===== PAGE 1 =====
# STATE OF MONTANA DEPARTMENT OF LIVESTOCK BRANDS ENFORCEMENT DIVISION PO BOX 202001, HELENA MT 59620-2001 406-444-2045

# NOTICE OF SECURITY INTEREST COVERING BRANDED LIVESTOCK

Debtor/Brand Owner_Address ___

_Phone( )

(Note: The Department of Livestock can only file liens against recorded MONTANA brands)

ONLY ONE BRAND AND POSITION PER SPECIES (UP TO 3 SPECIES) IS ALLOWED PER FORM

DRAW RECORDED MONTANA BRAND

<div style="text-align: center;"><img src="imgs/img_in_image_box_518_871_2145_1544.jpg" alt="Image" width="63%" /></div>


CHECK THE APPROPRIATE BOX THAT THIS LIEN APPLIES TO:

ALL BRANDED LIVESTOCK

□ CATTLE ONLY

□ HORSES ONLY

□ SHEEP ONLY

STATE POSITION ON: CATTLE:

SHEEP: ___ PAINT COLOR: _

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

Recorded Brand Owner(s) signature

Recorded Brand Owner(s) signature

Date

Signature Date

OFFICE USE ONLY

<div style="text-align: center;"><img src="imgs/img_in_image_box_136_2564_2507_2909.jpg" alt="Image" width="92%" /></div>


Date of Last Activity □□□●□□●□□

File Reference Number □□□□□□

Date of Last Activity □□□.□□□.□□□

Creation Date

JULORU



Filing No. □

Expiration Date └ └ └ └ └ └ └

Mortgage Code

Brand ID: ___