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Sample Claim of Lien

Free Sample Claim of Lien Agreement

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.

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 ___/___/____.

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 $__________.

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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