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Sample Preliminary Lien Notice

Use this Preliminary Lien Notice template to serve to all the various parties that are involved in your contract work project to establish your right to file a Mechanics lien. If the Preliminary Notice is sent and the claiment's bill is paid the Preliminary Lien Notice has no further legal effect. However, if the bill is not paid to the listed claimant the claimant may now file a Mechanics lien on the owner's listed property.






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Preliminary Lien Agreement

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Preliminary Lien Notice


Please note that ______________________________________________________________.

Whose address is at: ___________________________________________________________

City: _________________________________

County: ______________________________

State: ________________________________

Zip: __________________________________

Has furnished or will furnish labor, service, equipment or material to the work of improvement that is at the following location:

Address: ______________________________________________________________________

City: _________________________________

County: ______________________________

State: ________________________________

Zip: __________________________________

Work Tasks:

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________


_____________________________________________________________________________
Claimant Signature


The name and address of the person or business that contracted for the labor, services, and / or equipment as listed above is:

Name: ________________________________

Address: _____________________________

City: _________________________________

County: ______________________________

State: _______________________________

Zip: _________________________________


This preliminary lien notice is being served on the following persons and business entities at the listed addresses:

[ ] Owner

Name: ________________________________________________________________________

Address: ______________________________________________________________________

[ ] Original Contractor

Name: ________________________________________________________________________

Address: ______________________________________________________________________

[ ] Construction Lender

Name: ________________________________________________________________________

Address: ______________________________________________________________________

[ ] Insurer

Name: ________________________________________________________________________

Address: ______________________________________________________________________

[ ] Trust

Name: ________________________________________________________________________

Address:_______________________________________________________________________

[ ] Subcontractor

Name: ________________________________________________________________________

Address: ______________________________________________________________________

The estimated price of the labor, services, equipment or materials described above is:

$______________________________


Preliminary Lien Notice


I, __________________________________________ do hereby declare that I have served copies of the above Preliminary Lien Notice:

[ ] By personally delivering copies to (the name and title of person served the lien notice)

______________________________________________________________________________

at the following address: _________________________________________________________

on ____/____/______ at ____:______ AM / PM.

[ ] By First Class Certified or Registered Mail Service with postage prepaid and addressed to each of the above listed parties at their address shown above on ____/____/______.

I declare under the penalty of perjury that the foregoing is true and correct.

_____________________________________________________________________________
Signature and Date









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