Notice of Contract to Provide Labor and Materials

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


Inside Notice of Contract to Provide Labor and Materials