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Sample Claim of Lien

A Claim of Lien is a legal claim to property as security against any amount of money or services that were used for improvement purposes.











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Free Sample Claim of Lien Agreement

Word   PDF  

Claim of Lein


Notice is hereby given that on ____/____/______

The Claimant [Legal Name], AKA (The Claimant)

Located at [Address]

[City], [State] [Zip Code]

First provided labor or material for an improvement to:

Owner [Legal Name]

Located at [Address]

[City], [State] [Zip Code]

General Description of Property where work or materials were furnished:

_______________________________________________

_______________________________________________

The final day of providing labor or material was on ____/____/______.

Contractors:
The lien claimant’s amount is $__________. The lien claimant has received payment in total of $__________ and therefore claims a construction lien upon the above specified real property in the amount of $__________.

Laborers:
The lien claimant’s rate that is charged by the hour is $__________. For the labor there is a sum of $__________ and the lien claimant claims a construction lien upon the above described real property.


___________________________________________
Signature of Lien Claimant












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