Agisters Claim Form Fillable by QQ83Sg

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									TO: THE SHERIFF OF MISSOULA COUNTY

       Pursuant to the provisions of Section 71-3-1203, Montana Code Annotated, 2009, you
are hereby notified that the undersigned claims an agister's lien against the following
described property:


                                   (Year & Make of Vehicle)


                                       (License Number)


(Body Style)                                      (Serial Number)

       The amount of the claim for repairs, towing and storage is $          ,+$      accruing

daily storage.

       The registered owner of the vehicle is      .

       His address is       .

       The name of the person at whose request the services were performed and materials

furnished is      .

       We request that you advertise and sell such property to satisfy said lien.

       Dated at Missoula, Montana, this _______ day of        , 20       .

       Business name (if applicable)

       By _______________________________ Title:                Phone:
             (signature)


STATE OF MONTANA

County of Missoula

       The within instrument was subscribed and sworn to before me, this __________ day of

_________________, 20           , by      .


                                                       ________________________________
       (NOTARY SEAL)




                                                                                   MCSO Form C-1

								
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