Fill and Sign the Notice of Breeders Lien 497329668 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 __________________________________________________ (N ame of Stallion) leased to and used for breeding purposes on or about ___________________________ (dates) , by ______________________________________________________ (N ame 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 _______________________________________________ (N ame 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) . ________________________________________________________ (N ame 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 PUBLIC My Commission Expires: ______________________ (Form of acknowledgement/oath will vary from state to state)