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Ow instructions on Page 2. 1a. Contact Name: (optional) Telephone Number: 1b. Send Acknowledgment to: (Name and Address) THE ABOVE SPACE IS RESERVED FOR FILING OFFICE USE ONLY 2. File in (check one) Lien Index Only Lien and Notice Index 3. Debtor: Provide only one name of organization or individual (3a or 3b) for whom animals are kept. For best search results, provide exact legal name. 3a. Organization's Name OR First Name 3b. Individual's Last Name 3c. SSN/TIN * Suffix Middle Name 3.

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