C. Name and Address of Person/Company Leasing Land
If individual, last name first
AGRICULTURAL LANDLORD'S LIEN NOTICE ASL-5
NORTH DAKOTA SECRETARY OF STATE/REGISTERS OF DEEDS
SFN 50469 (7-99)
This form for county filing use only.
( SEAL )
My commission expires ____________________________________________
H. Dated this _______ day of _________________________, _________.
G. Contact Person
Subscribed and sworn to before me this
_______ day of _______________________________, _________.
Type Name, Company and Title
Reserved for Filing Officer Use
PLEASE TYPE. Please read instructions on back before completing.
A. Filing Fee Instructions
OR Please Bill Customer Billing Number:
B. File In:
Statutory Agricultural Lien Notice Only
D. Name and Address of Land Owner
On _______________________, _________ Land owner leased the following land to lessee (insert legal description)
and reserved title to the crops grown there. The lease was filed pursuant to North Dakota Century Code, Section 47-16-03 on
NOTICE OF LANDLORD'S LIEN
SFN 50469 (7-99)
FILING FEE INSTRUCTIONS: Clients may request to be billed for services. Upon approval a customer number is
provided. This number needs to be typed on the form for accurate billing processing. Without a customer number,
all fees must be paid at the time of filing.
FILE IN: Statutory Lien Notice Index only.
NAME OF PERSON/COMPANY LEASING LAND: List the name of the person or company, complete mailing
address, and social security number or tax identification number of the party renting. If an individual, enter last
name, first name, and middle name.
NAME OF LAND OWNER: List the name, mailing address, social security number or tax identification number and
NOTICE OF LANDLORD'S LIEN: Insert