= Menu

Sample Preliminary Lien Notice







Preliminary Lien Agreement

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.




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.

_______________________ Date_____
Signature





Word

PDF










Can't find the right form?

View Agreements & Notices for more free forms and templates.

A Small Business Assistant is in the office ... tell us what you want and we'll create a free template for you!