NOTICE OF CONTRACT TO PROVIDE LABOR AND MATERIALS
Code Sections 43-4.01
| NOTICE TO MECHANIC LIEN AGENT FOR § 43-4.01 NOTICE | |||
Delivery by Certified Mail | |||
Date ____________________ | |||
| Name Mechanic Lien Agent: ________________________________________ _ Address:_______________________ City, State, Zip:___________________________ | |||
| Claimant Name: _______________________________ | |||
| Address: | |||
| City: | State: | Zip: | |
| Phone: | Fax: | ||
| Building Permit # | Date of Permit | County/City Permit | |
| Property Description on Building Permit: | |||
Copy of Building Permit Attached: (__) Yes (__) No
The Claimant is providing labor and/or material for the construction of improvements on the property described. CLAIMANT SEEKS PAYMENT FOR LABOR PERFORMED OR MATERIAL FURNISHED. This Notice should be sent within 30 days after Claimant begins work.
_________________________
Claimant
State Specific Liens-Mechanic Forms
—- For State Specific Liens- Mechanic Forms you can download in Word format, go to
http://secure.uslegalforms.com/cgi-bin/forms/query.pl?S-C-B-B-liens
