Form ASL-1 (440) "Notice of Claim of Agricultural Services Lien" - Oregon

What Is Form ASL-1 (440)?

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 ASL-1 (440) by clicking the link below or browse more documents and templates provided by the Oregon Secretary of State.

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Download Form ASL-1 (440) "Notice of Claim of Agricultural Services 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)
ASL -1
Notice of Claim of Agricultural Services Lien
In keeping with ORS 192.410-192.595, the information on the application is public record.
Pursuant to ORS 87.242
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.
(Name of owner(s) of the chattels charged with this lien)
D
:
M
O
EBTOR
ARK
NE
If Individual, list last name first.
-
-
Business
Individual
1 NAME:
-
-
Business
Individual
2 NAME:
M
A
:
AILING
DDRESS
STATE
CITY
ZIPCODE
C
:
LAIMANT
NAME:
M
A
:
AILING
DDRESS
CITY
STATE
ZIPCODE
PHONE NUMBER
L
C
D
(
: $
IEN
LAIMANT
S
EMAND
after deducting all credits and offsets)
T
U
a lien upon certain chattels, including the following kinds of crops and/or described animals
HE
NDERSIGNED CLAIMS
grown in the year
upon or currently located at the following described farmland, range, ranch, orchard land:
T
L
A
I
C
upon the proceeds of the sale of any or all of said crops and animals and to the unborn progeny of said animals, which are
HE
IEN
LSO
S
LAIMED
in utero on the date of the filing of this claim of lien. This lien is claimed for labor performed, materials supplied and/or services provided by claimant at
the request of the owner of said chattels to aid the growing or harvesting of crops and for the raising of livestock upon the land described above.
The provided labor, materials and/or services consisted of
The amount for which this lien is claimed is a true and bona fide existing debt as of the date of the filing of this notice of claim of lien.
The date on which payment was due claimant for said labor, supplies and services was
The terms of extended payment (if any) are
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.
440 (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)
ASL -1
Notice of Claim of Agricultural Services Lien
In keeping with ORS 192.410-192.595, the information on the application is public record.
Pursuant to ORS 87.242
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.
(Name of owner(s) of the chattels charged with this lien)
D
:
M
O
EBTOR
ARK
NE
If Individual, list last name first.
-
-
Business
Individual
1 NAME:
-
-
Business
Individual
2 NAME:
M
A
:
AILING
DDRESS
STATE
CITY
ZIPCODE
C
:
LAIMANT
NAME:
M
A
:
AILING
DDRESS
CITY
STATE
ZIPCODE
PHONE NUMBER
L
C
D
(
: $
IEN
LAIMANT
S
EMAND
after deducting all credits and offsets)
T
U
a lien upon certain chattels, including the following kinds of crops and/or described animals
HE
NDERSIGNED CLAIMS
grown in the year
upon or currently located at the following described farmland, range, ranch, orchard land:
T
L
A
I
C
upon the proceeds of the sale of any or all of said crops and animals and to the unborn progeny of said animals, which are
HE
IEN
LSO
S
LAIMED
in utero on the date of the filing of this claim of lien. This lien is claimed for labor performed, materials supplied and/or services provided by claimant at
the request of the owner of said chattels to aid the growing or harvesting of crops and for the raising of livestock upon the land described above.
The provided labor, materials and/or services consisted of
The amount for which this lien is claimed is a true and bona fide existing debt as of the date of the filing of this notice of claim of lien.
The date on which payment was due claimant for said labor, supplies and services was
The terms of extended payment (if any) are
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.
440 (01/12)