STATE OF MONTANA DEPARTMENT OF LIVESTOCK BRANDS ENFORCEMENT DIVISION PO BOX 202001, HELENA MT 59620-2001 406-444-2045

OFFICE USE ONLY Transmittal Number_____ Amount Received_____ NO MONEY___

NOTICE OF SECURITY INTEREST COVERING BRANDED LIVESTOCK

Debtor/Brand Owner_Address ___

_Phone( )

SHEEP: ___ PAINT COLOR: _

STATE POSITION ON: CATTLE:___ HORSES:___

THIS IS TO NOTIFY YOU THAT WE ARE A SECURED PARTY UNDER A SECURITY INTEREST GIVEN BY THE ABOVE NAMED DEBTOR.

YOU ARE REQUESTED TO FILE THIS NOTICE OF SECURITY INTEREST ON THE RECORD OF THE ABOVE-DESCRIBED BRAND I N ACCORDANCE WITH 81-8-301(MCA).

WE ENCLOSED THE TWENTY-FIVE DOLLARS ($25.00) FEE PER RECORDED BRAND AS PROVIDED BY 81-8-304(MCA). WE RECOGNIZE THAT THIS SECURITY INTEREST IS TO BE RENE WED JANUARY 1, 1983 AND EVERY 5 YEARS THEREAFTER UNLESS SATISFIED BEFOREHAND. A LL LIENS THAT ARE NOT RENEWED WILL BE DELETED FROM DEP ARTMENT RECORDS, AS PROVIDED BY 81-8-301(MCA) SUB 2, 3, 4, & 5.

Lending Institution /Creditor

Street Address or PO Box _____ (_____) City, State & Zip Phone Number

Tax ID or Social Security Number

Signature Date

Recorded Brand Owner(s) signature

Recorded Brand Owner(s) signature Date

OFFICE USE ONLY

• ∙Date of Last Activity □□□●□□●□□

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File Reference Number □□□□□□

Date of Last Activity □□□.□□□.□□□

Creation Date JULORU

• ∙Expiration Date └ └ └ └ └ └ └

Filing No. □

• ∙Mortgage Code

Brand ID: ___

2017

2015