Fill and Sign the Notice of Breeders Lien Form

Notice of Breeder's Lien Please take notice that I, the undersigned ______________________________________ (Name of Owner), of ____________________________________________________________ ____________________________________________________________ (Address of Owner), now am, and at all times mentioned in this Notice was, the Owner of that certain (e.g., thoroughbred stallion) ___________________________________________________ named __________________________________________________ (Name of Stallion) leased to and used for breeding purposes on or about ___________________________ (dates), by ______________________________________________________ (Name of Lessee), of _______________________________________________________________________________________________________________________________________ (Address of Lessee), the owner of a certain (e.g., thoroughbred mare)_________________________________________, described as follows: (e.g., describe mare, bitch, etc.)__________________________________ ____________________________________________________________________________________________________________________________________________________________ _____________________________________________________________________________.The above-mentioned _______________________________________________ (Name of Lessee), made an Agreement in writing to pay me __________________________ (dollar amount) for the breeding services of said (e.g., thoroughbred stallion) ____________________ _____________________________________, and such services were performed by the said (e.g., stallion) __________________________________________________ at (Address of Lessee) ______________________________________________________________________ ___________________________________________________________________________, on (dates). ________________________________________________________ (Name of Lessee) has not made the agreed payment for the services of the (e.g., stallion) ___________________________________________________.The undersigned claims a lien of ___________________________________ (dollar amount) on the above-mentioned (e.g., thoroughbred mare) ____________________________ _______________________________________ for the services described in this notice, and a further lien in the same amount upon the offspring resulting from the services of the said (e.g., stallion) _____________________________________________.Witness my signature this the ____ day of _____________________________________, 20______. __________________________________________(Name and Signature of Owner) STATE OF _______________________________________________COUNTY OF _____________________________________Personally appeared before me, the undersigned authority in and for the said County and State, on this _____ day of _______________________________________________, 20____, within my jurisdiction, the within- named __________________________________________________ (Name of Owner), who acknowledged that he executed the above and foregoing instrument.__________________________________________NOTARY PUBLICMy Commission Expires:______________________ (Form of acknowledgement/oath will vary from state to state)