional Sheet if Necessary.
DEBTOR
C
O
HECK
NE If Individual, list last name first.
P
:
URCHASER
-
-
Business
Individual
NAME 1
-
-
Business
Individual
NAME 2
ADDRESS
CITY
STATE
ZIPCODE
P
:
RODUCER
NAME
ADDRESS
CITY
STATE
ZIPCODE
S
A
P
D
(
: $
TATEMENT
MOUNT OF
RODUCER
S
EMAND
after Deducting All Credits and Offsets)
D
P
D
T
B
:
ESCRIPTION OF
RODUCE
ELIVERED OR
RANSFERRED
Y
D
P
O
D
:
ATE
AYMENT
RIGINALLY
UE
I hereby declare that the above statement is true to the best of my knowledge and belief, and that I understand it is made for use as evidence in
court and is subject to penalty for perjury.
Signature of Claimant or Representative:
Printed Name:
RETURN TO (Please Type or Print within the box):
FEES
Required Processing Fee
$15.00
Processing Fees are nonrefundable.
“Corporation Division.”
Please make check payable to
NOTE:
Fees may be paid with VISA or MasterCard. The card number and expiration date should be
submitted on a separate sheet for your protection.
430 (01/12)
Secretary of State
Print
Corporation Division - UCC
255 Capitol St. NE, Ste. 151
Reset
Salem, OR 97310-1327
Phone: (503) 986-2200
Fax: (503) 373-1166
FilingInOregon.com
(Reserved for Filing Officer Use)
APL -1
Notice of Agricultural Produce Lien
In keeping with ORS 192.410-192.595, the information on the application is public record.
Pursuant to ORS 87.710
We must release this information to all parties upon request and it may be posted on our website.
Please Type or Print Legibly in Black Ink. Attach Additional Sheet if Necessary.
DEBTOR
C
O
HECK
NE If Individual, list last name first.
P
:
URCHASER
-
-
Business
Individual
NAME 1
-
-
Business
Individual
NAME 2
ADDRESS
CITY
STATE
ZIPCODE
P
:
RODUCER
NAME
ADDRESS
CITY
STATE
ZIPCODE
S
A
P
D
(
: $
TATEMENT
MOUNT OF
RODUCER
S
EMAND
after Deducting All Credits and Offsets)
D
P
D
T
B
:
ESCRIPTION OF
RODUCE
ELIVERED OR
RANSFERRED
Y
D
P
O
D
:
ATE
AYMENT
RIGINALLY
UE
I hereby declare that the above statement is true to the best of my knowledge and belief, and that I understand it is made for use as evidence in
court and is subject to penalty for perjury.
Signature of Claimant or Representative:
Printed Name:
RETURN TO (Please Type or Print within the box):
FEES
Required Processing Fee
$15.00
Processing Fees are nonrefundable.
“Corporation Division.”
Please make check payable to
NOTE:
Fees may be paid with VISA or MasterCard. The card number and expiration date should be
submitted on a separate sheet for your protection.
430 (01/12)